Table of Contents
IV. Diagnosing Stomach Problems
What is GERD?
Gastroesophageal reflux disease, or GERD, is a common gastrointestinal disorder. In the United States, one in five adults has GERD. Symptoms of this condition are often misunderstood because this condition may appear similar to many other gastrointestinal disorders. GERD is generally treatable, but serious complications can occur if it is left untreated for long periods. [1]
GERD occurs when stomach acid flows back into the esophagus, which is the tube that connects the mouth and stomach. Acid reflux can lead to unpleasant symptoms and irritate the lining of your esophagus. Most people will experience some form of acid reflux in their lifetime. You may have severe GERD if you experience symptoms at least twice a week.
Several medications and procedures are available to treat GERD. Once you receive an accurate diagnosis, you may be prescribed medications like Nexium (esomeprazole), Protonix (pantoprazole), Prevacid (lansoprazole), or metoclopramide. These drugs can help reduce stomach acid and improve symptoms of heartburn and acid reflux. Read on to learn more about gastroesophageal reflux disease. [2]
Symptoms of GERD
Symptoms of GERD depend on the severity of your condition. Some symptoms may come on gradually, and people may not notice anything out of the ordinary at first. Over time, these symptoms will become more severe and start to impact daily activities. Common symptoms may include:
- Burning sensation in the chest after eating
- Difficulty swallowing
- Regurgitation of food or sour liquid
- The sensation of a lump in the throat
- Disrupted sleep
- Chronic cough
- Laryngitis
- New or worsening asthma
- Cavities
- Bad breath
These symptoms may be worse at night and cause increased sensations of chest pain. Chest pain is a distressing symptom, so if you frequently experience chest pain, you may want to check with a doctor to make sure you are not having heart problems. [2]
Risk Factors
Anyone can experience GERD, but several risk factors may increase the chance of developing this condition. Common causes of gastrointestinal problems may involve:
A malfunctioning lower esophageal sphincter (LES): The LES is responsible for closing and opening the esophagus's lower end. This part of the body acts as a pressure barrier against the contents of the stomach. The LES may become weak or lose tone, leading to food passing from the stomach into the esophagus. The esophagus cannot deal with stomach acid, so this acidic substance can irritate and damage the esophagus.
Obesity: If you are overweight or obese, you are at an increased risk of acid reflux. Extra weight on the abdomen can cause pressure on the stomach, which may weaken the LES and lead to stomach acid escaping into the esophagus.
Asthma: Asthma and GERD are often linked. Over 75 percent of people with asthma also have GERD. Scientists think that chronic coughing with asthma attacks can lead to chest pressure, which can trigger acid reflux. Asthma drugs also dilate airways and may relax the LES, which can cause reflux. [3]
Pregnancy: Pregnant women often complain of acid reflux. This may be because increased levels of estrogen and progesterone relax the LES. A woman’s expanding belly can also put pressure on the abdomen, resulting in heartburn and possibly GERD.
Smoking: If you smoke or are surrounded by second-hand smoke, you may be at risk for GERD. Smoking decreases the amount of saliva in the mouth and causes the stomach to empty more slowly. This can lead to an increase in stomach acid.
Genetics: If you inherit certain genes that lead to muscular or structural problems in the esophagus or stomach, you are more likely to develop GERD. Other gastrointestinal disorders that result from GERD, like Barrett's esophagus and esophageal cancer, have significant genetic overlap.
Foods that stimulate acid production: When the stomach produces too much acid, GERD is more likely to occur. Everyone's stomach reacts differently to foods, but certain foods may increase the rate of heartburn and stomach acid. Foods high in salt can also trigger heartburn. Some common foods that may be a problem include:
- Alcohol
- Black pepper
- Citrus fruit and juices
- Tomato juice
- Carbonated beverages
- Caffeinated beverages [3]
Diagnosing Stomach Problems
As mentioned earlier, GERD may be difficult to diagnose at first. You may have to undergo several tests, so a proper diagnosis and treatment plan can be established. Your doctor may recommend the following tests:
Upper endoscopy: If your doctor thinks you may be suffering from GERD, you may get an upper endoscopy, which examines the inside of the esophagus and stomach. This is done by inserting a thin, flexible tube with a camera at the end down into the throat. Once your doctor gets a view of your stomach, they can determine if inflammation or damage is present. An endoscopy can also collect tissue samples to test for other diseases or cancer.
Esophageal manometry: A manometry test involves a measurement of the rhythmic muscle contractions of the esophagus. This test can determine the force exerted by the esophagus muscles and if the muscles are working properly.
Ambulatory acid probe test: A doctor will place a monitor in the esophagus to identify if stomach acid is being regurgitated. The monitor is placed through the nose and into the esophagus. It will stay there for two days to get an accurate reading. This monitor connects to a small computer that you can wear around your waist.
X-ray: Doctors may also have you drink a chalky liquid that will coat the inside lining of your digestive tract. An x-ray will then be done, which allows a clear view of where the liquid rests in the esophagus and stomach. This test will determine if the stomach is leaking and disrupting the chalk coating. [2]
Treatment
If you are newly experiencing acid reflux problems, you may reach for over-the-counter antacids to neutralize stomach acid. Proton pump inhibitor medications may also be prescribed for severe GERD symptoms. These drugs block stomach acid production and allow time for damaged esophageal tissue to heal. Common proton pump inhibitors include Nexium (esomeprazole), Protonix (pantoprazole), and Prevacid (lansoprazole).
You may also be prescribed a drug that improves the movement of the bowels. Drugs like metoclopramide can be used for esophageal or stomach-emptying problems. This drug can also improve nausea, vomiting, heartburn, and the uncomfortable feeling of fullness after a meal. Talk to your doctor to determine the correct medication and treatment plan for you. [4]
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