Approximately 10 to 20 percent of people have symptoms of Gastroesophageal Reflux Disease (GERD) on at least a weekly basis. Symptoms occur when stomach acid enters back into the esophagus, the tube carrying food from the mouth into the stomach.

Common symptoms of GERD include burning behind the breastbone or regurgitation of acidic tasting liquid into the mouth. Chest pain not due to heart disease may be related to GERD. Less common symptoms include a sensation of a lump in the throat, frequent hoarseness or sore throat, the need for frequent throat clearing, and coughing.

Medical evaluation and treatment of GERD is important because individuals may develop complications from GERD including narrowing of the esophagus–resulting in difficulty swallowing, esophageal ulceration with painful swallowing, asthma, Barrett’s esophagus and esophageal cancer. Barrett’s esophagus is a change in the cells lining the esophagus and may lead to development of esophageal cancer.

Common treatment options include lifestyle changes and medical therapy.  Endoscopic therapy of GERD may also be considered. Medical therapy may range from taking over the counter antacids as needed to daily prescription medications. Symptoms can improve with smoking cessation, elevating the head of the bed six to eight inches, avoiding lying down for a couple of hours after eating and weight loss. Avoidance of fatty foods, chocolate, peppermint, excessive alcohol, carbonated beverages and citrus fruits may also help. Due to the effectiveness of medical therapy, surgery is rarely needed but is available in certain circumstances to provide symptom relief.

Difficulty swallowing, unexplained weight loss, anemia, dark colored stools or lack of improvement with aggressive medical therapy require endoscopic examination. Most experts also recommend endoscopic evaluation in patients requiring long term medical therapy.

At the time of endoscopy, sedation is given and usually leads to a painless procedure. A thin tube with a light and a camera is introduced into the mouth and advanced through the esophagus and stomach into the small intestine to allow for identification of GERD complications.

If you have symptoms suggestive of GERD, please discuss them with a doctor and ask if medical therapy or gastroenterologic consultation is warranted.

Bryan F. Thompson, M.D., graduated with honors from Auburn University and received his medical degree from the University of South Alabama. He completed his internal medicine residency in gastroenterology and hepatology fellowship at the University of Alabama at Birmingham.