Gastroesophageal reflux (GERD, heartburn)

Description Backward flow of co...

Description

Backward flow of contents from the stomach into the esophagus causes gastroesophageal reflux or heartburn. The digestive fluid in the stomach irritates the lining of the esophagus, and over a long period of time can cause esophageal damage, including narrowing (stricture) and a condition called Barrett's esophagus (a precancerous change in the cells of the lower esophagus). Lying flat while sleeping may worsen the symptoms. The following conditions increase the risk of this condition: drinking alcohol, obesity, smoking, pregnancy, diabetes, and scleroderma.

Symptoms

Burning in the throat and chest, bitter taste in the mouth, burning pain in chest that goes away with antacids, regurgitation of food into the throat, nausea, chronic cough, hoarseness.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. Other tests may be performed to rule out other causes of pain. An esophagogastroduodenoscopy (EGD) may be performed to visualize the esophageal irritation.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, H. Pylori blood antibody test, Urea breath test (H. Pylori)

Other Specific Tests: D-dimer, EKG (electrocardiogram), Troponin, EGD (esophagogastroduodenoscopy), and X-ray

Specialists:
Gastroenterology, Internal Medicine, Pediatrics, Family Practice, Pediatric Gastroenterology

Treatment

Patients should avoid lifestyle activities that worsen the disease (such as smoking, drinking alcohol or coffee or lying down soon after eating) . Treatment depends on the severity of the illness and includes: proton pump inhibitors (omeprazole/Prilosec, pantoprazole/Protonix), H2 blockers (cimetidine/Tagamet, ranitidine/Zantac), antacids, and pro-motility drugs (metoclopramide/Reglan). Surgery may be recommended for severe and persistent symptoms, including fundoplication.