Introduction to Acid Reflux  | About GERD (Acid Reflux) 2  | Acid Reflux (GERD) What is GERD?. 3  | when is GER really called Acid Reflux disease (GERD)?. 5  | what about secondary ger?. 6  | what is silent ger?. 6  | Laryngopharyngeal Reflux. 7  | Reflux. 7  | What causes Acid Reflux?. 8  | Can children really have ACID REFLUX DISEASE (GERD)?. 11  | What are the symptoms of GERD (Acid Reflux)?. 12  | Symptoms for Adults. 13  | less common Acid Reflux Disease/GERD symptoms include: 13  | Complication of Acid Reflux Disease/GERD symptoms: 13  | Important warning symptoms of Acid Reflux Disease/GERD: 14  | Symptoms for Children. 14  | Is Reflux a new disease?. 16  | How serious is reflux?. 16  | What are the possible complications of reflux?. 17  | How is GERD (Acid Reflux) diagnosed?. 18  | Natural treatment of acid reflux. 21  | Natural remedies for acid reflux. 23  | How is Acid Reflux treated?. 24  | Medications commonly used in the treatment of acid reflux include: 24  | Other treatments include the following: 25  | Specific Instructions for Infants With GER.. 26  | What if symptoms persist for ACID REFLUX DISEASE (GERD)?. 30  | ger and Acid Reflux disease (GERD) - what's the difference?. 34  | Surgical Treatment for ACID REFLUX DISEASE (GERD).. 34  | We are committed to improving your health. 35  | Self-care tips. 35  | We are committed to improving your health. 37  | Self-care tips for ACID REFLUX DISEASE (GERD).. 38  | Symptoms of GER.. 39  | Speak with your child's health care provider if any of the following occur: 40  | Implants for ACID REFLUX DISEASE (GERD).. 41  | What are the long-term complications of ACID REFLUX DISEASE (GERD)?. 41  | Hope Through Research. 42  | Who gets ACID REFLUX DISEASE (GERD)?. 43  | How do you get Acid Reflux?. 43  | How serious is Acid Reflux?. 44  | How long does Acid Reflux last?. 44  | Sources.

Acid Reflux Introduction

Acid Reflux =  GERD  

Acid reflux is also GERD, and the most frequent symptoms of ACID REFLUX DISEASE (GERD) are so common that they may not be associated with a disease. Self-diagnosis can lead to mistreatment. Consultation with a physician is essential to proper diagnosis and treatment of GERD.

Gastroesophageal reflux disease, or GERD, affects at least an estimated 5% to 7% of the global population—men, women, and children. (Prevalence based on once per day heartburn.) Heartburn and/or acid regurgitation experienced weekly has been found to occur in 19.8% of individuals.(1)

Persistent heartburn is the most frequent—but not the only—symptom of ACID REFLUX DISEASE (GERD). (The disease may be present even without apparent symptoms.) Heartburn is so common that it often is not associated with a serious disease, like ACID REFLUX DISEASE (GERD). All too often, ACID REFLUX DISEASE (GERD) is either self- treated or mistreated.

ACID REFLUX DISEASE (GERD) is a chronic disease. Treatment usually must be maintained on a long-term basis, even after symptoms have been brought under control. Issues of daily living, and compliance with long-term use of medication need to be addressed as well. This can be accomplished through follow-up, support, and education.

Various methods to effectively treat ACID REFLUX DISEASE (GERD) range from lifestyle measures to the use of medication or surgical procedures. It is essential for individuals who suffer persistent heartburn or other chronic and recurrent symptoms of ACID REFLUX DISEASE (GERD) to seek an accurate diagnosis, to work with their physician, and to receive the most effective treatment available.

Acid Reflux (GERD) What is GERD?

Gastroesophageal reflux is also sometimes referred to as acid reflux. It is a disorder where the acid contents of the stomach flow back (reflux) into the esophagus. The esophagus is the tube that connects the throat and stomach.

However, the esophagus doesn’t have a protective lining like the stomach, so the acid from gastroesophageal reflux causes the lower part of the esophagus to become inflamed and painful. This condition is called reflux esophagitis.

Acid reflux is a condition where gastric juices containing acid travel back from the stomach into the esophagus (gullet or swallowing tube). Symptoms of acid reflux include:

Heartburn (a burning feeling rising from the stomach or lower chest up towards the neck).

Regurgitation (bringing food back up into the mouth).

Chest pain.

Difficulty in swallowing (dysphagia).

Hoarseness, dental erosion and asthma (because acidic juices can make their way into the throat, mouth and air passages of the lungs).

Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents leak back, or reflux, into the esophagus. The LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach. The esophagus carries food from the mouth to the stomach.

When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn. The fluid may even be tasted in the back of the mouth, and this is called acid indigestion. Occasional heartburn is common but does not necessarily mean one has ACID REFLUX DISEASE (GERD). Heartburn that occurs more than twice a week may be considered ACID REFLUX DISEASE (GERD), and it can eventually lead to more serious health problems.

Anyone, including infants, children and pregnant women, can have ACID REFLUX DISEASE (GERD).

Gastroesophageal Reflux (GER) or Reflux is the medical term used to describe a condition in which stomach contents - food and gastric acid - frequently flow back up out of the stomach into the esophagus.

The food that comes up may or may not flow all the way out of the mouth. It may be forceful vomiting which rapidly and completely empties the stomach, or it can be more like a "wet burp" that doesn't reach the mouth

When a baby or child (or anyone for that matter) is referred to as having GER, the term represents a benign condition in which the child is having frequent "reflux" episodes.  This is also called "Functional GER" and does not cause complications, lead to long term problems, affect growth or development or even necessarily require medical intervention. 

The category of GER can range from reflux material simply entering the distal (bottom of the) esophagus to spitting up and even frequent projectile vomiting.  Projectile vomiting alone is not considered to be a complication and as long as no other complications arise, it is considered GER.

when is ger really called Acid Reflux disease (GERD)?

In contrast, GER (Gastro Esophageal Reflux) is referred to as GERD (Gastro Esophageal Reflux Disease) when complications arise.  ACID REFLUX DISEASE (GERD) is a pathological** process and the complications can be typical (failure to thrive, feeding and oral aversions, esophagitis, etc) or atypical (wheezing, pneumonia, chronic sinusitis, etc). 

Patients with ACID REFLUX DISEASE (GERD) have complications arising from their GER that necessitate medical intervention.  ACID REFLUX DISEASE (GERD) is also referred to as "Pathogenic GER".  It is estimated that approximately one in three hundred children will present symptoms of ACID REFLUX DISEASE (GERD) and is more common in children with neurological impairments.

what about secondary ger?

In secondary GER, there is some underlying cause of the reflux episodes, something else is going on to cause the reflux episodes.  Some examples of secondary GER would be pyloric stenosis, food is being refluxed out of the stomach but it is actually being caused by the pyloric sphincter being blocked.  Other examples of secondary GER would be food allergies, metabolic disorders, infection, NG tubes, etc.

what is silent ger?

