Gastroesophageal Reflux Disease - GERD

GERD is a very common problem in the United States. It is estimated that 15% of the adult population suffer form GERD. The normal valve at the lower end of the esophagus (Lower esophageal Sphincter -LES) is tight and relaxes only with swallowing and thus prevents reflux of gastric acid into the esophagus. In patients with GERD there is inappropriate relaxation of LES causing acid reflux. In some patients the LES is very loose and these patients have severe GERD.

What are the symptoms of GERD?

GERD commonly presents with heartburn or chest discomfort. Some have chest pain resembling a heart attack while others have mild trouble swallowing. Some report regurgitation especially at night while lying down, Complications from GERD include Upper gastrointestinal bleeding that can cause vomiting of blood, narrowing of the esophagus (stricture) that cause extreme difficulty swallowing or food getting stuck in the esophagus.

How is GERD diagnosed?

The diagnosis of GERD is best made by Upper endoscopy that also allows us to exclude more serious problems such as stricture, Barrett’s esophagus, esophageal ulcerations, Helicobacter infection etc.

How is GERD treated?

Depending on the severity of the symptoms and endoscopic findings we decide the treatment agent for you. Commonly we use Proton Pump Inhibitors (PPI) like (protonix, nexium, dexilant) or H2 receptor blocker like (ranitidine, famotidine). Proton Pump Inhibitors that are powerful suppressors of acid secretion. These drugs do not prevent reflux but change the refluxed material from potent acid to a neutral material that does not harm the esophagus.

When patients sleep at night, there is loss of gravity that in the upright position can help in preventing reflux. There are many measures one can take to minimize or prevent GERD. These include:

  1. Lose weight
  2. Wear loose clothes at night
  3. Do not eat 2-3 hours before retiring to bed
  4. Avoid Peppermint or excess Caffeine beverages
  5. Elevated the head end of bed with 8-12 inch blocks (pillows alone don’t help)
  6. Avoid Nicotine (smoking, chewing tobacco) or Excess alcohol

What can I do to control GERD, if medications are not helping?

The first and foremost thing to do is to talk to your doctor and seen consultation with a Gastroenterologist if you have not seen one. If you are seeing one currently then you probably need to make him aware of your ongoing symptoms and seek better treatment.

Better treatment can be any of the following :

  • change in medication
  • higher dose of same medication
  • addition of a new agent. Sometimes we use PPI and H2 blocker together, or even some other agent. Please refer to the section on GERD Medications.

:: Clear Lake Office

Coastal Gastroenterology Associates

1015 Medical Center Blvd
Suite 1400
Webster, TX 77598

Phone: (281) 557-2527

:: Texas City Office

Coastal Gastroenterology Associates

7111 Medical Center Drive
2nd Floor 
Texas City, TX 77591

(by appointment only)