What Is GERD? Symptoms, Causes, Diagnosis, Treatment, and Prevention

胃食管反流疾病（GERD）是一种慢性条件，其中胃的内容物有时会向后流入食道（将食物从喉部带入胃部的管）。

Your doctor may also use these names for GERD:

• Acid消化不良
• Acid reflux
• Acid regurgitation
• Heartburn
• 回流

GERD can interfere with daily living, but most people can get relief from it through lifestyle changes, home remedies, and medical treatment.（1）

“GERD has increasingly become a personalized disease,” says亚伯拉罕汗，MD，胃肠学家和医疗总监Center for Esophageal Healthat NYU Langone Health in New York City. Not everyone with GERD has the same underlying causes, symptoms, or amount of injury to the esophagus or aerodigestive tract, he says.

尽管如此，还有一些典型的恐怖迹象。

The most common symptom of GERD is frequent heartburn, felt by a painful, burning sensation in the middle of your chest. “Usually, if the heartburn is mild and less than two times a week, it is considered mild GERD,” saysSaleem Chowdhry, MD, a gastroenterologist at the Cleveland Clinic. “Symptoms more than two times a week and where there is concern for inflammation in the esophagus is considered moderate or severe GERD."

其他常见症状的GERD：

• Chest pain
• Regurgitating your stomach’s contents
• Difficulty swallowing
• Bad breath
• Nausea and vomiting
• Sore throator an irritated feeling in your esophagus (2)

胃酸有助于消化食物。当酸流入食管时，它会导致刺激导致GERD的症状。（2）

A ring of muscle called the lower esophageal sphincter (LES) normally keeps the top of your stomach closed. It relaxes and opens when you're swallowing to allow food through.

当你没有吞咽时，莱德·莱斯放松并打开时会发生。这允许您的胃内容物流恢复食道。（3)

“The lower esophageal sphincter’s role is to keep the acid restricted to the stomach,” Dr. Chowdhry says. “However, there are various conditions that can cause it to relax.” These include the following:

• Belching or eating a large meal
• Eating certain foods, including those high in fats, chocolate, and peppermint
• Increased pressure on the abdomen from being overweight, obese, or pregnant
• Side effects from certain medications, including抗组胺药,calcium channel blockers, painkillers,sedatives,抗抑郁药, andasthma medication
• 吸烟或吸入secondhand smoke
• Having ahiatal hernia,打开隔膜的允许upper part of the stomach to move up into the chest. This lowers the pressure in the esophageal sphincter.

Being pregnant is a major risk factor for GERD due to increased pressure on the abdomen and hormonal changes.

根据克利夫兰诊所的说法，一些孕妇经历了令人毛骨悚然的胃灼热。（4)

Other causes and risk factors:

• Consuming alcoholic, caffeinated, or carbonated beverages
• Eating certain foods, such as chocolate, citrus fruits, onions, peppermint, tomatoes, or spicy or fried foods
• 吃大餐
• Eating soon before going to bed
• Lying flat soon after eating
• Taking certain medicines, includingaspirinand certaindrugs for asthma，高血压，过敏，抑郁症，bob ios下载 ，疼痛（1,2,4）

A诊断凸实子主要是基于您拥有的症状以及您有频率，尽管它们必须发生频繁的频率和快速规则。

"Some epidemiologic studies would suggest clinically significant symptoms would be at least twice a week, but some studies include patients with GERD as having symptoms only as often as once a month,” Dr. Khan says.

Your doctor will work with you to determine if you have GERD. Diagnostic tests for GERD include the following:

• 上内窥镜检查This is a test in which your doctor inserts a thin tube with an attached light and camera down your throat. This allows for an examination of your esophagus and stomach to detect inflammation or any other complications.
• Esophageal pH and Impedance Monitoring此测试测量您的食道中酸的量，同时您携带正常的日常活动，如进食和睡觉。您的医生将执行该程序，涉及在医院或门诊中心插入鼻子或嘴的鼻子或嘴。管子被拉回食管并贴在脸颊外面。监视器佩戴24小时，您的医生会要求您保留当您的症状有任何模式是否有什么时间的日记，以及您的食用。
• Bravo Wireless Esophageal pH Monitoring这个测试还在你的食道d测量pH值uring your everyday life to determine if you have GERD. The monitor is a small capsule that's placed in your esophagus during an endoscopy and transmits information to a receiver worn on your belt or waistband. The test usually lasts 48 hours, and the capsule will pass through your digestive tract in a few days.
• Esophageal ManometryThis procedure measures the muscle contractions in your esophagus when you swallow. It can show your doctor if your symptoms are due to a weak sphincter muscle.
• Upper Digestive SystemX-RayTaken after you drink a chalky liquid, this procedure will allow your doctor to see a silhouette of your esophagus, stomach, and upper intestine. You may also be asked to swallow a barium pill to check for a narrowing of the esophagus or other conditions like hiatal hernias orulcers。（5,6)

