Heartburn, Acid Reflux and GERD Overview

If you feel a burning sensation in your throat or you have chest pains after eating, acid reflux could be the culprit. Acid reflux occurs when stomach acid backs up into your esophagus. This may cause heartburn and may ultimately cause damage to the lining of the esophagus.

When you swallow, a muscle called the lower esophageal sphincter (LES) relaxes to allow food and liquid to flow down into your stomach, and then it closes again. Sometimes, this muscle relaxes abnormally or weakens causing stomach acid to flow back up into your esophagus and a burning sensation in your throat. 

Some acid reflux symptoms include the taste of regurgitated food or a sour liquid at the back of your mouth, or a burning sensation in your chest, which is known as heartburn. This backwash of acid can irritate the lining of your esophagus, making it inflamed.

Over time, the inflammation can erode the esophagus and lead to complications such as bleeding or difficulty swallowing. GERD, also known as gastroesophageal reflux disease, is when a person experiences chronic acid reflux. If you are experiencing chest pain that comes and goes on a regular basis, it’s time to schedule an appointment with a board-certified gastroenterologist.

Acid Reflux/GERD Symptoms

  • Burning sensation in your chest (heartburn),
  • Burning sensation in your throat and a sour taste in your mouth
  • Chest pain or gas pains in your chest
  • Difficulty swallowing (dysphagia)
  • Dry cough
  • Hoarseness or a sore throat
  • Regurgitating food or a sour liquid (acid reflux)
  • Feeling of a lump in your throat

Acid Reflux/GERD Risk Factors

  • Obesity
  • Hiatal hernia
  • Pregnancy
  • Smoking
  • Asthma
  • Diabetes
  • Overeating
  • Connective tissue disorders, such as scleroderma

People who have GERD or experience acid reflux on a regular basis are at an increased risk of precancerous changes to the esophagus, known as Barrett’s esophagus, and esophageal cancer. These changes are associated with an increased risk of esophageal cancer. The risk of cancer is low, but your doctor will likely recommend regular endoscopy exams to look for early warning signs of esophageal cancer.

GERD Diagnosis

  • When acid reflux becomes chronic, your doctor can perform various procedures and tests to diagnose GERD and help you develop the appropriate care approach.
  • Barium esophagram – An X-ray of your upper digestive system. The procedure requires drinking a chalky liquid that coats and fills the inside lining of your digestive tract. This allows the doctor to see the shape and condition of your esophagus, stomach and upper intestine.
  • Upper endoscopy – By passing a flexible tube down your throat, an endoscopy allows the doctor to examine the inside of your esophagus. You doctor might also use the endoscopy to collect a sample of tissue from your esophagus for further testing. The test is usually performed with sedation.
  • Esophageal pH (acid) test – The test uses a device to monitor the amount of acid in your esophagus as well as identify when and how long stomach acid regurgitates into your esophagus.
  • Esophageal motility test – The test measures the movement and pressure in your esophagus.

Lifestyle Changes Help Treat Acid Reflux/GERD

  • Maintain a healthy weight
  • Avoid tight-fitting clothes
  • Avoid food and drinks that trigger heartburn (common triggers are fatty or fried foods, tomato sauce, alcohol, mint, garlic, onion and caffeine)
  • Watch portion sizes – larger and higher-fat meals tend to stay in the stomach longer before moving to the small intestine, so the LES and esophagus are potentially exposed to stomach contents and acid for a longer period
  • Keep a heartburn  – record your symptoms, the time they occurred, what you ate and activities you engaged in before you experienced the discomfort
  • Don’t lie down after a meal
  • Elevate your head when lying down
  • Don’t smoke

While some people experience acid reflux/GERD and heartburn relief by making changes to their lifestyle or by taking over-the-counter medications such as antacids, H2 blockers and PPIs, others may continue to experience symptoms. If four to eight weeks of twice-daily PPI therapy is unsuccessful, further investigation with endoscopy is recommended. There are some procedures that can be done to treat GERD.

Acid Reflux/GERD Treatments

  • Nissen fundoplication – surgery to reinforce the lower esophageal sphincter
  • Surgery to create a barrier preventing the backup of stomach acid
  • Stretta procedure –a procedure to produce scar tissue in the esophagus
  • Linx – surgery to strengthen the lower esophageal sphincter

Nothing substitutes advice from a fellowship-trained gastroenterologist. If you have chest pain that comes and goes or experience chest pain after eating, it’s time to schedule an appointment to find out if you have GERD.