Silent GER refers to GER or GERD without any outward or typical symptoms.  This could mean that a child isn't vomiting or appearing uncomfortable but is having reflux episodes.  Some children may swallow the refluxed material (refluxate) back down instead of throwing it up, in some kids it may not come up enough to actually come out the mouth. 

This can be much more difficult to diagnose, since the most common symptoms are not present.  It can also be more damaging as the refluxate burns the esophagus on the way up and again on the way down.  Whether or not the silent reflux needs to be treated depends on the complications that are arising from it.

Laryngopharyngeal Reflux

When reflux makes it's way up all the way up through the upper sphincter and to the back of the throat causing problems with hoarseness, sore throats, chronic cough, etc, it's referred to as Laryngopharyngeal Reflux.

Reflux

Also known as: Heartburn, gastroesophageal reflux disease, (GERD), "reflux", or acid reflux.

Gastroesophageal reflux is also sometimes referred to as acid reflux. It is a disorder where the acid contents of the stomach flow back (reflux) into the esophagus. The esophagus is the tube that connects the throat and stomach.

However, the esophagus doesn’t have a protective lining like the stomach, so the acid from gastroesophageal reflux causes the lower part of the esophagus to become inflamed and painful. This condition is called reflux esophagitis.

Acid reflux disease, or gastroesophageal reflux (GERD), is often mistaken for occasional heartburn because heartburn is its most common symptom.  But unlike occasional heartburn, the heartburn symptoms of acid reflux disease usually occur 2 or more days a week for at least 3 months and can damage your esophagus.

Acid reflux disease occurs when the reflux of stomach acid into the esophagus is frequent enough to impact your daily life and/or damage the esophagus. At the top of your stomach is a muscle called the lower esophageal sphincter (LES), which normally opens and closes allowing food to enter. It also prevents the acid in your stomach from backing up into your esophagus.

With acid reflux, or GERD, the LES opens at inappropriate times, allowing acid from the stomach to get into the esophagus, where it doesn't belong.

Acid reflux disease can also lead to more serious medical conditions that require hospitalization and even surgery. In some acid reflux patients, acid can be regurgitated into the lungs, causing wheezing or cough.

Acid reflux in the throat can cause sore throat. If acid reaches the mouth, it can dissolve the enamel of the teeth. Severe, persistent reflux can lead to changes in the cells that line the esophagus which is called a Barrett’s esophagus. 

This is important to monitor as Barrett’s esophagus can change into cancer of the esophagus. Millions of people have acid reflux disease and suffer from its most common symptom - frequent and persistent heartburn.

Acid reflux disease can be treated and controlled. Visiting your doctor to make the proper diagnosis, taking medicine as prescribed and making relevant changes to your lifestyle can help you work toward relieving your symptoms and maintaining a healthy digestive system.

What causes Acid Reflux?

No one knows why people get ACID REFLUX DISEASE (GERD). A hiatal hernia may contribute. A hiatal hernia occurs when the upper part of the stomach is above the diaphragm, the muscle wall that separates the stomach from the chest. The diaphragm helps the LES keep acid from coming up into the esophagus. When a hiatal hernia is present, it is easier for the acid to come up. In this way, a hiatal hernia can cause reflux. A hiatal hernia can happen in people of any age; many otherwise healthy people over 50 have a small one.

Acid refluxes from the stomach when the lower esophageal sphincter (LES) isn’t working properly. This sphincter is usually tightly closed and opens only when food passes from the esophagus into the stomach. In addition to the conditions listed under “Who gets it?”, there are a number of factors that can cause the LES to open and let stomach acids reflux.

These include eating very large meals, lying down within two to three hours of eating, and taking certain drugs including diazepam, meperidine, theophylline, morphine, prostaglandins, calcium channel blockers, nitrate heart medications, and anticholinergic and adrenergic drugs.

If you are prone to acid reflux, eating greasy foods and foods such as chocolate and peppermint can also relax the LES. Caffeine, alcohol, and nicotine may also aggravate acid reflux.

Other factors that may contribute to ACID REFLUX DISEASE (GERD) include:

Alcohol use

Overweight

Pregnancy

Smoking

Also, certain foods can be associated with reflux events, including:

Citrus fruits

Chocolate

Drinks with caffeine

Fatty and fried foods

Garlic and onions

Mint flavorings

Spicy foods

Tomato-based foods, like spaghetti sauce, chili and pizza

Acid refluxes from the stomach when the lower esophageal sphincter (LES) isn’t working properly. This sphincter is usually tightly closed and opens only when food passes from the esophagus into the stomach. In addition to the conditions listed under “Who gets it?”, there are a number of factors that can cause the LES to open and let stomach acids reflux.

These include eating very large meals, lying down within two to three hours of eating, and taking certain drugs including diazepam, meperidine, theophylline, morphine, prostaglandins, calcium channel blockers, nitrate heart medications, and anticholinergic and adrenergic drugs.

If you are prone to acid reflux, eating greasy foods and foods such as chocolate and peppermint can also relax the LES. Caffeine, alcohol, and nicotine may also aggravate acid reflux.

The most common cause of acid reflux is an improperly functioning ring of muscle called the lower esophageal sphincter (LES) where the stomach and esophagus join. The LES normally opens to allow swallowing, belching and vomiting and then closes immediately. If this sphincter stays relaxed, or relaxes periodically, the food and stomach acid can escape back into the esophagus.

There are many reasons for the sphincter to work improperly; bending over, breathing hard, wearing tight clothes and overeating can all force food upwards; spices, smoke and other substances can weaken the muscle; some foods are not well tolerated and don't digest easily; and allergies and other medical problems can cause the valve to open.

We strongly suspect that acid reflux is not just a single disease, but several diseases that look alike. The symptoms look so similar that they would look like a single disease.

Some children just seem to be born with an immature digestive system and it could be a food allergy in others. In some families, ACID REFLUX DISEASE (GERD) is inherited. There are many medical problems that cause ACID REFLUX DISEASE (GERD) including low tone and long ligaments.

Can children have ACID REFLUX DISEASE (GERD)?

Studies show that ACID REFLUX DISEASE (GERD) is common and may be overlooked in infants and children.* It can cause repeated vomiting, coughing and other respiratory problems. Children's immature digestive systems are usually to blame, and most infants grow out of ACID REFLUX DISEASE (GERD) by the time they are 1 year old. Still, you should talk to your child's doctor if the problem occurs regularly and causes discomfort.

Your doctor may recommend simple strategies for avoiding reflux, like burping the infant several times during feeding or keeping the infant in an upright position for 30 minutes after feeding. If your child is older, the doctor may recommend avoiding:

Sodas that contain caffeine

Chocolate and peppermint

Spicy foods like pizza

Acidic foods like oranges and tomatoes

Fried and fatty foods

Avoiding food two to three hours before bed may also help. The doctor may recommend that the child sleep with head raised. If these changes do not work, the doctor may prescribe medicine for your child. In rare cases, a child may need surgery.

