GERD (Gastroesophageal Reflux Disease)

Gastroesophageal reflux disease (GERD) is a digestive problem where there is too much backflow of the stomach’s contents into the esophagus. It’s very common, with about 20% of the adult population experiencing GERD symptoms at least weekly. While the majority of people with GERD do not have any visible damage to the esophagus (no ulcers or precancerous lesions), quality of life can be severely affected. Rarely, patients can develop cancer of the esophagus or strictures resulting in dysphagia (difficulty swallowing food or liquids).

At the University of Michigan’s Esophageal Disorders Program through the U-M Division of Gastroenterology, our dedicated, multidisciplinary team includes experts in minimally invasive surgery, thoracic surgery, radiology, allergy, and pathology.and has broad experience managing patients with gastroesophageal reflux disease symptoms that have not responded to standard medical therapies. We provide the newest in diagnostic testing for GERD, and our robust clinical research includes multiple studies on the causes and treatments for GERD symptoms that are resistant to standard treatments.

GERD Symptoms and Risk Factors

Typical symptoms of GERD include: 

  • Heartburn (burning behind the breastbone traveling toward the neck)
  • Regurgitation (effortless movement of stomach contents into the chest)

Unusual symptoms if presenting without the typical symptoms above: 

  • Excess saliva
  • Sensation of a lump in the back of the throat
  • Coughing
  • Hoarseness
  • Sore throat 

Contact your doctor if you have any of the following symptoms: 

  • Unexplained weight loss
  • Trouble swallowing
  • Choking
  • Blood in the stools
  • Vomiting
  • Pain with swallowing 

Risk factors include being overweight, and jobs that require stooping, bending, or heavy lifting.

Diagnosing GERD

To diagnose GERD, we begin with a thorough conversation to understand your symptoms. Your doctor may determine that additional tests are necessary. They may include: 

  • Upper endoscopy, also known as an esophagogastroduodenoscopy or EGD, uses an endoscope—a lighted, flexible tube, about the thickness of a finger—to examine the upper gastrointestinal tract while you are sedated. The EGD examines the esophagus, stomach, and duodenum, which is the first part of the small intestine. A special instrument may be passed through the tube to take a small piece of tissue (a biopsy) for examination in the laboratory.
  • Ambulatory pH/impedance monitoring uses a thin probe that goes through the nose into the esophagus, and is connected to an external data recorder. The recorder measures the amount of reflux (both acidic and non-acidic) traveling into the esophagus. The patient goes home with it for a day, keeps a diary of symptoms, and returns the next day to have it removed.
  • Catheterless pH capsule uses a pH sensor that is temporarily attached to the wall of the esophagus at the time of an upper endoscopy. Using radio waves, the data is transmitted wirelessly to the external data recorder. This provides data on acid reflux, but not non-acidic reflux. 
  • High-resolution esophageal manometry uses a thin catheter placed through the nose into the esophagus, to measure pressures and coordination of the esophagus while the patient takes sips of water. This helps us rule out rare causes of regurgitation, is needed to accurately place the pH/impedance sensor, and is important to determine whether surgery would be appropriate. We utilize high-resolution esophageal manometry, which gives much greater detail in the swallowing mechanism than the previous technology, which is still often in use at other medical centers.

GERD Treatment Options

There are a variety of treatments for GERD: 

Lifestyle changes may be helpful in relieving some GERD symptoms. Your doctor may ask you to avoid certain foods that can make your symptoms worse, such as chocolate, alcohol, coffee, citrus and tomato-based products. Other recommendations may include losing weight, raising the head of your bed and quitting smoking. 

Over the counter and prescribed medications, which can help relieve symptoms and/or decrease the acid produced from the stomach. 

Surgery may be recommended for patients with typical GERD symptoms who have only a partial response to medication, who have had other conditions excluded, and who have GERD documented using ambulatory pH/impedance monitoring.

Other Information About Digestive and Liver Health

To see related medical services we offer, visit our Digestive and Liver Health overview page.

Make an Appointment

To schedule an appointment to discuss your need for treatment for GERD, call us at 888-229-7408.