Critical Questions: GERD

Critical Questions: GERD

The following questions and answers were provided by Mitchell Bernsen, MD, managing partner at Illinois Gastroenterology Group, a member of Health Plus Physicians Organization.


Q: My chest burns sometimes after I eat or go to sleep. Why does this happen?

A: Acid reflux is caused by the reflux of digestive enzymes from the stomach into the esophagus due to multiple causes. One common cause is due to the malfunction of the lower esophageal sphincter (LES). The LES is a ring of muscle between the esophagus and stomach. It relaxes to allow food to enter the stomach and tightens to block acid from refluxing back into the esophagus. When the LES relaxes inappropriately, it allows stomach acids to reflux into the esophagus too often, and it causes chronic irritation and damage to your esophagus.

Q: How do I know if I have GERD, and what symptoms should I look for?

A: Gastroesophageal Reflux Disease (GERD) can only be diagnosed by medical professionals by obtaining a detailed patient history and a diagnostic evaluation. Common symptoms of GERD are heartburn—burning/pain in the stomach and chest; sour/acid taste in the mouth and difficulty swallowing.

Q: Do I have simple or problematic GERD?

A: May people experience occasional mild heartburn symptoms and can be treated easily with antacids, which work quickly for easy relief of symptoms. If you experience heartburn symptoms for more than two to three days a week for weeks at a time, then you have to be evaluated for GERD and may need medical treatment.

Q: I am concerned because I have heartburn, but I don’t experience typical symptoms.

A: Some people have atypical symptoms that may be due to GERD and need to be discussed with a medical professional.  Some of these symptoms may include: hoarseness of voice, wheezing/asthma-like symptoms, persistent cough, ear pain, dental problems, sore tongue and abnormal taste.

Q: Am I at risk for esophageal cancer?

A: About 10 percent of people with a diagnosis of GERD will develop a change in the lining of the esophagus, called Barrett’s esophagus. This is a precancerous change of the tissue of the esophagus. However, studies have shown that of those people diagnosed with Barrett’s, over a period of 10 years, only 10 out of 1,000 people will possibly develop cancer.

Q: I was told that I have a hiatal hernia. Do I need treatment?

A: Your diaphragm normally has a small opening (hiatus) through which your esophagus passes to connect to your stomach. If this opening enlarges, the stomach can push up through it and cause a hiatal hernia. Most hiatal hernias are small and do not cause problems. You may never even know you have a hiatal hernia unless it is found when checking for another condition. However, a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn. Under these conditions, medical therapy with acid blockers or surgery may need to be done to correct the problem.

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Originally published in the Fall 2015 print edition.