Frequent heartburn can be an uncomfortable and sometimes serious health problem. Learn why this condition occurs and how it's treated.

Gastroesophageal reflux disease (GERD), gastro-oesophageal reflux disease (GORD), gastric reflux disease, or acid reflux disease is a chronic symptom of mucosal damage caused by stomach acid coming up from the stomach into the esophagus.

GERD is usually caused by changes in the barrier between the stomach and the esophagus, including abnormal relaxation of the lower esophageal sphincter, which normally holds the top of the stomach closed, impaired expulsion of gastric reflux from the esophagus, or a hiatal hernia. These changes may be permanent or temporary.

Treatment is typically via lifestyle changes and medications such as proton pump inhibitors, H₂ receptor blockers or antacids with or without alginic acid. Surgery may be an option in those who do not improve.

Signs and Symptoms

• Heartburn
• Chest pain
• Sore throat
• Hoarseness
• Frequent throat clearing
• Coughing
• Loss of dental enamel
• Water brash
• Globus hystericus(“lump in the throat” sensation)

Causes

Factors that can contribute to GERD:

• Hiatal hernia
• Obesity
• Zollinger-Ellison syndrome
• Hypercalcemia
• Scleroderma and systemic sclerosis
• The use of medicines such as prednisolone
• Visceroptosis or Glénard syndrome

Treatment

The current asthma guidelines recommend that medical management of GERD be instituted for patients who have asthma and complain of frequent heartburn (pyrosis), particularly those who have frequent episodes of nocturnal asthma. Three categories of medications are widely available for the treatment of reflux disease:

 

1.       Proton pump inhibitors (PPIs)

2.       H2 antagonists

3.       Antacids

Conclusion

Health care providers should be aware that GERD is a potential trigger of asthma, although not all asthma patients with GERD experience reflux symptoms. All patients with asthma should be questioned about reflux symptoms, and anti reflux therapy, in particular high-dose PPI therapy, should be initiated if appropriate. If symptoms are not improved after 3 months of empiric therapy, then either reflux is inadequately controlled or GERD-induced asthma is not present. Referral to a gastroenterologist may be warranted.