Gastroesophageal Reflux Disease (GERD) occurs when contents of the stomach surge into the esophagus because of a weakened lower esophageal sphincter (LES), a muscular valve between the stomach and the esophagus. Symptoms include a burning sensation in the chest or abdomen, indigestion, regurgitation, difficulty in sleeping after eating, hoarseness and sore throat. The severity of GERD depends on LES dysfunction as well as the type and amount of fluid brought up from the stomach and the neutralizing effect of saliva.

 
 
 

Factors that may cause GERD include foods like chocolate, peppermint, spicy fried and fatty foods, coffee and alcoholic beverages. Studies show smoking and obesity can also be contributing factors.

 
 
 

GERD affects almost half of the population of the United States. Forty percent of adults (over 60 million people) suffer from a form of heartburn at least once a month, according to a Gallup survey. About 25 million adults suffer daily from heartburn. About 25 percent of pregnant women suffer daily heartburn. Seven percent, or 18 million people, are chronic sufferers who take over-the-counter or prescription medications. GERD sufferers are 53% female and 47% male, and are concentrated among young and middle age adults (18-59), according to HCIA Primary Procedures, 1994. Recent studies show that GERD in infants and children is more common than previously thought.

While the overwhelming majority of patients suffering from GERD are treated effectively by primary care physicians, about 0.7 percent of Americans fail to control their symptoms with standard medical therapy.

 
 
 

GERD sometimes results in serious complications such as esophagitis, a result of too much stomach acid in the esophagus. Esophagitis can cause esophageal bleeding or ulcers as well as a narrowing of the esophagus from scarring. Barrett's esophagus is a condition that causes severe damage to the skin-like lining of the esophagus and may be a precursor to esophageal cancer.

 
 

Some simple precautionary steps can be taken to reduce or eliminate GERD, including smoking cessation and the avoidance of foods and beverages than can weaken or irritate the LES, such as citrus, tomato products, pepper, fried or fatty foods, chocolate, coffee and alcoholic beverages. Doctors also suggest eating smaller-portioned meals two to three hours before bedtime to allow the amount of stomach acid to decrease as the stomach empties. Elevating the head of a bed or sleeping on an angle reduces heartburn by allowing gravity to minimize reflux of stomach contents into the esophagus. Overweight individuals often find relief by losing weight.

 

 
 

A wave of advertising may lead people to the erroneous conclusion that heartburn relief is as simple as popping two tablets every three hours, but GERD should be treated as a potentially serious problem. Gastroenterologists warn that persistent heartburn is a disease and needs attention.

If you've been to your local pharmacy, you are aware that its shelves are packed with an army of products that promise relief from heartburn. The choices can be overwhelming and confusing. Antacids, like Rolaids or Tums, neutralize pain. Coating agents, such as Gaviscon, form a layer of foam on top of your stomach's contents to protect the esophagus from acid. H2 blockers, like Pepcid AC and Zantac 75, block the pain altogether.

H2 blockers were once considered the standard therapy to treat GERD, but increasingly, doctors are turning to newer types of prescription drugs like 'promotility' agents, such as Propulsid, which increase the pace at which the stomach empties, giving acid less of a chance to form, and proton-pump inhibitors, such as Prilosec, which are stronger than H2 blockers and virtually halt acid production.