It can start out with a burning feeling in your upper abdomen, especially after you eat. This feeling can extend up to your throat. You can even get a bitter taste in your mouth. Big meals and tight waistbands tend to make it worse. If you have these symptoms, you could have gastroesophageal reflux disease (GERD).
GERD is a condition in which the stomach contents along with acidic digestive juices called acids flow back or "reflux" up the esophagus, the tube between the throat and the stomach. The esophagus is not designed to cope with stomach acid and is easily irritated. This irritation leads to the burning symptoms and can damage the esophagus. It can cause narrowing of the esophagus, ulcers, and even Barrett's esophagus, a precancerous change in the lining.
Millions of Americans have GERD and don't know it. They know that they have a lot of heartburn, but don't see their doctor for it. But, making a few dietary and other changes, and taking medications, can help stop GERD.
Several classes of medications are available over the counter for treatment of GERD.
- Antacids. Many contain calcium carbonate that decreases the acidity of the stomach contents.
- H2 blockers, such as Tagamet, Pepcid, and Zantac, are sold over-the-counter. These medications cut the amount of acid that the stomach makes. They take about 30 minutes to work and give longer relief than antacids. Talk to your doctor or pharmacist before taking them, because they do not mix with some prescription medications.
- Proton pump inhibitors, such as Prilosec, stop acid production by acting directly on the cells that produce stomach acid. Some of these medications are available over-the-counter, although they should not be taken long-term without a doctor's recommendation. They can be more effective than H2 blockers or antacids, but it may take longer for them to start working.
Most doctors recommend antacids and self-care measures for occasional heartburn. An H2 blocker, with or without an antacid, may be recommended for more-frequent heartburn. H2 blockers and proton pump inhibitors are also available by prescription in stronger doses.
If you get symptoms when you lie down in bed, you might try raising the head of the bed by placing blocks under the bed legs at the head of the bed.
Here are some other measures you can take to lessen GERD:
- Avoid tobacco. Smoking can increase stomach acid.
- Maintain a healthy weight. Being overweight can make GERD worse.
- Don't wear tight clothes. Tight belts and waist bands can push stomach acids up into the esophagus.
- Learn to recognize your heartburn triggers. Common triggers include fatty foods, alcohol, chocolate, and citrus fruits and juices.
Rarely, surgery may be needed if lifestyle changes and medication do not relieve the symptoms. But the key is that people with persistent or severe symptoms of heartburn need to see their doctors.
Created on 12/05/2002
Updated on 07/07/2011
- International Foundation for Functional Gastrointestinal Disorders: About GERD.
- National Digestive Diseases Information Clearinghouse. Heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD).
- Kahrilas PJ, Shaheen NJ, Vaezi MF, et al. American Gastroenterological Association medical position statement on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135(4): 1383-1391.