GERD Acid reflux: symptoms and complications

Matthew Carns, M.D.

Mankato Clinic Gastroenterology

9.3.14

Gastroesophageal Reflux Disease

• Some reflux of stomach contents into the esophagus is normal

• Reflux of gastric contents that causes symptoms is generally classified as GERD

• Acid reflux may cause damage without causing symptoms

Acid reflux

Acid reflux is a common problem

• 10-22 percent of adults in the Western Hemisphere report GERD symptoms

• Less than 5 percent of adults in Asia report GERD symptoms

Risk factors • Obesity

• Hiatal hernia

• Pregnancy

• Smoking

• Dry mouth

• Asthma

• Diabetes

• Delayed stomach emptying

• Connective tissue disorders such as scleroderma

Symptoms of acid reflux • Heartburn

• Regurgitation

• Water brash

• Difficulty swallowing

• Painful swallowing

• A sensation of a lump in the throat (globus)

• Cough

• Nausea

Acid reflux can damage the esophagus

• Esophageal inflammation or erosive esophagitis

• Narrowing known as ring or stricture

• Barrett’s esophagus

• A change in the esophagus that can develop into cancer

Healthy esophagus

Esophageal inflammation

Esophageal ring

Brett’s esophagus

Esophageal cancer

Diagnosis • Symptoms

• Trial of medication to see if therapy improves symptoms

• Endoscopy

• pH monitoring • pH probe or Bravo study

• Abdominal ultrasound to evaluate gallbladder/biliary problems that may mimic GERD

Endoscopy

Bravo pH monitoring

Treatment of acid reflux

• Non-medical therapy

• Medical therapy

Non-medical therapy • Dietary changes

• Smaller meals

• Avoid meals before bed

• Avoid problem foods

• Avoid carbonation

• Weight loss

• Don’t smoke

• Reduce alcohol

• Consider elevating the head of the bed

Medical therapy

Medications • Antacids

• Neutralize secreted acids

• H2 receptor blockers (Pepcid, Zantac, Tagamet) • Block histamine and reduce acid production

• Proton pump inhibitors (Prilosec, Nexium, Protonix) • “Break” the acid pump

• Most powerful acid reducing medications

• Possible long-term use side effects such as bone fracture

Talk to your doctor!

• Acid reflux is a common, treatable disease

• Untreated acid reflux can cause damage to the esophagus, including cancer

• Deciding on an evaluation and treatment plan will require teamwork with your doctor

Thank you