GERD, or Gastroesophageal Reflux Disease, is a condition in which contents of the stomach or small intestine such as stomach acid repeatedly back up into the esophagus (the tube connecting the throat to the stomach).
Most commonly, the refluxed gastric (stomach) contents are acidic, but bile (non-acidic fluid) may also be present in the gastric juice. GERD is a common problem in the United States, where the symptom of heartburn, at least once a week, is present in 20 percent of the population. In addition, GERD accounts for 75 percent of overall esophageal diseases in the United States.
Over 60 million Americans experience heartburn at least once a month; 25 million Americans experience it daily. In the Houston area, it is estimated that approximately 375,000 people suffer from chronic heartburn. Are you one of these people?
If you think you have GERD, take this quick self-assessment. If you answer YES to one or more of these questions (symptoms), there is a good chance you may have GERD.
Acid Reflux is closely related to GERD, but the terms aren't necessarily interchangeable. Acid reflux is the backward flow of stomach acid into the esophagus — the tube that connects the throat and stomach. Acid reflux is more specifically known as gastroesophageal reflux. If you have frequent, ongoing heartburn, you may have a more serious condition, such as gastroesophageal reflux disease (GERD).
GERD is a serious problem and patients with severe GERD have a quality of life similar to patients with angina or heart failure. Further, complications of GERD such as Barrett’s esophagus and peptic stricture can occur in 50 percent of patients, and other esophageal and gastric abnormalities, such as a paraesophageal hernia are commonly associated with the disease.
The severity of the complications of GERD is directly related to the presence of a mechanically defective lower esophageal sphincter (malfunctioning of the valve between the esophagus and the stomach) and presence of both acid and bile in the esophagus.
Combined reflux of gastric acid and bile into the esophagus causes severe damage to its lining. This can result in changes in the esophagus called Barrett’s esophagus, which can be transformed to dysplasia (abnormal cells in the esophagus) and esophageal adenocarcinoma (cancer).
GERD is caused by a mechanically defective lower esophageal sphincter (malfunctioning of the valve between the esophagus and the stomach). This valve controls the passage of food from the esophagus into the stomach.
When the valve does not function well (does not close properly) food, acid and bile reflux back into the esophagus causing gastroesophageal reflux disease.
Patients with recurring symptoms of reflux have an eightfold increase in the risk of esophageal adenocarcinoma. Therefore, we believe that GERD is a serious health problem and anyone with more than the occasional episode of heartburn or regurgitation, and in particular anyone with dysphagia (difficulty swallowing) should be evaluated with an upper endoscopy.
Below is a schematic presentation of three consecutive swallows recorded during an esophageal motility study (high-resolution manometry) in a patient with a normal esophageal body study. The arrow shows the direction of the esophageal contractions in a normal esophagus. Each color corresponds to a certain amount of pressure.
The next image is a simple schematic presentation of three consecutive swallows recorded during an esophageal motility study in a patient with a normal esophageal body study. The arrow shows the direction of the esophageal contractions in a normal esophagus.
Esophageal impedance study: This study is performed to measure the reflux of bile (non-acidic fluid) inside the esophagus.
Thorough evaluations performed at Memorial Hermann help Houston GERD sufferers understand their treatment options. We provide a visual, microscopic, physiologic and functional evaluation of GERD and the esophagus. Diagnostic tests include:
At Memorial Hermann, we take a comprehensive approach to treating GERD since many don't find relief through standard treatments. Our treatment options are customized to each individual, and may include:
If you have questions or are looking for more information, please complete the form below and we will contact you.