The burning sensation in your chest that comes with GERD can last anywhere from a few minutes to a few hours.（7)

While occasional episodes of heartburn are normal, the heartburn that comes with GERD is regular or severe. Generally, GERD-related heartburn may occur two or more times a week, or it may happen once or twice a month but recur for several years, Khan explains. But again, severity and frequency will vary by individual.（8)

How long a person lives with GERD is also very dependent on the individual. “Some patients with dietary adjustments can reverse the triggers leading to GERD,” Khan says. “Others, if overweight, will need to lose weight to alter the pressure dynamics of the upper GI tract and reverse the reason to reflux. But others, even with appropriate diet and lifestyle habits for GERD, cannot significantly reverse the reflux they have.”

Your doctor may recommend a number of differenttreatments for GERD。

The first recommendation is often lifestyle changes, which may include eliminating or avoiding certain foods, eating smaller meals, or staying upright for a couple of hours after eating.

Medication Options

A number of over-the-counter (OTC) drugs are available to treat GERD and its symptoms:

• 抗酸These neutralize stomach acid and offer quick but mild relief. Overuse of抗酸can cause side effects, including diarrhea and kidney problems.
• H-2-Receptor BlockersWhile they also reduce acid production, they don't work as quickly as antacids, but they do provide longer relief. These drugs may reduce acid production from the stomach for up to 12 hours.
• Proton Pump InhibitorsCalledPPI., they effectively suppress stomach acid and help heal your esophagus.

If you don’t see much improvement on an OTC drug, your doctor may prescribe a prescription-strength version of an H-2-receptor blocker or PPI. There’s also a medication calledBaclofen.，增强了较低的食道括约肌。（6）

Surgery Options

If lifestyle changes and drugs aren’t enough to manage your GERD, you may be a candidate for surgery. Surgical procedures to treat GERD include these options:

• FundoplicationIn this minimally invasive procedure, a surgeon sews the top of the stomach around the esophagus. This adds pressure to the lower end of the esophagus to prevent reflux.
• LINX Device另一个微创手术，这是涉及一根微小的磁珠环，围绕胃和食道相遇的区域。珠子中的磁吸引力足以防止回流但足够弱以使食物通过。
• Transoral Incisionless Fundoplication (TIF)在该较新的过程中，聚丙烯紧固件拧紧较低的食道。使用插入穿过嘴的内窥镜进行TIF，不需要手术切口。（6）

Learn More About Treatments for GERD

Prevention of GERD

某些生活方式的变化可能有助于降低GERD的剧集频率：

• 避免触发GERD的食物和饮料，包括酒精，咖啡因，脂肪食品，辛辣食物，薄荷，柑橘类水果，西红柿和碳酸饮料
• Eating small meals throughout the day, rather than large amounts of food a few times a day
• Sitting upright while eating
• Eating at least three hours before bedtime
• 保持健康的体重
• Eating foods slowly
• Quitting smoking
• Not wearing tight-fitting clothing
• Not lying down after a meal
• Elevating the head of your bed

It may also be helpful to keep a journal of foods that trigger episodes of GERD and detail your symptoms to discuss with a healthcare provider. They will discuss a personalized approach with you to prevent future episodes. (6,9,10)

GERD isn’t usually life-threatening, but it can result in complications:

食管狭窄这是一个缩小的食道when damage from stomach acid causes a buildup of scar tissue.

Also known as a peptic stricture, this condition can cause problems with swallowing — even though it can also reduce the frequency and severity of heartburn. (2,3)

Esophageal UlcerThis is an open sore in the esophagus, caused by tissue damage from stomach acid. It can lead to pain, bleeding, and problems with swallowing. (2)

Barrett’s EsophagusThis is a precancerous condition in which the lining of the esophagus changes to one that more closely resembles the lining of the intestines.

