At Tennessee Heartburn Clinic, our medical team has more than 20 years of medical experience and specializes in the treatment of disorders of the digestive system like Gastroesophageal Reflux Disease (GERD).
GERD is a digestive reflux disorder. It is caused when gastric acid from your stomach flows back up into your food pipe or esophagus. Heartburn is the most common symptom.
This condition generally stems from just two underlying causes: those that have to do with reflux chemistry and those that stem from anatomical dysfunction.
Chemical causes can include:
- Fluids refluxed from the stomach irritating or damaging the esophagus
- General sensitivity of esophageal tissue, often caused by natural low acid intolerance, use of prescription drugs or other drugs as alcohol and tobacco
Most of the time, however, GERD can be attributed to a patient’s own anatomy. The biology of swallowing, for healthy patients, is simple. When a person with normal, healthy anatomy swallows, the valve between the esophagus and the stomach (gastroesophageal valve) opens. This allows food to pass. The valve then closes to prevent stomach contents from backwashing or refluxing back up into the esophagus. A normal, healthy valve serves as an effective anti-reflux barrier and experts consider it the most important factor in preventing GERD.
For people with GERD, this valve becomes dysfunctional and does not close appropriately. This allows abnormal amounts of both acidic and non-acidic fluids to backwash into the esophagus.
What causes the Gastroesophageal Valve to become dysfunctional?
Any one of the following factors, or a combination of these factors, can result in disruption of the gastroesophageal valve and abnormal exposure of the esophagus to acid reflux.
- Genetic: Anatomy varies from person to person; some people naturally have valves that function less competently than others.
- Injury to the upper chest: Often the result of a sports-related injury or a traumatic accident, these incidents can cause the valve to lose its shape.
- Obesity or diet related issues: Excess weight can cause distortion of normal anatomy.
- Age: As people age, musculature can lose its integrity and affect the anatomy in the esophagus and stomach area.
GERD can look and feel different for each patient. Although chronic reflux can include a wide range of symptoms, they can be broadly grouped as typical or atypical depending on their severity.
Mild symptoms may include heartburn and regurgitation on occasion, perhaps after indulging in a heavy meal, greasy, or acidic foods. Changes to your diet are sometimes sufficient to alleviate these symptoms and control mild acid reflux. Severe chronic GERD sufferers can experience symptoms as often as several times a week or even daily.
Contrary to popular belief, you don’t always experience heartburn when you have GERD. Although this is the most common symptom, it is not a guaranteed warning sign of this condition, nor is the absence of heartburn enough to rule it out. People managing GERD will often blame acid reflux for some or all of their symptoms. However, there are other stomach fluids besides acid that can reflux and cause discomfort and damage. In fact, non-acid reflux carries enormous risk to the esophagus, even if they aren’t as obvious a sign of GERD.
Common symptoms include:
- Difficulty swallowing
- Excessive saliva
- Regurgitation gas and bloating
- Pain or discomfort in the chest
- Intolerance of certain foods and liquid
- Bad breath or a sour taste in the mouth
Atypical, or less common, symptoms include:
- Hoarseness or laryngitis
- Frequent swallowing
- Asthma or asthma-like symptoms
- Excessive clearing of the throat
- Chronic dry, irritated or sore throat
- Persistent cough
- Burning in the mouth or throat (acid taste in the mouth)
- Dental erosion, therapy-resistant gum disease or inflammation
- Discomfort in the ears and nose
- Trouble sleeping
Chronic, prolonged exposure to reflux may result in inflammation, irritation or swelling of the esophagus. This condition, known as esophagitis, can be accompanied by more concerning complications such as ulcers, hemorrhage or precancerous cellular changes.
While symptoms alone can significantly interfere with one’s quality of life, GERD is also associated with the development of Barrett’s esophagus, a condition that causes a cellular change in the lining of the lower esophagus. In a percentage of patients, it can progress to esophageal cancer, a potentially life-threatening illness. To avoid this and additional potential complications, it is important to take GERD symptoms seriously and seek evaluation and diagnosis from a healthcare professional as soon as possible.
The severity of GERD varies from person to person. For this reason, different treatment options may be appropriate.
The most important goals of any GERD treatment are:
- Symptom control
- Prevention of GERD-related complications
- Healing of esophagitis
There are non-surgical treatments, such as lifestyle changes and medications that can help control GERD. If your symptoms still persist and affect your daily life, surgery may be required. Here’s more information about GERD treatment options.
Having heartburn or reflux from time to time is normal. Reflux that becomes chronic and impacts your daily life is not normal. If you suffer reflux symptoms more than twice a week, you may have GERD. For more information or to schedule an appointment, call (931) 484-5141.