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Digestive Disorders

Gastro-esophageal Reflux Disease (GERD)

Gastro-esophageal reflux disease (GERD) is a medical term for acid that moves into the "food swallowing tube" (esophagus) from the stomach. Sometimes acid moves up the swallowing tube, into the nose or mouth. The strong acid can burn and irritate the swallowing tube, throat, and vocal cords. GERD symptoms are not the same for everyone. You may feel burning in your chest or throat called "heartburn." Or, you may notice a bad taste in your mouth, sore throat, voice changes, cough, wheezing, or swallowing problems. If you feel no symptoms at all, you may have "silent reflux."

GERD and Breathing Problems

The vocal cords cover the opening to the breathing tube. When swallowing, the vocal cords close to keep food and water out of the lungs. When breathing, the vocal cords open to let air in and out of the lungs. If the vocal cords are damaged by acid, they do not open and close at the right time. Vocal cord dysfunction (VCD) is the medical term for vocal cords that do no work properly. VCD can cause breathing problems like shortness of breath, coughing, and wheezing. If you already have breathing problems, like asthma, it can make your breathing worse.

What Causes GERD?

Acid can move into the swallowing tube if the muscle at the top of the stomach opens or relaxes. Many foods and medicines can cause the muscle to relax. Acid can also move into the swallowing tube if there is pressure in the belly. This is caused by:

How is GERD Diagnosed?

Often GERD is diagnosed by your symptoms. Your doctor may give you a trial of medicine to see if your symptoms go away. At other times, the only way and most accurate way to diagnose GERD is with a pH probe test. The pH probe is a tiny tube that is threaded into the nose to the lower swallowing tube. It measures the acid in the swallowing tube. After 24 hours it is taken out, and the readings are checked. If acid levels are high (GERD), then medicine is started.

How is GERD Treated?

Change your "lifestyle":

Take medicine:

If you have GERD less that 3 times a week, over-the-counter antacids work well. Antacids come in pill or liquid form. The medicine lowers acid in your stomach for a short time. Follow the directions on the bottle. Take antacids 1 hour before or 2 hours after your other medicines. Tell your provider if you are using these medicines and how often.

If you have GERD more that 3 times a week or have other problems caused by GERD, you may need a prescription medicine. There are 2 types of prescription medicine used.

  1. H2 blockers: Tagamet® (cimetidine); Zantac® (ranitidine); Axid® (nizatidine); or Pepcid® (famotidine). H2 blockers cut down the amount of acid made in the stomach.
  2. Proton pump inhibitors (PPI): AcipHex® (rabeprazole); Nexium® (esomepraole); Prevacid® (lansoprazole); Prilosec® (omeprazole); Protonix® (Pantoprazole). PPI medicine blocks acid from being made in the stomach. PPI is the strongest of all the acid medicines.

Your provider will put you on the medicine that is best for your symptoms. Take this medicine as directed. After a few months, your doctor may try to cut back on the amount of acid medicine you take to see if the problem is getting better. The goal is for you to take the least amount of medicine to treat your symptoms. Continue lifestyle changes while you are on the medicine. If you do not get better, your provider may send you to a stomach specialist (gastroenterologist).

When to Call Your Provider:

Call your provider if you notice:

For more information:

Go to the Digestive Disorders health topic, where you can:

This article is a NetWellness exclusive. NetWellness Article

Last Reviewed: Dec 12, 2006

The Ohio State University Cathy Benninger, APRN, C-AE
Clinical Assistant Professor
Director, OSU Asthma Center Educational Program
OSU Asthma Center
Pulmonary, Allergy, Critical Care & Sleep Medicine
Department of Internal Medicine
College of Medicine
The Ohio State University
Cathy   Benninger, APRN, C-AE

The Ohio State University John G. Mastronarde, MD
Assistant Professor, Co-Director
OSU Asthma Center
Pulmonary, Allergy, Critical Care & Sleep Medicine
Department of Internal Medicine
College of Medicine
The Ohio State University
John G. Mastronarde, MD