Gastroesophageal reflux, often simply called GERD or acid reflux, affects both infants and adults. When acidic stomach contents enter the esophagus, the tube that leads from the mouth to the stomach, heartburn -- a burning, uncomfortable sensation -- occurs. A sore throat, coughing, hoarseness, trouble swallowing or hiccups can also occur. Acid can back up into the throat or mouth in some cases. Acid reflux can be aggravated by a number of foods and lifestyle choices.
Causes
A weakness of the muscle between the stomach and esophagus, called the lower esophageal sphincter, causes acid reflux. While the stomach is made of tissue that can withstand high acid levels, the esophagus is not. Acidic material in the esophagus and throat causes the burning associated with reflux.
The tissues of the esophagus become inflamed and can develop ulcers over time. The esophagus can also develop strictures, or narrowed areas which can make solid food difficult to swallow.
Risk Factors
Infants often outgrow GER by their first birthday. In adults, obesity, smoking, alcohol, asthma, pregnancy and diabetes can all increase the risk of developing acid reflux. Some foods can also aggravate reflux, including caffeine or carbonated beverages, chocolate, tomato-based foods, spicy food and fatty foods. Eliminating risk factors can improve acid reflux.
Complications
Acid reflux can cause severe complications. Repeated, untreated bouts of acid reflux can cause Barrett's esophagus -- changes in the esophageal lining that increase the risk of developing esophageal cancer. The changes to the lining that occur do not go away even if your reflux improves; people with Barrett's esophagus should have endoscopic exams every two to three years, The Merck Manuals Online Medical Library suggests. Erosion and ulcers of the lining can lead to heavy bleeding. If swallowing becomes painful or difficult, weight loss can occur. Dental problems can also arise.
Treatment
Keeping infants upright for 30 minutes after feeding can help reduce acid reflux. In addition to eliminating risk factors, eating small, frequent meals, staying upright for three hours after meals, wearing loose fitting clothing, not eating for two to three hours before bedtime and elevating the head of the bed between 6 and 8 inches on blocks can also help. A number of medications are used to treat acid reflux, including over-the-counter antacids, drugs called proton pump inhibitors that block acid production and H2 blockers, which reduce stomach acid production. Acid blockers come in both over-the-counter and prescription strengths. Surgical repair by tightening the sphincter muscles, a procedure called fundoplication, may help some people.
