Written by Dr. Jonathan Kiev, a cardiothoracic surgeon at UK HealthCare.
GERD stands for gastroesophageal reflux, a scientific term for garden-variety heartburn.
It’s a common medical condition that can cause pain and aggravating symptoms. Although over-the-counter medications can alleviate the symptoms of GERD, it’s still important to talk to your doctor about your heartburn so that they can assess the underlying cause of the problem.
Here are some of the questions I hear most frequently from my patients about GERD, why it happens and how it’s treated.
Why do I have pain?
Your stomach contents are acidic, which helps you digest food. However, if that acidic fluid gets into your esophagus, you may experience burning and discomfort. Over time, that acid may actually injure the lining of your esophagus and cause the lining to change.
This pattern of repeated injury can be very harmful and can lead to precancerous conditions if not treated.
Why does GERD occur?
There is a valve in between the esophagus and the stomach that prevents acid reflux, but many things can disrupt this valve or cause it to relax. When that happens, acid can sneak into the esophagus.
Being overweight, being pregnant, eating certain foods and even certain occupations that cause the body to be bent over promote acid reflux and the development of heartburn.
I went to the emergency room because I had chest pain, but my heart was OK. Is this normal?
Yes. GERD symptoms like chest pain or burning may mimic the symptoms of a heart attack, and the emergency room will always consider heart issues first as they can be life threatening. If that happens, you may receive a “GI cocktail” to help alleviate the pain and burning and to differentiate the pain from a heart-related condition.
Do the medicines I see on TV work?
Over-the-counter antacids shut down the pump in the stomach that creates acid to help reduce pain. When you take antacids, you still may have reflux, but the fluid being regurgitated into the esophagus no longer burns the lining.
Patients who take medication but continue to experience hoarseness, food regurgitation or bad breath may require a surgical procedure since the active reflux is still occurring.
What are treatment options if I don’t want to take medicines?
The most reliable procedure to prevent reflux and even allow the esophagus to heal from the chronic damage of GERD and acid exposure is a procedure called a fundoplication. This operation involves wrapping the upper part of the stomach around the lower portion of the esophagus, which recreates the valve mechanism that is no longer working.
This should stop your heartburn and allow your esophagus to heal.
Who can do this operation? How long does it take?
Minimally invasive surgeons and thoracic surgeons are trained to perform this procedure, and it takes a little more than an hour to complete.
Most patients do very well and are able to stop taking medication.
Can heartburn cause esophageal cancer?
Chronic acid reflux may change the lining of the esophagus, causing a condition known as Barrett’s esophagitis. This condition can lead to esophageal cancer.
This is why it’s important for your doctor to understand the cause of your heartburn and monitor the lining of your esophagus on a regular basis.
- One common cause of GERD is a hiatal hernia, which occurs when a portion of the stomach sneaks out of the abdomen above the diaphragm. Check out our Q&A with Dr. Kiev about hiatal hernias and how they’re treated.
- At UK HealthCare’s cardiothoracic surgery program, our multidisciplinary team offers a patient-centered approach to treating a wide variety of concerns. Learn more about our program.