*Jung AD. Gastroesophageal reflux in infants and children. American Family Physician. 2001; 64(11): 1853-1860.

What are the symptoms of GERD (Acid Reflux)?

The main symptom of gastroesophageal reflux is heartburn. Other symptoms include cramping, difficult or painful swallowing, pain behind or just below the breastbone, spitting up at night, excessive salivation, sore throat, hoarseness, coughing, shortness of breath, bad breath, and fluid or vomit inhaled into the lungs.

 Symptoms can appear when you lie down after eating, but are relieved by sitting up. Heartburn can be severe and spread to your neck, jaw, arms, and back. People with heartburn frequently regurgitate stomach contents into their mouths, leaving a bitter taste.

If gastroesophageal reflux occurs frequently, it can lead to reflux esophagitis, esophageal narrowing, esophageal ulcer, and Barrett’s syndrome, which is a change in the lining of the esophagus that can lead to esophageal cancer.

The main symptoms are persistent heartburn and acid regurgitation. Some people have ACID REFLUX DISEASE (GERD) without heartburn. Instead, they experience pain in the chest, hoarseness in the morning or trouble swallowing. You may feel like you have food stuck in your throat or like you are choking or your throat is tight. ACID REFLUX DISEASE (GERD) can also cause a dry cough and bad breath.

Symptoms for Adults

The most prominent symptom of acid reflux is heartburn, the sensation of burning pain in the chest coming upward towards the mouth caused by reflux of acidic contents from the stomach to the esophagus.

Patients with acid reflux disease also tend to get the feeling of a sour or salty taste at the back of their throats due to regurgitation. This can sometimes happen even if the pain of heartburn is absent.

less common Acid Reflux Disease/GERD symptoms include:

Chest pain without any of the above

Dysphagia (difficulty swallowing)

Halitosis (bad breath)

Regurgitation (vomit-like taste in the mouth)

Repeated throat clearing

Water brash (the sensation of a large amount of non-acid liquid due to sudden hypersecretion of saliva)

Complication of Acid Reflux Disease/GERD symptoms:

Strictures or scarring of esophagus (especially young children).

Barrett's esophagus (sometimes referred to as Barrett's Disease)

Esophageal cancer

Important warning symptoms of Acid Reflux Disease/GERD:

Trouble swallowing Dysphagia requires immediate medical attention

Vomiting blood or partially digested blood (looks like coffee grounds) requires immediate medical attention as does digested blood in the stools.

Symptoms for Children

Acid Reflux Disease is commonly overlooked in infants and children. Symptoms may vary from typical adult symptoms. Acid Reflux Disease / GERD in children may cause repeated vomiting, effortless spitting up, coughing, and other respiratory problems.

Inconsolable crying, failure to gain adequate weight, refusing food and bad breath are also common. Children may have one symptom or many - no single symptom is universally present in all children with Acid Reflux Disease.

Babies' immature digestive systems are usually the cause, and most infants stop having acid reflux by the time they reach their first birthday. Some children don't outgrow acid reflux, however, and continue to have it into their teen years.

Children that have had heartburn that doesn't seem to go away, or any other symptoms of Acid Reflux Disease for a while, should talk to their parents and visit their doctor.

The main symptom of gastroesophageal reflux is heartburn. Other symptoms include cramping, difficult or painful swallowing, pain behind or just below the breastbone, spitting up at night, excessive salivation, sore throat, hoarseness, coughing, shortness of breath, bad breath, and fluid or vomit inhaled into the lungs. Symptoms can appear when you lie down after eating, but are relieved by sitting up.

Heartburn can be severe and spread to your neck, jaw, arms, and back. People with heartburn frequently regurgitate stomach contents into their mouths, leaving a bitter taste. If gastroesophageal reflux occurs frequently, it can lead to reflux esophagitis, esophageal narrowing, esophageal ulcer, and Barrett’s syndrome, which is a change in the lining of the esophagus that can lead to esophageal cancer.

There are many different symptoms of GER. Your child may only have a few of these symptoms. The most common symptoms include:

pain, irritability, constant or sudden crying, "colic"

frequent spitting-up or vomiting

vomiting or spitting-up more than one hour after eating

not outgrowing the spitting-up stage

refusing food or accepting only a few bites besides being hungry

poor sleep habits, frequent waking

"wet burp" or "wet hiccup" sounds

bad breath

The less common symptoms of pediatric GER include:

constant eating and drinking (to soothe a sore throat)

intolerance of certain foods

poor weight gain; weight loss

swallowing problems, gagging, choking

hoarse voice

frequent red, sore throat

respiratory problems; pneumonia, bronchitis, wheezing, asthma, nighttime cough, apnea, aspiration, noisy or labored breathing

ear infections

constantly running nose; sinus infections

tooth enamel erosion

excessive salvation, drooling

peculiar neck arching, Sandifer's Syndrome

If you think your child may have GER, please contact your child's doctor. It is also very important to let your doctor know if your child develops new symptoms or if the symptoms change.

Is Reflux a new disease?

No. It is simply more common than previously thought, and diagnostic tests have improved, making it easier to detect reflux. Also, more is now known about the potentially serious consequences of untreated reflux in babies. It is still under-recognized and under-diagnosed. Some researchers believe as many as 7,000,000 children in the US have GER

How serious is reflux?

Many young babies (about 65%) regurgitate a small amount of milk occasionally, especially when burping after meals. This "spitting up" is normal. Others vomit a large portion of every feeding.

The severity of the reflux itself is not what matters. Reflux only becomes a problem when the child is showing signs of complications. When babies develop complications they are said to have Gastroesophageal Reflux DISEASE or GERD.

What are the possible complications of reflux?

Most babies with mild reflux get better by age one without developing any medical complications. They are very challenging to care for and it can be very stressful on the family regardless of whether it is a medical problem.

When stomach acid flows into the esophagus it can cause a burning sensation called "heartburn." If the acid reflux causes reddening and swelling of the esophagus, this is called esophagitis. Esophagitis can be quite painful and can reduce the desire to eat.

Severe esophagitis can lead to bleeding from the inflamed portion of the esophagus. Scar tissue can also form inside the lower esophagus if swelling has been present for a long time. When the scar tissue forms it reduces the size of the esophageal opening and makes swallowing difficult. This type of scar is called a stricture.

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Another possible complication of acid reflux is poor growth due to a lack of adequate nutrition. Malnutrition or "failure to thrive" can result from losing too much food from frequent vomiting or from lack of appetite due to pain.

If inadequate growth continues, developing vital organs can be damaged and the child may not have enough energy to learn to walk and run.

Babies with acid reflux can also develop respiratory problems from stomach contents entering the nose, windpipe or lungs. When material enters the lungs this is called aspiration.

Many babies are first diagnosed as having acid reflux while investigating the cause of recurrent breathing problems such as wheezing, stridor or pneumonia. Acid reflux is now recognized as a cause of sinus infections.

