Gastroesophageal reflux disease (GERD) is a condition that results from digestion when liquid contents that include hydrochloric acid and pepsin (digestion enzyme) from the stomach reverse direction and regurgitate (reflux) back into the esophagus. Bile also may backwash on occasion. The esophagus is the anatomical pathway (food pipe) extending from the throat to the pylorus (stomach) that food travels down after being swallowed. This back flow of acid that irritates and inflames the esophagus is GERD. J. Simic, MD, estimates that almost one-third of adults experience GERD monthly, while almost 10 percent of adults experience GERD daily or weekly.
Heartburn and Pain
As hydrochloric acid backs up into the esophagus, nerve fibers of the esophagus become stimulated, and it is this neural stimulation that produces the heartburn associated with GERD. Heartburn, the primary symptom, frequently is described as a burning-like pain in the center of the chest. For some, however, this pain is sharp and feels like pressure instead of burning. Pain that accompanies GERD also can be similar to cardiac-related pain prior to a heart attack (angina). The esophagus is positioned behind the heart, which is how the term "heartburn" came to be used when describing the burning esophageal pain, according to J. Simic, MD.
Some physicians believe that the lower esophageal sphincter (LES), located at the bottom of the esophagus, may be the most salient structure regarding gastro-esophageal reflux. Under normal functioning, the LES relaxes for the purpose of letting food pass into the stomach, and then tightens up again to close off the end of the esophagus from the opening of the stomach. Consequently, no digestive contents from the stomach can flow back through this ring-like sphincter and into the esophagus. In individuals with GERD, however, the LES does not remain closed; instead, the LES loosens between swallows which permits the backwash of stomach contents, especially digestive acid.
Secondary Symptoms
In addition to heartburn, common accompanying symptoms may include: a dry cough, hoarseness in the voice, or a sore throat. Dysphagia or difficulty swallowing is also common.
Other Symptoms
Other symptoms that may be reported are nausea & vomiting, belching, and a bitter taste in the mouth.
