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SOUTH DENVER GASTROENTEROLOGY, P.C.

GERD
in Denver

What is GERD?

Gastroesophageal reflux disease (GERD) is a condition in which stomach acid flows back into the esophagus (the tube that connects the mouth to the stomach). Frequent acid reflux can result in a number of symptoms as well as irritation of the lining of the esophagus.

Acid reflux occurs when the valve at the end of the esophagus called the lower esophageal sphincter (LES) doesn’t always close properly, and a backwash of acid then flows back up through the esophagus. A hiatal hernia, whereby the top of the stomach extends above the diaphragm into the chest cavity, worsens the integrity of the gastroesophageal junction (GE junction) and increases GERD symptoms.

Common symptoms of GERD include:

  • Heartburn.
  • Chest pain.
  • Sore throat.
  • Regurgitation.
  • Chronic cough.
  • Sour taste in the mouth.
  • Hoarseness.
  • Disrupted sleep.

It’s also important to note that for some people GERD is “silent” without symptoms, but the condition can still present with complications.

What are GERD “alarm” symptoms?

  • Trouble swallowing or food getting stuck
  • Painful swallowing
  • Weight loss
  • Anemia
  • Bleeding (such as vomiting blood)

If you have alarm symptoms, it is very important to see an SDG provider as soon as possible for evaluation and endoscopy.

How is GERD Diagnosed?

If you are experiencing GERD symptoms, be sure to bring this up with your doctor. He or she will be able to diagnose GERD based on a history and physical exam. If your GERD symptoms are persistent or not responding well to initial management, your SDG provider can better assist in management. An upper endoscopy and other testing may be needed to assess the severity of GERD, manage symptoms, and screen for and treat GERD complications.

What are GERD Complications?

  • Esophagitis (inflammation of the esophagus) – this will require more aggressive medical therapy.
  • Stricture (narrowing) of the esophagus – dilation of the esophagus can be performed during an upper endoscopy to improve swallowing.
  • Barrett’s esophagus – this is a precancerous condition that requires surveillance endoscopies to reduce the risk of esophageal cancer.
  • Eosinophilic esophagitis.

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Treatment Options for GERD

There are many different treatment options for GERD, depending on the severity of your symptoms. These may include:

Diet and Lifestyle Changes

Your doctor may suggest certain changes to help control your GERD symptoms such as eating smaller servings of food, eating slowly and avoiding certain foods that may trigger GERD such as caffeine, alcohol and fatty foods. Stopping smoking and staying at a healthy weight can also be helpful in managing symptoms.

Medical Therapy

There are a number of over the counter (OTC) and prescription products and medications that can help reduce GERD symptoms and complications. OTC antacids that buffer stomach acid (such as TUMS and Gaviscon) can provide quick relief. Medications, including H-2-receptor blockers (such as famotidine) and proton pump inhibitors (such as omeprazole), provide more sustained symptom relief, and may be necessary to heal esophagitis and prevent GERD complications. All of these options are safe, and the medical regimen will be customized by your SDG provider.

Surgery

The vast majority of patients with GERD can be managed well and safely with dietary and lifestyle changes coupled with medical management. Occasionally, for individuals who do not respond to these first line therapeutic options, surgical intervention may be considered to physically reduce acid reflux. But these procedures are also associated with potential complications. Surgical procedures do not decrease the risk for esophageal cancer in patients with Barrett’s esophagus.

Tips for Preventing GERD Symptoms

There are some steps that can be taken to prevent the frequent heartburn that occurs along with GERD. These include the following lifestyle changes for a more comfortable you:

  • Avoid eating 2-3 hours before bed.
  • Prop up your head with a pillow while you sleep.
  • Avoid taking NSAIDs such as aspirin, ibuprofen or naproxen. Take acetaminophen instead.
  • Keep stress levels down.
  • Avoid trigger foods such as citrus fruits, chocolate, peppermint, tomato products, garlic, onions and spicy or fatty foods.

GERD FAQs

What are the symptoms of GERD in adults?

Common GERD symptoms in adults include heartburn, chest discomfort, burning in the chest or throat, a bad taste in the mouth and sometimes nausea and difficulty or painful swallowing. If your GERD symptoms continue after taking over-the-counter medication, medical intervention is needed. Schedule an appointment with a South Denver GI provider today.

What foods should be avoided with GERD?

There are certain foods that can make GERD symptoms worse, including alcohol, caffeine, carbonated beverages, citrus fruits and juices, chocolate, tomatoes, garlic, mint, spicy foods, fried foods and fatty foods.

Can GERD last for days?

Yes, some people can experience GERD symptoms on a daily basis and for long periods of time.

Can GERD cause back ache?

The symptoms of GERD include heartburn which can cause lower back pain.

Does stress worsen GERD?

It is possible for stress to worsen GERD. Emotional stress can increase acid production in the stomach.

Does milk help acid reflux?

Nonfat milk can act as a temporary buffer between the stomach lining and acidic stomach contents and provide immediate relief from heartburn symptoms.

How can I sleep with acid reflux?

