GERD (Reflux) / Esophageal Reflux

Acid reflux from the stomach into the esophagus. Causes heartburn, pain when swallowing, and chronic cough.

Gastroesophageal reflux disease (GERD (Reflux), in English: GERD, Esophageal Reflux) is a disorder in which acidic content, which normally remains in the stomach, flows from the stomach up into the esophagus and causes a burn in the inner lining of the esophagus (the tube that connects the mouth to the stomach). Sometimes gastric juices can even reach the throat and the oral cavity.

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GERD (Reflux) means to flow back or to return. Gastroesophageal reflux is a condition in which what is in the stomach returns to the esophagus.

During normal digestion, the lower esophageal sphincter opens to allow food into the stomach. Afterward, it closes to prevent food and acidic gastric juices from flowing back into the esophagus. GERD (Reflux) occurs when the lower esophageal sphincter is weak or relaxes when it should not.

The upward movement of acidic content into the esophagus causes various symptoms that impair the patient's quality of life, including heartburn. Furthermore, the burn caused by the acidic content can result in long-term damage.

Gastroesophageal reflux disease is caused by a malfunction of the muscular ring between the esophagus and the stomach. This ring is called the lower esophageal sphincter.

GERD symptoms can be alleviated through dietary and lifestyle changes. However, some individuals may require medication or surgery.

Risk factors for GERD (Reflux)

More than 25% of the population in Israel suffer from heartburn at least once a month, and over 5% of adults experience heartburn daily, including many pregnant women. Recent studies show that GERD is more common in infants and children than doctors previously thought. This can cause repeated episodes of vomiting. It can also lead to coughing and other breathing problems.

Some physicians believe that hiatal hernia may weaken the lower esophageal sphincter and increase the risk of gastroesophageal reflux. A hiatal hernia occurs when the upper part of the stomach moves into the chest through a small opening in the diaphragm (the diaphragmatic hiatus). The diaphragm is the muscle that separates the abdomen from the chest.

Recent studies indicate that the opening in the diaphragm assists in supporting the lower end of the esophagus.

It is important to note that many people with a hiatal hernia do not experience heartburn or GERD (Reflux). However, a hiatal hernia may allow stomach contents to leak more easily into the esophagus.

Coughing, vomiting, straining, or sudden physical exertion may increase abdominal pressure and lead to a hiatal hernia. Many healthy people aged 50 and over have a small hiatal hernia. Although it is usually a condition of middle age, hiatal hernias can affect people of all ages.

Hiatal hernias usually do not require treatment. However, treatment may be necessary if the hernia is at risk of strangulation, or is twisted in a way that cuts off the blood supply. Treatment for the hernia may be needed if you also have severe GERD (Reflux) or inflammation.

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Several other factors can increase the likelihood of developing GERD (Reflux):

Overweight or obesity, pregnancy, delayed gastric emptying, connective tissue diseases such as rheumatoid arthritis, scleroderma, or lupus, dietary and lifestyle choices can worsen acid reflux if you already have it: smoking, certain foods and drinks, including chocolate and fatty or fried foods, coffee, and alcohol, large meals, eating before bedtime, certain medications including aspirin.

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The most common symptom of GERD (Reflux) is heartburn. This usually feels like a burning pain in the chest that starts behind your breastbone and moves upward toward your neck and throat. Many people say it feels as though food is coming back up into the mouth, leaving a sour or bitter taste.

The burning, pressure, or pain of heartburn can last up to two hours. It is often worse after eating. Lying down or bending over can also trigger heartburn. Many people feel better if they stand upright or take an antacid that neutralizes acid in the esophagus.
People sometimes mistake heartburn pain for the pain of heart disease or a heart attack, but there are differences.
Physical activity can worsen the pain in heart disease, and rest may relieve it.
Heartburn pain is less likely to be brought on by physical activity. However, you cannot always tell the difference, so seek immediate medical assistance if you experience chest pain. In addition to pain, you may also experience nausea, bad breath, breathing difficulties, difficulty swallowing, vomiting, erosion of tooth enamel, and the sensation of a lump in the throat. If you have acid reflux at night, you may also have: persistent cough, laryngitis, sudden onset or worsening of asthma, or sleep problems.

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In addition to heartburn, you may also experience:

Nausea

Bad breath

Breathing difficulties

Difficulty swallowing

Vomiting

Erosion of tooth enamel

Sensation of a lump in the throat

Persistent cough

Laryngitis

Sudden onset or worsening of asthma

Sleep problems