Gastroesophageal reflux disease Health Article

Signs and tests

A number of tests may help diagnose reflux or identify complications:

• A barium swallow showing reflux
• A positive Bernstein test for gastric acid reflux
• Continuous esophageal pH monitoring showing reflux
• Endoscopy showing ulceration or inflammation of the esophagus, or Barrett's esophagus
• Esophageal manometry showing abnormal sphincter pressure
• A positive stool guaiac, which may diagnose bleeding from the irritation in the esophagus

Treatment

General measures include:

• Avoiding alcohol and tobacco
• Avoiding dietary fat, chocolate, caffeine, peppermint, onions, garlic, citrus juices, and tomato products (which may cause lower esophageal pressure)
• Avoiding lying down after meals
• Sleeping with the head of the bed elevated
• Taking medication with plenty of water
• Weight reduction

Medications that alleviate symptoms include:

• Over-the-counter antacids after meals and at bedtime, although they do not last very long
• Histamine H2 receptor blockers, mostly for milder symptoms
• Promotility agents
• Proton pump inhibitors, which may take up to four days to relieve symptoms

Expectations (prognosis)

The majority of people respond to nonsurgical measures, with lifestyle changes and medications. However, many patients need to continue to take drugs to control their symptoms.

Complications

• Barrett's esophagus (a change in the lining of the esophagus that can increase the risk of cancer)
• Bronchospasm (irritation and resulting spasm of airways due to acid)
• Chronic pulmonary disease
• Esophageal ulcer
• Hoarseness
• Inflammation of the esophagus
• Stricture (a narrowing of the esophagus due to scarring from the inflammation)

Calling your health care provider

Call your health care provider if symptoms worsen or do not improve with lifestyle changes or medication.

Also call for any of the following symptoms:

• Bleeding
• Choking (coughing, shortness of breath)
• Early satiety (feeling filled up quickly when eating)
• Frequent vomiting
• Hoarseness
• Loss of appetite
• Trouble swallowing (dysphagia) or pain with swallowing (odynophagia)
• Weight loss