Stomach acid can melt tooth enamel. Please take your child to a dentist as soon as his or her teeth start coming in. Make sure that the dentist watches for tooth decay and enamel erosion.

Your child probably won't develop any serious medical problems, but is it important to be aware of the possibilities so that you can consult your doctor if you see any signs of trouble.

How is GERD (Acid Reflux) diagnosed?

Your doctor will take a complete medical history and review your symptoms. He or she may refer you to a gastroenterologist. Tests used for diagnosis include x-rays, which are taken after a patient drinks a barium solution and lies down with the head lower than the feet, and esophagoscopy, where a flexible viewing tube is inserted into the esophagus for a close examination.

A tissue sample (biopsy) may be taken during this test and studied for Barrett’s syndrome. Other tests include esophageal manometry, which measures pressure in the lower esophageal sphincter, and the Bernstein test, which measures the acidity in the esophagus.

A detailed history taking is vital to the diagnosis of Acid Reflux Disease. Useful investigations may include barium swallow X-rays, esophageal manometry, esophageal pH monitoring and Esophagogastroduodenoscopy (EGD).

In general, an EGD is done when the acid reflux patient does not respond well to treatment, has had symptoms or required medications for a prolonged time (generally 5 years), has dysphagia, anemia, blood in the stool (detected chemically), has weight loss, or has changes in the voice.

Esophagogastroduodenoscopy (EGD) (a form of endoscopy) involves the insertion of a thin scope through the mouth and throat into the esophagus and stomach (often while the patient is sedated) in order to assess the internal surface of the esophagus, stomach and duodenum

Acid reflux is diagnosed primarily based on the symptoms displayed. Often, if the symptoms are quite typical of reflux, the doctor will start treatment without first performing any tests.

If the baby responds well, tests may be unnecessary unless the doctor has reason to believe there might be another medical condition. See some ways that other parents have used to track their child's symptoms.

The first test is typically a Barium Swallow X-ray (Fluoroscopy) that can show strictures of the esophagus and deformities of the upper digestive tract. The baby is given a small amount of a chalky liquid that shows up well on the x-ray film, forming a distinct outline of the esophagus and stomach.

The x-ray will also show some of the nearby organs. Since most babies don't conveniently spit up during the test, it usually just serves to rule out other problems, such as obstructions, but doesn't actually confirm the diagnosis of reflux.

A 24 hour ph-Probe Study is the most accurate way to diagnose acid reflux. A very thin flexible tube is placed in the baby's esophagus with the tip just above the stomach.

The probe is connected to a recording device which monitors the acid levels in the esophagus, and shows precisely when reflux episodes occur. Most young babies will reflux occasionally but when acid levels are high much of the time the child can be said to have "pathological" or "clinical" reflux.

A Milk Scan (Scintigraphy) is a series of scans (either computerized or with a hand held machine) that show how food moves out of the stomach.

The child is fed either liquids or solids mixed with a radio-labeled powder and scanned several times. This study is used primarily if slow stomach emptying is suspected but it also shows reflux episodes and whether the food gets into the lungs.

A flexible scope (Endoscope) can be used to examine the upper digestive tract and airway. Biopsies of the esophagus, stomach and upper portion of the small intestine can be taken during the endoscopy.

These tissue samples are examined for signs of digestive problems other than reflux, to check the severity of esophageal inflammation caused by the acid, and to detect abnormal cell growth called Barrett's Esophagus.

This procedure also allows the doctor to examine the sphincters and actually watch them open and close. Obstructions and ulcers may also be seen through an endoscope.

PAGER has a video tape of a lecture titled: Indications for Testing in Pediatric ACID REFLUX DISEASE (GERD). It is an excellent lesson on all of the disgnostic tests and what they can (and cant') reveal. I covers all of the tests except the Intraluminal Impedence Monitor (IIM) and Electro Gastrogram (EGG) which are new.

Your doctor will take a complete medical history and review your symptoms. He or she may refer you to a gastroenterologist. Tests used for diagnosis include x-rays, which are taken after a patient drinks a barium solution and lies down with the head lower than the feet, and esophagoscopy, where a flexible viewing tube is inserted into the esophagus for a close examination.

A tissue sample (biopsy) may be taken during this test and studied for Barrett’s syndrome. Other tests include esophageal manometry, which measures pressure in the lower esophageal sphincter, and the Bernstein test, which measures the acidity in the esophagus.

An infant who spits or vomits may have GER. The doctor or nurse will talk with you about your child's symptoms and will examine your child.

If the infant is healthy, happy, and growing well, no tests or treatment may be needed. Tests may be ordered to help determine whether your child's symptoms are related to GER. Sometimes, treatment is started without tests.

Natural treatment of acid reflux

Acid reflux, also known as "reflux esophagitis", is an inflammation of the esophagus caused by regurgitation of the contents of the stomach. Acid reflux is most often recognized by its symptom of "heartburn" which reportedly affects 1 out of every 10 adults in the U.S. on a daily basis.

Also called "Gastroesophageal Reflux Disease" (GERD), as well as "reflux" or "reflux esophagitis", it is a problem almost everyone experiences at some time - it occurs when acid from the stomach backs up into the esophagus - some people experience it in a severe and frequent manner.  

Today, in our drug-oriented society, the treatment of acid reflux is mostly based on the suppression of acid. These drugs are promoted as miracle cures for heartburn for millions of people and are major moneymaker$ for the drug companie$.

Consider the mass marketing tactics of "Prilosec", the original “Purple Pill” for heartburn that became the #1 selling prescription drug for seniors in the world.(1) "Prilosec" earns its manufacturer AstraZeneca $6 billion dollars/year.

When the patent on "Prilosec" expired, its maker, AstraZeneca, embarked on a $500 million marketing campaign to move consumers onto their next expensive “Purple Pill", "Nexium". It's hard to watch TV for 30 minutes without seeing a “Purple Pill" ad. AstraZeneca even hired 1,300 new sales representatives just to promote the new “Purple Pill".

Even though studies indicated, and many experts concurred, that "Nexium" was hardly more effective than the original drug, AstraZeneca managed to successfully transfer 42% of patients taking "Prilosec" over to "Nexium". It is important for you to be aware of when a drug is truly a necessity, and when it is simply a tool to increase a drug companie's profits.

Drugs are rarely the best solution for the common ulcer and other related stomach problems. It is clear that "Prilosec", and other drugs similar to it, are indeed effective at what they do. If they were not, it would be impossible for these drug companies to convince people to buy them. But drugs do NOT solve the acid reflux problem. In fact, they actually make it worse.

The so-called "proton pump inhibitors" such as "Prilosec" and "Prevacid", and the H2 blocker agents such as "Zantac", "Pepcid" and "Tagament", are some of the worst drugs you could possible take.

