Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease (GERD) is
the backward flow (reflux) of acid from the
stomach into the esophagus. The valve
between the stomach and the esophagus (the
tube that connects the stomach to your
mouth) becomes weak and allows stomach
acid to flow upward. This can cause
irritation to the lining of the esophagus.
Sometimes the damage to the lining is called
erosive esophagitis or esophagitis. Problems
include esophagitis, strictures and Barrett’s
esophagus. Barrett’s is a change of the
lining of the esophagus to look like the
lining of the stomach and can lead to cancer
in a small number of patients. Yet, most
reflux is not this severe. This handout will
help explain GERD. If you have any
questions, please ask your nurse or doctor.
Avoid things that make GERD worse:
● Cut down or quit smoking.
● Do not use belts or clothes that are tight
fitting around the waist.
● Raise the head of your bed so it is 6 to 8
inches higher than the foot of the bed
(using extra pillow is not enough).
● Do not use a stack of pillows that causes
bending at the waist.
● Exercise, but not close to bedtime, as it
may make the symptoms worse.
● Bending over or lying down may cause
GERD symptoms to worsen in some people.
● Do not eat too much food at one time.
Four to five small meals are better than
three big meals.
● Chew your food well.
● If you are going to use alcohol, drink a
small amount with a meal. Alcohol
makes your stomach put out more acid.
Drinking it with food helps to buffer the
● Do not eat or drink within 3 hours of
● Being overweight makes the symptoms
worse. If you need to lose weight, please
ask your doctor or nurse for advice.
● Do not eat meals that are high in fat and
low in fiber.
Avoid foods and drinks that cause heartburn
and indigestion. Some people report that all
foods or drinks cause symptoms and others
are not bothered by any.
Some examples of foods that may cause
● Hot spicy food
● Orange juice, grapefruit juice
● Peppermint and spearmint
● Onions and tomato products
● Caffeinated or decaffeinated coffee, soda,
● Tell your doctor or health care provider
the medicines that you are taking.
● Do not stop taking your medicines
without first talking to your Doctor.
● The following can cause or worsen GERD
- Alendronate (Fosamax ),
Pamidronate (Aredia ),
Risedronate (Actonel )
- Anticholinergic agents such as
- Belladonna alkaloids, atropine,
- Albuterol tablets and syrup
- Clindamycin (Cleocin ),
Doxycycline (Vibramycin ),
- Ferrous sulfate (Iron
- Nicotine replacement
- Anti-inflammatory medications
such as aspirin, ibuprofen
- Nifedipine (Adalat , Procardia )
- Potassium Supplements (Slow
- Warfarin (Coumadin )
Signs and Symptoms of GERD
● Heartburn or other symptoms 2 or
more times per week.
● Acid or sour taste in your mouth
● Food from the stomach backing up
in your mouth.
In more severe cases:
● Weight loss without trying to lose
● Trouble swallowing
● Feeling that food is trapped in your
chest behind the breast bone.
● Burning chest pain that moves up
toward the neck and throat.
● Symptoms lasting up to several hours
and often worsened by eating.
● Vomiting blood or having tarry black
● Feeling acid backing up into the
windpipe causing shortness of
breath, dry cough or hoarseness.
Your doctor may want you to have an
endoscopy to help make a diagnosis. A
doctor passes a flexible tube that has a light
on one end and an eyepiece at the other
down your throat and into your esophagus
and stomach to look at the lining of your
stomach. You will receive drugs before the
procedure so that you may not even
remember it after it is over. For more details
ask for Health Facts for You #4330.
The goal in treating GERD is to stop the
symptoms, heal esophagitis, prevent it from
coming back, and avoid further problems.
Along with making changes in diet and
habits, the drugs listed below may be used:
ξ Antacids such as Tums , Rolaids ,
Maalox , or Mylanta may stop or help
mild symptoms and are used as needed
for quick relief. They neutralize
stomach acid. Antacids that contain
alginic acid like Gaviscon may be more
effective in GERD. You can buy these
without a prescription and they can be
used with newer medicines to treat
ξ H2 blockers such as ranitidine
(Zantac ≤), cimetidine (Tagamet ≤),
famotidine (Pepcid ≤) and nizatidine
(Axid ≤) reduce the amount of stomach
acid. They decrease the backflow of
stomach acid into the esophagus and
help relieve symptoms. Low doses of H2
blockers can be bought without a
prescription and work well for mild
reflux. With a prescription, you can get
larger doses. When taken twice a day,
they work well in treating GERD and are
used to prevent the return of symptoms.
ξ Proton pump inhibitors (PPIs) such as
esomeprazole (Nexium ≤), lansoprazole
(Prevacid ≤), omeprazole (Prilosec ≤,
Prilosec OTC ≤) pantoprazole
(Protonix ≤), and rabeprazole (Aciphex ≤)
stop the production of acid in the
stomach. These medicines work to heal
more serious forms of GERD and are
used to prevent symptoms from coming
ξ Promotility agents such as
metoclopramide (Reglan ) help prevent
the backflow of stomach acid by making
the valve between the stomach and
esophagus stronger. Metoclopramide
also moves food and gastric juices
through the stomach more quickly. It can
treat mild to moderate GERD when the
stomach and intestines move too slowly
and cause the symptoms.
More information can be found at the
following internet addresses:
ξ The American Gastroenterological
Association at: http://www.gastro.org/
ξ The National Digestive Diseases
Information Clearinghouse at:
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 10/2017 University of Wisconsin
Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5694