Gastroesophageal reflux disease (GERD) is a chronic condition that affects nearly 20 percent of American adults. People with GERD spend billions on over-the-counter and prescription medications to combat painful heartburn.
While most people experience occasional heartburn, also known as gastroesophageal reflux, GERD is a chronic condition with symptoms that can occur daily. It can cause serious complications over time if it’s left untreated. But can treating it reverse or at least reduce the damage caused by GERD?
When a person swallows, a complex set of muscles near the mouth and tongue work with the epiglottis to close off the windpipe to protect the lungs and move the food into the esophagus. The esophagus is the narrow tube connecting the throat to the stomach.
At the bottom of the esophagus is a ring of muscles known as the lower esophageal sphincter (LES). A healthy LES relaxes enough to allow proper movement of food from the esophagus into the stomach.
In people with GERD, the LES relaxes too much and allows stomach acid to enter the esophagus. This can cause a painful burning sensation in the mid-abdomen, chest, and throat.
While the stomach has a tough lining to protect it from acid, the esophagus doesn’t. This means the sensitive esophageal tissue may be injured over time.
The acid often also backs up into the mouth, damaging other structures along the way. Sometimes the acid ends up being aspirated into the windpipe and lungs, causing problems there as well.
Complications of GERD may include:
- Barrett's esophagus
- erosive esophagitis
- esophageal stricture, which is a narrowing of the esophagus
- dental disease
- asthma flare-ups
Symptoms of GERD can be serious, especially in older people. They may include a severely inflamed esophagus and difficulty swallowing.
Barrett’s esophagus tends to occur more commonly in people who have GERD.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, only a small percentage of people with GERD develop Barrett’s esophagus. The average age for diagnosis is 55, and it’s more common in men.
People with Barrett’s esophagus are at higher risk of developing esophageal cancer because of damage to the lining of the esophagus.
Risk factors for Barrett’s esophagus include severe and chronic GERD, obesity, tobacco smoking, and intake of food and drinks that trigger GERD.
Acid irritation and inflammation can injure the esophagus over time, creating a condition known as erosive esophagitis. People who are obese, especially obese white men, are at the greatest risk of developing erosive esophagitis.
Some people with the condition experience bleeding. This can be seen in dark-colored stools, as well as vomit that looks bloody or like coffee grounds.
Ulcers in the esophagus can cause long-term or severe bleeding, which may result in iron-deficiency anemia. This is a serious condition that requires immediate attention and ongoing care.
The esophagus may become severely injured and inflamed over time. This can result in scarring and the development of a narrowed, band-like area known as a stricture. A stricture may result in dysphagia (impaired swallowing). Strictures typically require treatment.
Tooth enamel can become eroded from acid backing up into the mouth. People with significant GERD also have more gum disease, tooth loss, and mouth inflammation, likely due to ineffective saliva.
GERD and asthma often appear together. The reflux of acid into the esophagus may trigger an immune response, making the airways more irritable. Small amounts of acid may also end up in the mouth and then be inhaled. This also causes airway inflammation and irritation. These processes can trigger asthma flare-ups and make asthma more difficult to control.
Certain asthma medications and asthma flares can also relax the LES, making GERD symptoms worse in some people.
People with GERD are at increased risk for other respiratory and throat conditions, including:
- chronic laryngitis
- chronic cough
- granulomas, consisting of inflamed pink bumps on the vocal cords
- hoarse voice and difficulty speaking
- aspiration pneumonia (often recurring and serious)
- idiopathic pulmonary fibrosis, a restrictive lung disease where lung scarring occurs
- sleep disorders
- constant throat clearing
Some people with GERD have mild symptoms that can be treated successfully by lifestyle changes, such as:
- quitting smoking
- losing weight
- eating smaller portions at meals
- staying upright for a few hours after meals
Also, avoiding certain foods that trigger GERD symptoms can provide relief. These foods may include:
- citrus fruits
- colas and other carbonated beverages
- fried and fatty foods
- tomato sauce
In milder cases of GERD, lifestyle changes may allow the body to heal itself. This lowers the risk for long-term damage to the esophagus, throat, or teeth.
However, sometimes lifestyle changes are not enough. More significant cases of GERD can often be treated and controlled with medications such as:
- histamine H2-receptor antagonists, known as H2 blockers, such as famotidine (Pepcid) or cimetidine (Tagamet)
- proton pump inhibitors such as lansoprazole (Prevacid) and omeprazole (Prilosec)
Surgery can be an effective treatment for hard-to-control GERD in people who don’t respond to other treatments. Once GERD symptoms are under adequate control, there will be less risk for further damage to the esophagus, throat, or teeth.
While GERD can be a painful disturbance to your lifestyle, it doesn’t necessarily affect your lifespan. Those who can manage their symptoms effectively will have a healthier and improved quality of life.
Some therapies may work better for some than others. A physician can help you in finding the most effective way to treat your GERD to lower your risk for associated complications.