Here's why: these drugs dramatically reduce the amount of hydrochloric acid you have in your stomach, thereby diminishing drastically your ability to digest your food properly. This reduction in the amount of stomach acid also reduces a very important defense mechanism against food-borne infections and increases your likelihood of food poisoning. Not digesting your food properly also increases your risks for nearly every other chronic degenerative diseases.

Two studies (2) with laboratory mice, conducted by Howard Hughes Medical Institute scientists at the University of Michigan Medical School, indicate that reducing the amount of hydrochloric acid you have in your stomach could be exactly the wrong thing to do.

Natural remedies for acid reflux

Drugs are not the answer in this case. Many of us may have forgotten that the drug "Propulsid" was often used for this acid reflux and subsequently pulled from the market a few years ago after causing many deaths.

What should one do to remedy acid reflux? Following a detoxification diet, drinking about 1 gallon of filtered water daily along with high doses of quality probiotics goes a long way toward restoring normal stomach function for most people. Normally, you should try to drink enough water each day to keep your urine a light yellow shade. However, when you suffer from acid reflux, more water may be necessary to dilute the acid and normalize the pH in your stomach.

Also, many people find relief in the wormwood herb Artemisia asiatica. Another effective option, is GARLIC. Garlic is one food that you should be eating every day. It has a wonderful ability to optimize bowel flora and kill pathogenic organisms such as H. pylori. H. pylori is the only bacterial organism in the stomach that cannot be killed by hydrochloric acid.

75% of people with gastritis test positive for Helicobacter pylori, although many other species of bacteria can trigger inflammatory changes too, and often co-exist along with Helicobacter.  

It's important to remember that the garlic must be fresh. You need to CHEW the garlic or crush it using a spoon before swallowing it, if you are not going to put it in your juice. If you swallow the cloves intact you will not convert the allicin in the garlic to its active ingredient.

How is Acid Reflux treated?

Medications commonly used in the treatment of acid reflux include:

Acid suppressants, such as histamine2-receptor antagonists (blockers). Histamine is a chemical released in the body under different conditions, but particularly during inflammation. In the stomach it can release more acid, so blocking it reduces acid production.

Proton pump inhibitors, which reduce the production of acid in the stomach by acting on cells in the stomach wall that make acid and release it into the stomach.

Prokinetic agents, which promote emptying of the stomach so it does not overfill. They work by increasing the pressure of the lower esophageal sphincter (the muscular valve between the lower end of the stomach and the small bowel)

Antacids are over-the-counter medicines that are commonly used to treat mild acid-related symptoms, like heartburn or indigestion, and work by neutralising acid in the stomach. However, they are not usually recommended to treat the frequent heartburn suffered by people with ACID REFLUX DISEASE (GERD).

http://www.gerd.com/intro/noframe/gena_shk.htm

The treatment of reflux depends on the infant's symptoms and age. Some babies may not need treatment, because GER often resolves by itself. Healthy, happy babies may only need their feedings thickened with cereal and to be kept upright after they are fed. Overfeeding can aggravate reflux, so your health care provider may suggest different ways of handling feedings.

For example, smaller quantities with more frequent feeding can help decrease the chances of regurgitating. If a food allergy is suspected, you may be asked to change the baby's formula, or to modify your diet if you are breastfeeding, for 1 to 2 weeks. If a child is not growing well, feedings with higher calorie content or tube feeding may be recommended.

Other treatments include the following:

When a child is uncomfortable, has difficulty sleeping or eating, or does not grow, the doctor or nurse may suggest a medication. Different types of medicine can be used to treat reflux by decreasing the acid secreted by the stomach. One class of medications, called H2-blockers, includes cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), and nizatidine (Axid).

Another type of medication is the proton-pump inhibitors, such as esomeprazole (Nexium), omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), and pantoprazole (Protonix). Please note that the authors of this fact sheet do not specifically endorse the use of drugs for children that have not been tested in children ("off label" use). Such a determination can only be made under the recommendation of the treating health care provider.

Very rarely infants have severe GER that prevents them from growing or causes breathing problems. In some of these infants, surgery may be the best option.

Your child's doctor or nurse will discuss GER with you and suggest treatment if needed. The potential complications of the medications will be explained. Most infants don't need medications and will outgrow reflux by 1 or 2 years of age.

Specific Instructions for Infants With GER

If the baby is bottle fed, add up to one tablespoon of rice cereal to 2 ounces of infant milk (including expressed breast milk). If the mixture is too thick for your infant to take easily, you can change the nipple size or cross cut the nipple.

Burp your baby after 1 or 2 ounces of formula are taken. For breastfed infants, burp after feeding on each side.

Do not overfeed. Talk to your child's doctor or nurse about the amounts of formula or breast milk that your baby is taking.

When possible, hold your infant upright in your arms for 30 minutes after feeding.

Infants with GER should usually sleep on their backs, as is suggested for all infants. Rarely, a physician may suggest other sleep positions.

Points to Remember

GER occurs when stomach contents back up into the esophagus.

GER is common in infants but most children grow out of it.

In infants, GER may cause spitting up, vomiting, coughing, poor feeding, or blood in the stools.

Treatment depends on the infant's symptoms and age, and may include changes in eating and sleeping habits. Medication may also be an option, or surgery in severe cases.

The main goal of gastroesophageal reflux treatment is the relief of symptoms and prevention of relapses. For mild cases, your doctor may prescribe antacids to take after meals and at bedtime.

It may also be helpful to raise the head of your bed to keep the acid flowing away from the esophagus while you sleep. Your doctor may advise you to avoid fatty foods and drinks such as coffee and alcohol that can aggravate this condition.

There are drugs called histamine receptor blockers that help to reduce stomach acids. Some people find that proton-pump inhibitors are more effective at inhibiting acid production than the histamine receptor blockers.

There are also drugs, called prokinetic or motility drugs, that make the lower esophageal sphincter close more tightly.

Additional drug therapy, including omepraxole or lansoprazole, can quickly heal esophageal inflammation. A narrowed esophagus is treated with drug therapy and dilation. Surgery is only recommended if the symptoms don’t respond to other treatments. Less than 25% of people with gastroesophageal reflux require surgery.

The main goal of gastroesophageal reflux treatment is the relief of symptoms and prevention of relapses. For mild cases, your doctor may prescribe antacids to take after meals and at bedtime. It may also be helpful to raise the head of your bed to keep the acid flowing away from the esophagus while you sleep.

Your doctor may advise you to avoid fatty foods and drinks such as coffee and alcohol that can aggravate this condition. There are drugs called histamine receptor blockers that help to reduce stomach acids.

Some people find that proton-pump inhibitors are more effective at inhibiting acid production than the histamine receptor blockers. There are also drugs, called prokinetic or motility drugs, that make the lower esophageal sphincter close more tightly.

Additional drug therapy, including omepraxole or lansoprazole, can quickly heal esophageal inflammation. A narrowed esophagus is treated with drug therapy and dilation. Surgery is only recommended if the symptoms don’t respond to other treatments. Less than 25% of people with gastroesophageal reflux require surgery.