It has been found that sleeping on your left side can reduce acid reflux. You may also sleep with your upper body elevated. Sleeping on your back is the worst position for GERD, as it makes reflux more likely. Also it is best not to eat within three hours of going to bed.

Can GERD cause chest pain?

Yes sometimes, but there are many other causes of chest pain and you should first be evaluated by your primary care provider.

What is a hiatus hernia?

This occurs when the top of the stomach slips up through the hiatus of the diaphragm into the chest and typically worsens GERD.

What is Barretts esophagus?

Barretts esophagus is a GERD-related condition that develops in some adults with chronic reflux. It is a potentially precancerous condition that requires endoscopic surveillance. To advance Barretts esophagus treatment, South Denver GI was the first GI practice in Denver to add WATS3D to esophageal biopsies. This technology cells identifies precancerous cells at earlier stages, enabling treatment or removal long before the cells can turn into esophageal cancer.

What are some less typical GERD symptoms?

Sometimes GERD can cause a coughing, hoarseness, shortness of breath, painful throat, or a lump in the throat feeling.

Can GERD be asymptomatic but still cause complications?

Yes, some patients do not feel GERD symptoms, but may develop inflammation or esophagitis, and sometimes other complications such as strictures, with trouble swallowing or Barretts esophagus.

When should I seek GI care for GERD?

If you have persistent GERD symptoms, or worrisome alarm symptoms such as trouble swallowing, painful swallowing, weight loss, anemia or black stools, you should seek evaluation and care with a South Denver GI provider.

How is GERD treated?

GERD can be managed with dietary and lifestyle changes, over the counter antacids and acid reducing medications. If your GERD is persistent or worsening, or if you have alarming symptoms, you should seek care with a South Denver GI provider.

Is GERD curable or not?

Yes, GERD can be cured. The most common treatment for GERD is medication, which can help to decrease the amount of acid in your stomach.

What does GERD pain feel like?

GERD pain often is described as chest pain that mimics a heart attack. It can be described as a squeezing pressure behind the breast bone and can last for hours.

What are the 8 symptoms of GERD?

Common symptoms of GERD include heartburn, regurgitation, the feeling of food being caught in your throat, coughing, chest pain, vomiting, sore throat, and hoarseness.

How do I get rid of GERD forever?

Surgery to tighten the LES valve and repair any hernia that is present can cure GERD.

How long does GERD take to heal?

Healing of the esophagus may occur within 6-8 weeks.

Whats the best medicine for GERD?

Prescription-strength GERD treatments include proton pump inhibitors such as Nexium, Prevacid, Prilosec, Protonix and more.

Is GERD a lifelong disease?

GERD is usually a chronic, usually lifelong disease that often relapses once treatment is stopped. South Denver GI provides expert diagnostic and medical treatment for GERD.

Is banana good for acid reflux?

Bananas are a low-acid fruit that can help neutralize the stomach acid by coating an irritated esophageal lining.

What kind of doctor treats acid reflux?

A gastroenterologist who specializes in treating the disorders and diseases that affect the digestive system which includes the GI tract, pancreas, liver, bile ducts and gallbladder, or a doctor specializing in internal medicine can treat acid reflux.

If I have chronic acid reflux, when should I be referred to a gastroenterologist?

If your acid reflux persists during or after an 8 week trial of a prescription or over the counter medicine such as Prevacid or Nexium, you should schedule an appointment with a GI provider.

Am I at risk of esophageal cancer?

The following factors can make you at more at risk of esophageal cancer: smoking, alcohol consumption, diet lacking in fruits and vegetables, obesity or injury to the esophagus like a chemical burn. Patients over the age of 55 are also more at risk. In addition, chronic GERD that progresses to Barrett’s esophagus is associated with increased risk for esophageal cancer.

Should I consider testing for Barrett's esophagus?

If you have chronic GERD symptoms, you should consider testing for Barrett’s esophagus. Men with a family history of Barrett’s esophagus or esophageal cancer are especially at risk for this condition.

What tests are done to confirm or rule out GERD?

To test for GERD, an upper endoscopy, ambulatory acid probe test, or X-ray are commonly recommended. During an upper endoscopy, your doctor will insert a thin tube with a light and camera down your throat so that they can see into your esophagus and stomach. An ambulatory acid probe test can be performed similarly with a monitor placed in your esophagus to track when and how long stomach acid is present.

Is surgery an option to treat GERD?

South Denver GI offers many non-invasive and non-surgical options that can effectively treat GERD. Surgery is an option if these less invasive measures are ineffective, but we recommend first trying medical management

What are the risks and benefits of surgery for GERD?

Surgery for GERD can reduce the occurrence of acid reflux But like any surgery, there are some risks of complications such as a reaction to the anesthesia, bleeding and injury to the esophagus or stomach. Chronic side effects may occur as well Some patients may need a second surgery if acid reflux comes back, meaning this more invasive approach is not always a permanent one.

Your South Denver GI Team

At South Denver GI, our team of physicians and advanced practice providers have the expertise to provide you with outstanding care. If you would like to learn more about GERD or need to schedule an appointment at our office, contact us today!


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