While Barrett’s esophagus can reducesymptoms of heartburn, it increases your risk of esophageal cancer by a factor of about 30. (2,3)

Esophageal Cancer这种致命的癌症，目前的治疗方法无法做出慢，可能是多年来未经治疗的壮观。（3）

据国家糖尿病和消化疾病研究所和肾脏疾病称，约有20％的美国人口经验杰德。（1）

更多人经常经常经常经常酸反流，但不经常才能获得历史资格。

There’s evidence to suggest that people the United States and Europe are at a higher risk for GERD than people in other parts of the world.

According to a研究发表在杂志Gut, between 10 and 20 percent of participants in North America and Europe experienced heartburn or acid regurgitation at least weekly, compared with less than 5 percent of people in Asia. A number of factors may explain this, the researchers say, including higher prevalence of obesity and co-occurring conditions like respiratory diseases.

Frequent heartburn appears to be more common in North America than in Europe, with differences across countries and regions.

Men and women seem to be about equally likely to experience GERD. (11)

GERD的症状可以重叠与一些更严重的健康状况，包括主要心灵事件。GERD也可能触发哮喘等呼吸问题。杰德可能会混淆eosinophilic esophagitis (EoE), a chronic disease of the esophagus.

GERD与心脏病发作

The chest pain that comes with both heartburn and a heart attack can sometimes feel similar, and it may be difficult to distinguish between the two.

If you have persistent chest pain and are unsure if it is heartburn, seek emergency medical help right away. If you experienced a period of unexplained chest pain that dissipated within a few hours and you did not seek care, call your doctor to discuss your symptoms. Both heartburn and a developing heart attack can cause chest pain that goes away after a while. Your doctor will help you decide if you should come in for further evaluation.（12)

GERD and哮喘

Not only can GERD trigger asthma-like symptoms but the reverse is also true. Researchers aren’t exactly sure why, but they theorize that the aspiration of stomach acid into the airways caused by GERD can lead to breathing difficulties. And if you already have asthma, the pressure changes that occur inside the chest and abdomen during anasthma attackcan aggravate acid reflux.

Getting control over one of these conditions can help alleviate the other. Proper identification and diagnosis of these conditions is essential for treatment.（13)

Favorite Organizations for Essential GERD Information

About GERD

The official website for the International Foundation for胃肠道Disorders, About GERD is a nonprofit patient support organization that offers a wealth of resources for people living with functional gastrointestinal (GI) and motility disorders. The website has information on symptoms of GERD and other GI conditions and treatment options. Plus, there are monthly Twitter chats. Find out information about each month’s chat on the foundation’sblog。

American Gastroenterological Association

This organization provides information for doctors, researchers, patient educators, and patients on GI disorders, including GERD. The site also includes a患者中心，由专家编写的信息，并由患者顾问审核，以确保普遍受众可以理解。不要错过animated video on YouTubeonpreventing GERDduring the holidays. (It’s actually useful for anytime you might not be in control of your menu.)

American College of Gastroenterology

The American College of Gastroenterology is a professional association of gastroenterologists and GI professionals. The site is a main resource for doctors and professionals, but it also has a patient section with facts and information for various GI conditions, including a search option for finding a gastroenterologistin your area。

Favorite Online Resources on GERD

梅奥诊所

This great resource lets you know what tests to expect for a GERD diagnosis, what treatments your doctor might suggest, and even a couple of herbs to try — in addition to your doctor’s treatment regimen — to help relieve your symptoms. You can also look for a doctor in your area in the "Find a Doctor" section on the main page.

National Institute of Diabetes and Digestive and Kidney Diseases

该研究所是国家卫生研究院的司，由联邦政府资助研究许多疾病，包括GERD。除了有关条件和治疗的审核基本信息外，该网站还提供有关如何参与临床试验的信息，您可能想要与您的医生讨论。

生活方式指南的GERD

Cleveland Clinic

This resource indicates foods to avoid as well as choices from certain categories less likely to produce symptoms. Example: Nonfat or fat-free sour cream and cream cheese get a thumbs-up; the full-fat versions get a thumbs-down.

Academy of Nutrition and Dietetics

The Academy of Nutrition and Dietetics has a great page illustrating how GERD occurs to help you better understand the condition. The site also provides dietary tips on foods to avoid and other ways to reduce triggers.

Favorite Blogs About GERD

Gastroenterology Associates

This blog, hosted by a gastroenterology practice, has basic information on GERD diagnosis and treatment. Topics include lifestyle changes, medication, and procedures to treat the condition.

Gabby

Motivational speaker, life coach, and author Gabrielle Bernstein’s website is packed with information about how to lead a healthy life. Her blog covers topics from meditation to healthy eating, including her personal experience with GERD and gut inflammation.

Additional reporting byMark Henricks。