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What Is GERD?

Gastroesophageal reflux disease (GERD) can be thought of as chronic heartburn. The term refers to the frequent backing up (reflux) of stomach contents (food, acid and/or bile) into the esophagus. GERD also refers to the array of medical complications, some serious, that can arise from this reflux.

Though it causes discomfort, occasional heartburn is not harmful. But if you have heartburn frequently, your stomach's acid may inflame the lining of your esophagus or swallowing tube, potentially narrowing it.

Stomach acid may also change the cells of your esophagus. This change, called Barrett's esophagus, increases the likelihood of cancer. Only a small percentage of people with GERD develop Barrett’s esophagus. Your stomach's contents can also move into your throat and be drawn past your vocal cords and into your lungs, where they can cause damage, along with hoarseness, a chronic dry cough, or asthma.

Anyone can develop GERD at any age. You are more likely to develop it as you get older. Nearly one out of every 10 American adults has heartburn daily. Pregnant women are especially prone to GERD; nearly one out of every four pregnant women has heartburn every day.

GERD and Heart Disease

GERD can cause a crushing pain in your chest identical to the pain of a heart attack. Sometimes medical professionals diagnose GERD after evaluating a patient for repeated episodes of chest pain that are found to be unrelated to heart disease.

IMPORTANT! Never ignore pain in your chest. If you think you are having a heart attack, any delay in getting help may be fatal. If your doctor says you have GERD, ask what you should do when you have chest pain.

Esophagitis, Barrett's Esophagus, and Cancer of the Esophagus

Esophagitis, or inflammation of the esophagus, is a major complication of GERD. If GERD is left untreated, esophagitis can cause bleeding, ulcers and chronic scarring. This scarring can narrow the esophagus, eventually interfering with your ability to swallow. People with esophagitis need to be checked for the development of Barrett's esophagus.

Barrett's esophagus results when the body replaces normal cells in the esophagus with cells similar to those inside the intestine. The presence of these cells is a precursor of adenocarcinoma, a particularly deadly kind of cancer. Developing Barrett's esophagus does not mean you will get cancer, but your chances of getting cancer will be greatly increased. Your doctor will want to check you on a regular basis in order to detect any cancer in its early stages.

Asthma and Other Complications

Pulmonary, or lung, damage is a major complication of GERD. GERD can lead to the formation of scar tissue in the lungs. It can also cause the onset of adult asthma. Some cases of adult-onset asthma, especially in those with no history of allergies or childhood asthma, can be traced to GERD. Treating GERD may help avoid the onset of asthma and sometimes can relieve asthma.

GERD can also lead to chronic hoarseness, a chronic cough, sleep disturbance, laryngitis, halitosis (bad breath), growths on the vocal cords, a feeling as if there is a lump in your throat, earaches, and dental problems.

What Causes It?

When you swallow, a muscular valve known as the lower esophageal sphincter, or LES, which is located where the esophagus joins the stomach, opens to let food into your stomach and then closes to keep your stomach contents from coming back up. The major cause of GERD is that this valve that does not function the way it should — either because it is weak or because it relaxes inappropriately. Hiatal hernia is a common cause of a weak LES.

Diet and lifestyle also play a role. Fatty foods, mints, chocolate, alcohol, coffee, and tea all relax the LES. So does nicotine, from cigarettes or chewing tobacco. Hormonal changes associated with pregnancy can temporarily weaken the LES, too. Obesity can lead to GERD because the pressure of extra weight pushing on your abdomen may "overpower" the LES, allowing reflux to occur. The same mechanism explains reflux that may occur when you bend over at the waist.

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