If you have had heartburn or any of the other symptoms for a while, you should see your doctor. You may want to visit an internist, a doctor who specializes in internal medicine, or a gastroenterologist, a doctor who treats diseases of the stomach and intestines. Depending on how severe your ACID REFLUX DISEASE (GERD) is, treatment may involve one or more of the following lifestyle changes and medications or surgery.

Lifestyle changes

If you smoke, stop.

Do not drink alcohol.

Lose weight if needed.

Eat small meals.

Wear loose-fitting clothes.

Avoid lying down for three hours after a meal.

Raise the head of your bed six to eight inches by putting blocks of wood under the bedposts — just using extra pillows will not help.

Medications

Your doctor may recommend over-the-counter antacids, which you can buy without a prescription, or medications that stop acid production or help the muscles that empty your stomach.

Antacids, such as Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids and Riopan, are usually the first drugs recommended to relieve heartburn and other mild ACID REFLUX DISEASE (GERD) symptoms. Many brands on the market use different combinations of three basic salts — magnesium, calcium and aluminum — with hydroxide or bicarbonate ions to neutralize the acid in your stomach. Antacids, however, have side effects.

Magnesium salt can lead to diarrhea, and aluminum salts can cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects. Calcium carbonate antacids, such as Tums, Titralac and Alka-2, can also be a supplemental source of calcium. They can cause constipation as well.

Foaming agents, such as Gaviscon, work by covering your stomach contents with foam to prevent reflux.

These drugs may help those who have no damage to the esophagus.

H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) and ranitidine (Zantac 75), impede acid production. They are available in prescription strength and over the counter. These drugs provide short-term relief, but over-the-counter H2 blockers should not be used for more than a few weeks at a time. They are effective for about half of those who have ACID REFLUX DISEASE (GERD) symptoms.

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Many people benefit from taking H2 blockers at bedtime in combination with a proton pump inhibitor.

Proton pump inhibitors include omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex) and esomeprazole (Nexium), which are all available by prescription. Proton pump inhibitors are more effective than H2 blockers and can relieve symptoms in almost everyone who has ACID REFLUX DISEASE (GERD).

Another group of drugs, prokinetics, helps strengthen the sphincter and makes the stomach empty faster. This group includes bethanechol (Urecholine) and metoclopramide (Reglan). Metoclopramide also improves muscle action in the digestive tract, but these drugs have frequent side effects that limit their usefulness.

Because drugs work in different ways, combinations of drugs may help control symptoms. People who get heartburn after eating may take both antacids and H2 blockers. The antacids work first to neutralize the acid in the stomach, while the H2 blockers act on acid production. By the time the antacid stops working, the H2 blocker will have stopped acid production. Your doctor is the best source of information on how to use medications for ACID REFLUX DISEASE (GERD).

What if symptoms persist for ACID REFLUX DISEASE (GERD)?

If your heartburn does not improve with lifestyle changes or drugs, you may need additional tests.

A barium swallow radiograph uses X-rays to help spot abnormalities such as a hiatal hernia and severe inflammation of the esophagus. With this test, you drink a solution and then X-rays are taken. Mild irritation will not appear on this test, although narrowing of the esophagus — called stricture — ulcers, hiatal hernia and other problems will.

Upper endoscopy is more accurate than a barium swallow radiograph and may be performed in a hospital or a doctor's office. The doctor will spray your throat to numb it and slide down a thin, flexible plastic tube called an endoscope. A tiny camera in the endoscope allows the doctor to see the surface of the esophagus and to search for abnormalities. If you have had moderate to severe symptoms and this procedure reveals injury to the esophagus, usually no other tests are needed to confirm ACID REFLUX DISEASE (GERD).

The doctor may use tiny tweezers (forceps) in the endoscope to remove a small piece of tissue for biopsy. A biopsy viewed under a microscope can reveal damage caused by acid reflux and rule out other problems if no infecting organisms or abnormal growths are found.

In an ambulatory pH monitoring examination, the doctor puts a tiny tube into the esophagus that will stay there for 24 hours. While you go about your normal activities, it measures when and how much acid comes up into your esophagus. This test is useful in people with ACID REFLUX DISEASE (GERD) symptoms but no esophageal damage.

The procedure is also helpful in detecting whether respiratory symptoms, including wheezing and coughing, are triggered by reflux.

Until researchers discover the root cause of acid reflux, a complete cure is not possible. There are, however, many different treatment methods available.

Most children will outgrow acid reflux in their first year of life and may not require anything more than careful position and feeding techniques. Only a few babies continue to reflux after age two. It is uncommon for acid reflux to continue past early childhood but it does happen.

Babies with reflux need to be positioned so gravity can help keep the food from coming back up out of the stomach. Many babies with acid reflux are held upright almost every waking minute.

In the past it was recommended that babies with reflux should never be left on their backs because refluxed food may be aspirated into the airway or lungs more easily in this position.

Babies with reflux were always kept in a prone (face down) position when sleeping. These positioning instructions are now being questioned in light of the Back to Sleep Campaign. Only you and your doctor can determine whether the risk of SIDS or the risk of reflux aspiration is greater for your child.

If your child experiences apnea or misses breaths, consult your doctor immediately. An apnea monitor may be used to determine whether your baby is safer on his or her back or stomach.

Often the head of the crib is raised to let gravity help keep your child's food down. A baby older than about three months will slide slowly to the bottom of a raised mattress. There are sheets with pockets available to remedy this problem. See the products page and ads.

Feeding instructions include positioning the baby vertically, thickening formula so it will splash less, burping frequently, adjusting the size of meals and avoiding spicy, fatty and acidic foods.

There are several types of medications used in the treatment of acid reflux: (see also our special newsletter on medications)

Antacids - Neutralize stomach acid.

Motility medicines - also prokinetic medications. These increase the muscle tone of the digestive tract and keep the food moving better. Bethanechol (Urecholine) and metoclopramide* (Reglan) are the only ones currently used in the United States.

Erythromycin and anti constipation medicines are sometimes used for this purpose. Cisapride (Propulsid) was withdrawn from the US market in July of 2000 and is only available in special circumstances.

Cisapride and domperidone are available in many countries. * Metoclopramide has significant side effects. Read the article in the Reading Room about it.

Acid Suppressers - Suppress acid production in the stomach, including: cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac). and Nazitidine (Axid).

Acid Blockers - Completely block acid production in the stomach. Omeprazole (Prilosec) and lanseprazole (Prevacid) are approved for use in children of certain ages. Rabeprazole (AcipHex) and pantoprazole (Protonix) are used for adults.

Frequently, some experimentation is needed to find the best drug since not all children react the same way, even to similar drugs.

If lack of weight gain and/or eating problems are severe, alternate methods of feeding can be used. The esophagus can be bypassed and food introduced directly into the stomach or intravenous nutrition can be used.

If reflux and complications are severe surgery can be performed to tighten the LES. The most common surgery is called a fundoplication. The very top of the stomach (fundus area) is wrapped around the base of the esophagus.

