What is acid reflux disease (GERD)?
Acid reflux describes a backflow of acid from the stomach into the swallowing tube or esophagus. This acid can irritate and sometimes damage the lining on the inside of the esophagus. Almost everyone experiences acid reflux at some time. The usual symptom is heartburn, an uncomfortable burning sensation behind the breastbone, most commonly occurring after a meal. In some individuals this reflux is frequent or severe enough to cause more significant problems. Thus, acid reflux disease is a chronic, clinical condition that occurs when reflux of stomach acid into the esophagus is severe enough to impact the patient’s life and/or damage the esophagus. Acid reflux disease is heartburn 2 or more days a week despite treatment and diet change.

I have never heard of acid reflux disease. Is it a new disease?
No. Acid reflux disease has probably been around as long as heartburn. The term is relatively new (about 20 years), however, and has really come into common usage over the past few years. Acid reflux disease is also called gastroesophageal reflux disease (GERD). Acid reflux disease is the preferred term because it accurately describes the problem - chronic reflux of stomach acid up into the esophagus where it can produce symptoms and sometimes damage.

What are some symptoms of acid reflux disease?
The major symptoms of acid reflux disease are:

• Heartburn (uncomfortable, rising, burning sensation behind the breastbone).
• Regurgitation of gastric acid or sour contents into the mouth.
• Difficult and/or painful swallowing.

Heartburn is the most common symptom of acid reflux disease. In some patients it may be accompanied by other acid reflux disease symptoms, such as regurgitation of gastric contents into the mouth and difficulty swallowing.

How do people get acid reflux disease? What causes acid reflux disease?
Acid reflux disease is caused by reflux of stomach acid into the esophagus. In most patients this is due to a transient relaxation of the "gate" or sphincter (LES) that keeps the lower end of the esophagus closed when a person is not swallowing food or liquids. This transient relaxation happens a few times each day in people without acid reflux disease. Why it happens more frequently in acid reflux disease patients isn’t known. The esophagus is not able to cope with acid as well as the stomach and is easily injured. It's the acid refluxing into the esophagus that produces the symptoms and potentially damages the esophagus.

How many people have acid reflux disease?
Recent statistics indicate that about fifteen (15) million people in the US alone suffer from acid reflux disease.

Who may get acid reflux disease?
Acid reflux disease affects people of every socioeconomic class, ethnic group and age. However, the incidence does seem to increase quite dramatically above the age of 40. More than 50 percent of people (both male and female) with acid reflux disease are between the ages of 45 to 64.

What is the difference between heartburn and acid reflux disease?
Acid reflux disease is a chronic disease and heartburn is its most common symptom. Heartburn is defined as a rising, burning sensation behind the breastbone caused by reflux of stomach acid into the esophagus. Frequent heartburn that disrupts one's lifestyle suggests the diagnosis of acid reflux disease. Only your doctor can determine if you suffer from acid reflux disease.

What is endoscopy and when is it used in acid reflux disease patients?
Endoscopy is a diagnostic test wherein a thin, flexible tube is swallowed by the patient to allow the physician to directly inspect the lining of the upper gastrointestinal tract. This procedure can be used to identify complications of acid reflux disease, such as the condition called Erosive Esophagitis, and to take small samples (biopsies) for further analysis. Acid reflux disease patients who have certain symptoms, such as difficulty in swallowing or painful swallowing, should be considered for endoscopy. Patients who fail to respond to therapy are also candidates for endoscopy.

What makes acid reflux disease symptoms worse?
The major factor is eating. Food and beverages stimulate the stomach to produce more acid that can reflux up into the esophagus. In some patients, lying down or taking certain medications can also worsen acid reflux.

What about acid reflux disease and smoking?
Smoking doesn't cause acid reflux disease but there is some evidence that smoking significantly worsens acid reflux disease. Nicotine is a risk factor for relaxation of the Lower Esophageal Sphincter (LES) and may cause increased heartburn. Stopping smoking is a good idea for multiple reasons.

Do any medications make acid reflux disease worse?
Yes. Medicines that delay emptying of acid from the stomach or that increase acid backup into the esophagus can worsen acid reflux disease. Also, medicines that relax the lower esophageal sphincter (LES) may make acid reflux disease symptoms worse. If you have, or suspect you have, acid reflux disease and you require medication for other conditions, you should make sure you inform your doctor about all medications you are taking including prescription and over-the-counter medications.

What should people with acid reflux disease avoid?
Acid reflux disease is a disease that is caused by gastric acid. However, certain foods can trigger symptoms in some patients. Lying down after a meal, wearing tight-fitting clothing, and even performing certain activities, such as bending over, can also trigger symptoms in patients. A good way to identify these "triggers" is to keep a diary of acid reflux disease symptoms noting when they occur. If symptoms follow a pattern and occur after certain foods or activities, these foods or activities should be avoided. A diary will also help patients continue to enjoy those foods or activities that do not seem to provoke symptoms, so that their lifestyle is not restricted unnecessarily. Patients should review their symptoms with their doctor, who can evaluate their condition and advise an appropriate treatment plan.

Can acid reflux disease be cured?
Unfortunately, acid reflux disease, in general, cannot be cured at present. In some cases, it may be a temporary condition associated with a specific aggravating factor such as pregnancy. In such cases, acid reflux disease will go away on its own when the pregnancy has ended. In most cases acid reflux disease is a chronic condition. However, it can be effectively managed with medications and lifestyle modifications in almost everybody. In some cases, surgery is an option. Surgery does not cure the underlying problem, but wraps part of the stomach around the lower end of the esophagus to help keep acid from getting back up into the esophagus. A doctor can evaluate the condition and advise on an appropriate treatment plan.