Q: I have very frequent heartburn, and I'm worried I have GERD. What causes GERD, and how is it treated?
A: Gastroesophageal reflux disease, or GERD, is a digestive disorder affecting the lining of the esophagus, or swallowing tube. Heartburn or indigestion are symptoms of GERD. People develop these symptoms when the muscular door, the sphincter muscle ring at the lower esophagus, relaxes too frequently or remains open. A hiatal hernia also may contribute to GERD. This kind of hernia occurs when the top of the stomach moves up above the diaphragm muscle, which normally separates the chest cavity from the stomach.
When gastric acid refluxes up to the esophagus, this can lead to heartburn and indigestion. Some patients may experience chronic hoarseness, throat clearing or cough. Untreated, severe GERD can lead to complications such as scar tissue or ulceration. In turn, these problems can cause difficulty with swallowing or anemia. A more unusual, but not rare, complication called Barrett's esophagus occurs when the normal lining of the esophagus is damaged by acid reflux, causing it to thicken and become red. This condition poses a small but increased risk of esophagus cancer.
The first line of treatment for GERD is lifestyle modification and medical management. Simple things like losing weight; eating small, low-fat meals; avoiding caffeine and alcohol and elevating the head of your bed are good places to start. Effective medications are available to treat GERD.
In some cases, surgery may be necessary to correct an overly relaxed sphincter or hiatal hernia. You will need to discuss which options would be the best for your specific situation if surgery is necessary.
Dr. Colleen Schmitt is a specialist in gastroenterology at Galen Medical Group and a member of the Chattanooga Hamilton County Medical Society.
Dr. Colleen M. Schmitt