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Gastroesophageal reflux - discharge

Definition

Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This article tells you what you need to do to manage your condition.

Alternative Names

Peptic esophagitis - discharge; Reflux esophagitis - discharge; GERD - discharge; Heartburn - chronic - discharge

Self-care

You can make many lifestyle changes to help treat your symptoms. Avoid foods that cause problems for you.

• Do not drink alcohol.
• Avoid drinks and foods that have caffeine, such as soda, coffee, tea, and chocolate.
• Avoid decaffeinated coffee. It also increases the level of acid in your stomach.
• Avoid high-acid fruits and vegetables, such as citrus fruits, pineapple, tomatoes, or tomato-based dishes (pizza, chili, and spaghetti) if you find that they cause heartburn.
• Avoid items with spearmint or peppermint.

Other lifestyle tips that may make your symptoms better are:

• Eat smaller meals, and eat more often.
• Lose weight, if you need to.
• If you smoke or chew tobacco, try to quit. Your health care provider can help.
• Exercise, but not right after eating.
• Reduce your stress and watch for stressful, tense times. Stress can bother your reflux problem.
• Bend at the knees, not your waist, to pick things up.
• Avoid wearing clothes that put pressure on your waist or stomach.
• Do not lie down for 3 to 4 hours after eating.

Avoid medicines such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain. Take any of your medicines with plenty of water. When you start a new medicine, remember to ask if it will make your heartburn worse.

Try these tips before going to sleep:

• Do not skip meals or eat a large meal for dinner to make up for missed meals.
• Avoid late night snacks.
• Do not lie down right after you eat. Remain upright for 3 to 4 hours after your last meal before you go to bed.
• Raise your bed 4 to 6 inches (10 to 15 centimeters) at the head of your bed, using blocks. You can also use a wedge support that raises the top half of your body when you are in bed. (Extra pillows that raise only your head may not help.)

Drug Treatment

Antacids can help neutralize your stomach acid. They do not help to treat the irritation in your esophagus. Common side effects of antacids include diarrhea or constipation.

Other over-the-counter drugs and prescription drugs can treat GERD. They work more slowly than antacids but give you longer relief. Your provider can tell you how to take these drugs. There are two different types of these drugs:

• H2 antagonists: famotidine (Pepcid), cimetidine (Tagamet), ranitidine (Zantac), and nizatidine (Axid)
• Proton pump inhibitors (PPI): omeprazole (Prilosec or Zegarid), esomeprazole (Nexium), lansoprazole (Prevacid), dexlansoprazole (Dexilant), rabeprazole (AcipHex), and pantoprazole (Protonix)

Follow-up

You will have follow-up visits with your provider to check your esophagus. You may also need to have dental check-ups. GERD can cause the enamel on your teeth to wear away.

When to Call the Doctor

Contact your provider if you have:

• Problems or pain with swallowing
• Choking
• A full feeling after eating a small meal portion
• Weight loss that cannot be explained
• Vomiting
• Loss of appetite
• Chest pain
• Bleeding, blood in your stools, or dark, tarry looking stools
• Hoarseness

References

Abdul-Hussein M, Castell DO. Gastroesophageal reflux disease (GERD). In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2023. Philadelphia, PA: Elsevier 2023:220-222.

Falk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 129.

Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):308-328. PMID: 23419381 pubmed.ncbi.nlm.nih.gov/23419381/.

Richter JE,Vaezi MF. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 46.

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