Gastroesophageal reflux disease (GERD) is a chronic digestive disorder in which stomach acid or bile frequently flows back (refluxes) into the esophagus, irritating its lining. It is estimated to affect approximately 20% of the US population and is one of the most common gastrointestinal conditions seen in primary care and gastroenterology practices. The lower esophageal sphincter (LES) — a ring of muscle at the bottom of the esophagus — normally acts as a one-way valve, allowing food to pass into the stomach while preventing stomach contents from refluxing upward. In GERD, the LES is weakened or relaxes abnormally, allowing acid to escape into the esophagus. Risk factors include obesity, pregnancy, hiatal hernia, smoking, certain medications (calcium channel blockers, antihistamines, NSAIDs), and dietary habits. The hallmark symptom of GERD is heartburn — a burning sensation in the chest or throat, especially after meals or when lying down. Other symptoms include regurgitation of food or sour liquid, difficulty swallowing (dysphagia), chronic sore throat, hoarseness, chronic cough, and the sensation of a lump in the throat. Less commonly, GERD presents as non-cardiac chest pain, which can be difficult to distinguish from cardiac causes. Untreated GERD can lead to serious complications including esophagitis (inflammation of the esophageal lining), esophageal stricture (narrowing), Barrett's esophagus (a precancerous change in the esophageal lining), and esophageal adenocarcinoma. Patients with Barrett's esophagus require regular endoscopic surveillance. Management involves lifestyle modifications (weight loss, elevating the head of the bed, avoiding trigger foods such as fatty foods, chocolate, caffeine, alcohol, and citrus, not eating within three hours of bedtime), antacids for mild symptoms, and acid-suppressing medications including H2 receptor antagonists and proton pump inhibitors (PPIs) for more persistent disease. Surgical options such as laparoscopic fundoplication or newer endoscopic procedures are available for patients who do not respond adequately to medical therapy. Our gastroenterology team at Silvaris offers comprehensive GERD evaluation and management.
