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GERD

Causes, symptoms & treatment

What is GERD?

Also known as acid reflux, GERD is a gastrointestinal disorder caused by a malfunction of the lower esophageal sphincter (LES), wherein it does not close after you swallow, allowing stomach acid to flow back into the esophagus.

In Canada alone, one in six people are impacted by the symptoms of GERD.

What Causes GERD?

The common causes of GERD include:

  • Hiatal hernias
  • Pregnancy
  • Smoking
  • Eating large meals or acidic foods
  • Drinking alcohol
  • Obesity
  • Taking certain medications

GERD Symptoms & Complications

Common symptoms of GERD include:

  • Sudden weight loss
  • Nausea
  • Frequent heartburn
  • Vomiting
  • Bloody stool
  • Sleep disturbances
  • Difficulty swallowing
  • Anemia
  • Chest pain
  • Chronic cough
  • Laryngitis
  • Anxiety
  • Asthma
  • Dyspepsia
  • Sour taste

Some complications associated with GERD include:

  • Barrett's esophagus
  • Esophageal ulcers
  • Other damage to the esophagus

When to See a Doctor

Make an appointment with your doctor if you experience any of the symptoms listed above and/or take over-the-counter heartburn medications more than twice a week.

Immediate medical attention is required if patients have chest pains, shortness of breath, jaw pain, or arm pain as these can be symptoms of a heart attack.

How to Diagnose GERD

GERD is sometimes mistaken for celiac disease, diabetes mellitus, gastroparesis, gallstones, or pancreatitis (and vice versa) because their symptoms are similar. There are five primary methods for diagnosing GERD.

Upper endoscopy

This test involves a small, flexible tube, outfitted with a light and camera, being inserted into the esophagus to check for damage and collect tissue samples.

24-hour pH monitoring

A catheter with pH sensors is inserted into the esophagus to measure acidity levels over a 24-hour period.

Barium x-ray

Patients drink a barium liquid that coats the upper digestive tract to allow it to be visible in an x-ray, with which doctors can identify damage or inflammation.

Capsule-based pH testing

A capsule with a pH sensor is inserted into the esophagus to check acidity levels over a 96-hour period.

Esophageal motility study (EMS)

A sensor-equipped catheter inserted into the esophagus evaluates the health of the LES by measuring movement and pressure.

GERD Treatment

Lifestyle changes and over-the-counter (OTC) medications are often the first course of treatment for GERD. If patients do not experience relief over a period of a few weeks, doctors might consider adding prescription medications or surgery to the treatment plan.

Top Prescribed GERD Medications

There are five main classifications of drugs that are used for the treatment of GERD, each with their own set of pros and cons. Patients should discuss their unique symptoms with their doctor to get appropriate guidance as to which medication (and dosage) is most likely to work for them.

    Antacids (Mylanta, Rolaids, Tums)

    Baclofen

    H-2 Receptor Blockers

  • Cimetidine (Tagamet HB)
  • Famotidine (Pepcid AC)
  • Nizatidine (Axid AR)

    • Proton Pump Inhibitors

  • Lansoprazole (Prevacid 24 HR)
  • Omeprazole (Prilosec OTC, Zegerid OTC)

    • Prescription Proton Pump Inhibitors

  • Pantoprazole (Protonix)
  • Rabeprazole (Aciphex)
  • Dexlansoprazole (Dexilant)