The muscle tone of the stomach can then help pinch the top of the stomach closed. Surgery is required by only a small number of infants and children with reflux.

ger and Acid Reflux disease (GERD) - what's the difference?

From the page about reflux, you've already learned what reflux is. Here, we will go into more detail on the different terms used to refer to reflux.  This information applies to adults as well, not just infants with reflux. 

The term reflux is a shorter way of referring to GER (Gastro Esophageal Reflux) and is simply defined as the backward flow of stomach contents up the esophagus.  GER is a physiological* process that happens to everyone—young and old—from time to time, particularly after meals and many times we are not even aware it is happening.

Surgical Treatment for ACID REFLUX DISEASE (GERD)

During the minimally invasive "reflux" procedure, specialists use pencil-thin cameras to see a detailed picture of your body. From there, they insert other tiny instruments through small incisions into the body to surgically correct the disorder.

A new, more effective esophageal "valve" is created by wrapping the stomach around the esophagus. The surgery is called Laparoscopic Nissen Fundoplication.

Since the procedure is performed through dime-size incisions, minimally invasive surgery is easier on you. Smaller incisions and less disruption inside the body mean less discomfort, a shorter hospital stay and faster recovery. The small incisions also provide better cosmetic results.

Patients who undergo the procedure report immediate relief from painful heartburn, regurgitation, hoarseness, chronic coughing, and swallowing difficulties. Most patients see these improvements while stopping all medications for reflux including antacids, H2 blockers, proton-pump inhibitors, and pro-motility medications. And...they can eat foods that they have not dared to try for years!

We are committed to improving your health

Taking a team approach to care, they work closely with patients' physicians and gastroenterology specialists to provide comprehensive care. A thorough medical evaluation is necessary prior to surgery. The evaluation may include an upper gastrointestinal x-ray and an upper gastrointestinal endoscopy as well as tests that measure pressure and function of the esophagus and stomach. You can expect to go home one or two days after the surgery. Together with your physician, they will provide follow-up care until you are fully recovered.

Self-care tips

If you have been diagnosed gastroesophageal reflux disease (GERD), follow your doctor’s instructions for care and treatment. Maintain a healthy diet, exercise regularly, and avoid eating large meals, drinking alcohol, and smoking cigarettes.

Wearing clothing that fits loosely around the stomach can help stop stomach acids from refluxing. You can help prevent gastroesophageal reflux by eating frequent, small meals; remaining upright for at least 3 hours after meals; and avoiding stress during meals or soon after eating.

Acid reflux occurs when the contents in the stomach backs up into the esophagus. The medical name is gastroesophageal reflux disease or ACID REFLUX DISEASE (GERD).

Many times acid reflux disease can be very severe with a lot of symptoms that you may become alarmed with. Other times it can be quite severe, even without noticeable symptoms.

If you understand the role of the stomach it is easier to understand how acid reflux disease can happen.

The stomach is a jelly bean or J shaped organ that lies just beneath the diaphragm that holds the upper organs in place behind the rib cage. It is an expandable muscular organ.

The stomach not only holds and stores the food that we eat, but also grinds it up into pin head size pieces, then empties by moving the food on down and out through the lower valve called the pylorus.

The lining of this stomach consists of millions of glands that produce various chemical secretions to sterilize and break down the food. The two main ones are hydrochloric acid and pepsinogen.

It is the hydrochloric acid that is the major role player in acid reflux disease. The main culprit is not the stomach itself, but relaxation of the upper valve of the stomach. This unique valve is called the lower esophageal sphincter. If this valve is relaxed or forced open then the stomach acid is pushed or forced back up into the esophagus causing damage to the very tender esophagus lining.

When you realize that food traveling from the mouth to the stomach only takes a few seconds, you then realize that there is no need for stomach acid to be present in your esophagus. It only a muscular tube that shuttles food and drink downward.

You may not realize that every day you eat certain foods that are relaxing to this upper valve. Even your every day stress can effect it.

Over eating or drinking can also effect the reverse opening of this valve. If you have two much food in your stomach at once, the stomach processing and churning the food can force that valve open. Small meals are to your advantage.

During the minimally invasive "reflux" procedure, our specialists use pencil-thin cameras to see a detailed picture of your body. From there, they insert other tiny instruments through small incisions into the body to surgically correct the disorder.

A new, more effective esophageal "valve" is created by wrapping the stomach around the esophagus. The surgery is called Laparoscopic Nissen Fundoplication.

Since the procedure is performed through dime-size incisions, minimally invasive surgery is easier on you. Smaller incisions and less disruption inside the body mean less discomfort, a shorter hospital stay and faster recovery.

The small incisions also provide better cosmetic results. Patients who undergo the procedure report immediate relief from painful heartburn, regurgitation, hoarseness, chronic coughing, and swallowing difficulties.

Most patients see these improvements while stopping all medications for reflux including antacids, H2 blockers, proton-pump inhibitors, and pro-motility medications. And...they can eat foods that they have not dared to try for years!

We are committed to improving your health

Taking a team approach to care, they work closely with patients' physicians and gastroenterology specialists to provide comprehensive care. A thorough medical evaluation is necessary prior to surgery.

The evaluation may include an upper gastrointestinal x-ray and an upper gastrointestinal endoscopy as well as tests that measure pressure and function of the esophagus and stomach. You can expect to go home one or two days after the surgery. Together with your physician, they will provide follow-up care until you are fully recovered.

Self-care tips for ACID REFLUX DISEASE (GERD)

If you have been diagnosed gastroesophageal reflux disease (GERD), follow your doctor’s instructions for care and treatment.

Maintain a healthy diet, exercise regularly, and avoid eating large meals, drinking alcohol, and smoking cigarettes. Wearing clothing that fits loosely around the stomach can help stop stomach acids from refluxing.

You can help prevent gastroesophageal reflux by eating frequent, small meals; remaining upright for at least 3 hours after meals; and avoiding stress during meals or soon after eating.

Gastroesophageal reflux (GER) occurs when stomach contents come back up into the esophagus (the tube that connects the mouth to the stomach) during or after a meal. A ring of muscle at the bottom of the esophagus opens and closes to allow food to enter the stomach. This ring of muscle is called the lower esophageal sphincter (LES).

This sphincter opens to release gas (burping) after meals in normal infants, children, and adults. When the sphincter opens in infants, the stomach contents often go up the esophagus and out the mouth (spitting up or vomiting). GER can also occur when babies cough, cry, or strain. Most infants with GER are happy and healthy even though they spit up or vomit.

Symptoms of GER

GER occurs often in normal infants. More than half of all babies experience reflux in the first 3 months of life. An infant with GER may experience these symptoms:

Spitting

Vomiting

Coughing

Irritability

Poor feeding

Blood in the stools

Only a small number of infants have severe symptoms due to GER. Most infants stop spitting up between the ages of 12 to 18 months.

