Gastroesophageal Reflux Disease (GERD) Symptoms

  • Symptoms

    The most common symptoms of GERD are heartburn and regurgitation Table 01. These symptoms are most likely to occur 1 to 3 hours after eating.

    Symptoms are most likely to occur when you bend over or lie down (especially on your back) after a heavy meal. Many people with GERD have symptoms at night that awaken them from sleep.

    Symptoms of GERD in most people are mild and do not last more than a couple of hours. In some people, GERD causes severe, disruptive, and possibly life-threatening symptoms and complications Table 01.

    Table 1.  Symptoms of GERD

    A burning sensation in the throat and chest (heartburn)
    A feeling of acid or stomach contents backing up into the esophagus (regurgitation)
    Chest pain that feels like angina (heart pain): tightness, pressure, heaviness
    Asthma (bronchospasm)
    Trouble swallowing (dysphagia)
    Chronic (recurring) nausea and vomiting
    Blood in the stool (bowel movement) or in the vomit
    Hoarseness (laryngitis)
    Chronic cough
    The sense that there is a lump in your throat or that you have to clear your throat all of the time
    Frequent belching
    Sleep apnea, which is the repeated but temporary interruption of breathing during sleep. Sleep apnea can lead to restless sleep, morning headaches, and afternoon drowsiness
    Iron deficiency in the blood (anemia) caused by chronic blood loss from ulcers in the esophagus
    A sour or bitter taste in the mouth

  • Risk Factors

    Your lifestyle and diet may increase your risk of GERD.

    There are many things that can irritate your esophagus or cause increased acid reflux, which can worsen your GERD symptoms.

    • Alcohol relaxes the lower esophageal sphincter (LES) muscles and may also irritate the esophagus.
    • Cigarette smoking and coffee are known to make symptoms of GERD worse.
    • Foods that tend to weaken the LES include those with high fat content, yellow onions, chocolate, and peppermint. Other foods, such as citrus fruits and spicy tomato drinks, can irritate the lining of the esophagus.
    • Carbonated beverages can cause the abdomen to bloat. The bloating may increase the pressure in the stomach and force acids back up into the esophagus.

    Medications can trigger symptoms of GERD.

    A number of drugs can cause the LES to relax or function improperly or can irritate the esophagus, causing GERD symptoms. Examples of these drugs include:

    • Theophylline and anticholinergics, both of which can be used to treat asthma
    • Calcium channel blockers and alpha-adrenergic antagonists, which can be used to treat hypertension and heart conditions
    • Beta-adrenergic agonists, which include bronchodilators such as albuterol (Proventil) and heart medications such as isoproterenol (Isuprel)
    • Nitrates, such as nitroglycerin
    • Tricyclic antidepressants, such as amitriptyline (Elavil)
    • Certain muscle relaxants, such as diazepam (Valium)
    • The hormone progesterone
    • Antibiotics, such as doxycycline and tetracycline
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Motrin, Advil), and naproxen (Aleve)
    • Potassium chloride or vitamin C supplements
    • Quinidine
    • Biphosphates such as alendronate (Fosamax), a drug used to treat osteoporosis

    To help prevent GERD symptoms caused by medications, it may help to drink at least 4 to 6 ounces of liquids when taking medicines and to take pills one at a time.

    Other medical conditions, such as hiatal hernia or traumatic injury, can make GERD worse.

    A muscular wall called the diaphragm separates the chest and lungs from the stomach and abdominal organs. When a portion of the stomach pushes through a weakened area of the diaphragm, the resulting condition (called a hiatal hernia) can irritate the esophagus. Trauma to the chest can damage the delicate muscles controlling LES tone. Either of these conditions can lead to symptoms of GERD.

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