In a small number of babies, GER may result in symptoms that are of concern. These include problems such as:

Poor growth due to an inability to hold down enough food

Irritability or refusing to feed due to pain

Blood loss from acid burning the esophagus

Breathing problems

These problems can be caused by disorders other than GER. Your health care provider needs to determine if GER is causing your child's symptom(s).

Speak with your child's health care provider if any of the following occur:

Vomiting large amounts or persistent projectile (forceful) vomiting, particularly in infants under 2 months of age.

Vomiting fluid that is green or yellow in color or looks like coffee grounds or blood.

Difficulty breathing after vomiting or spitting up.

Excessive irritability related to feeding, or refusing food, which seems to cause weight loss or poor weight gain.

Difficult or painful swallowing .

Surgery is an option when medicine and lifestyle changes do not work. Surgery may also be a reasonable alternative to a lifetime of drugs and discomfort.

Fundoplication, usually a specific variation called Nissen fundoplication, is the standard surgical treatment for ACID REFLUX DISEASE (GERD). The upper part of the stomach is wrapped around the LES to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia.

This fundoplication procedure may be done using a laparoscope and requires only tiny incisions in the abdomen. To perform the fundoplication, surgeons use small instruments that hold a tiny camera. Laparoscopic fundoplication has been used safely and effectively in people of all ages, even babies. When performed by experienced surgeons, the procedure is reported to be as good as standard fundoplication. Furthermore, people can leave the hospital in one to three days and return to work in two to three weeks.

In 2000, the U.S. Food and Drug Administration (FDA) approved two endoscopic devices to treat chronic heartburn. The Bard EndoCinch system puts stitches in the LES to create little pleats that help strengthen the muscle. The Stretta system uses electrodes to create tiny cuts on the LES. When the cuts heal, the scar tissue helps toughen the muscle. The long-term effects of these two procedures are unknown.

Implants for ACID REFLUX DISEASE (GERD)

Recently the FDA approved an implant that may help people with ACID REFLUX DISEASE (GERD) who wish to avoid surgery. Enteryx is a solution that becomes spongy and reinforces the LES to keep stomach acid from flowing into the esophagus. It is injected during endoscopy. The implant is approved for people who have ACID REFLUX DISEASE (GERD) and who require and respond to proton pump inhibitors. The long-term effects of the implant are unknown.

What are the long-term complications of ACID REFLUX DISEASE (GERD)?

Sometimes ACID REFLUX DISEASE (GERD) can cause serious complications. Inflammation of the esophagus from stomach acid causes bleeding or ulcers. In addition, scars from tissue damage can narrow the esophagus and make swallowing difficult. Some people develop Barrett's esophagus, where cells in the esophageal lining take on an abnormal shape and color, which over time can lead to cancer.

Also, studies have shown that asthma, chronic cough and pulmonary fibrosis may be aggravated or even caused by ACID REFLUX DISEASE (GERD).

For information about Barrett's esophagus, please see the Barrett's Esophagus fact sheet from the National Institute of Diabetes and Digestive and Kidney Diseases.

Hope Through Research

No one knows why some people who have heartburn develop ACID REFLUX DISEASE (GERD). Several factors may be involved, and research is under way on many levels. Risk factors — what makes some people get ACID REFLUX DISEASE (GERD) but not others — are being explored, as is ACID REFLUX DISEASE (GERD)'s role in other conditions such as asthma and bronchitis.

The role of hiatal hernia in ACID REFLUX DISEASE (GERD) continues to be debated and explored. It is a complex topic because some people have a hiatal hernia without having reflux, while others have reflux without having a hernia. .

Much research is needed into the role of the bacterium Helicobacter pylori. Our ability to eliminate H. pylori has been responsible for reduced rates of peptic ulcer disease and some gastric cancers. At the same time, ACID REFLUX DISEASE (GERD), Barrett's esophagus and cancers of the esophagus have increased. Researchers wonder whether having H. pylori helps prevent GERD and other diseases. Future treatment will be greatly affected by the results of this research.

GERD (Gastroesophageal Reflux Disease / Acid Reflux Disease) is injury to the esophagus that develops from chronic exposure of the esophagus to acid coming up from the stomach (acid reflux). In contrast, heartburn is the symptom of acid in the esophagus, characterized by a burning discomfort behind the breastbone (sternum).

Findings in Acid Reflux Disease include esophagitis (reflux esophagitis) - inflammatory changes in the esophageal lining (mucosa), strictures, difficulty swallowing (dysphagia) and chronic chest pain. Patients may have only one of those findings. Atypical symptoms of Acid Reflux include cough, hoarseness, changes of the voice, and sinusitis. Complicatons of Acid Reflux include stricture formation, Barrett's esophagus, esophageal ulcers and possibly even to esophageal cancer.

Occasional heartburn is common but does not necessarily mean one has Acid Reflux.  Patients that have heartburn symptoms more than once a week are at risk of developing Acid Reflux. A hiatal hernia is usually asymptomatic, but the presence of a hiatal hernia is a risk factor for development of Acid Reflux.

Who gets ACID REFLUX DISEASE (GERD)?

Anyone can suffer from gastroesophageal reflux, but it is more likely to affect people

who are obese, have a hiatal hernia, experience recurrent vomiting, or have scleroderma. Gastroesophageal reflux may also occur during pregnancy, or in those who have nasogastric tubes.

Anybody can suffer from gastroesophageal reflux, but it is more likely to affect people who are obese, have a hiatal hernia, experience recurrent vomiting, or have scleroderma. Gastroesophageal reflux may also occur during pregnancy, or in those who have nasogastric tubes.

How do you get Acid Reflux?

Some people experience this problem regularly and have a condition called gastroesophageal reflux disease or ACID REFLUX DISEASE (GERD).

The food in the stomach is partially digested by stomach acid and enzymes, which are special chemicals that help to break down food so the body can use it.

Normally, the partially digested acidic content in the stomach is delivered by the stomach muscle into the small intestine (bowel) for further digestion.

In patients with acid reflux, stomach acid content travels backwards into the esophagus, causing inflammation and damage.

Factors contributing to acid reflux include fatty foods, cigarettes, chocolate, caffeine, alcohol, obesity, pregnancy and delayed stomach emptying.

Obesity and pregnancy increase pressures within the abdomen (body trunk), pushing the stomach contents back into the esophagus.

Some patients have stomachs that empty their contents into the intestines very slowly.

A stomach full of food and acid is more prone to reflux, especially when the patient lies down (supine).

How serious is Acid Reflux?

For most people with acid reflux, the discomfort associated with symptoms can affect quality of life and everyday activities, including work. Acid reflux is also the cause of heartburn and in severe cases, this can be very troublesome. When esophagatis is present the lining of the esophagus is damaged and may become ulcerated and can result in narrowing, making swallowing of food and, sometimes, liquids, painful and difficult.

How long does Acid Reflux last?

Acid reflux can last several months or longer if not treated. Drug treatment is often only needed for a short time although it may have to be repeated since some symptoms may re-occur.