Overview
Acid reflux, hiatal hernia, GERD (gastroesophageal reflux disease), and esophagitis are interconnected conditions involving the digestive system, specifically the esophagus and the stomach.
- Acid reflux happens when stomach acid flows back up into the esophagus, causing symptoms like heartburn, regurgitation, and sometimes chest pain. Having occasional reflux is normal but if you have frequent or severe reflux, it can lead to complications like GERD.
- A hiatal hernia is a condition where part of the stomach pushes up through your diaphragm. Most people don’t even realize they have a hiatal hernia and small hiatal hernias don’t usually cause symptoms. If you have a large hiatal hernia, it can cause stomach acid to back up into the esophagus which leads to acid reflux.
- GERD is caused by persistent acid reflux which aggravates the esophagus lining. Most people have experienced acid reflux at some point in their lives. It becomes an issue when it happens more frequently. Symptoms include heartburn, chest pain, difficulty swallowing, and regurgitation.
- Esophagitis is inflammation of the esophagus, usually caused by stomach acid due to acid reflux or GERD. It can lead to symptoms such as difficulty or painful swallowing, chest pain, and heartburn.
How is it diagnosed?
Diagnosing can involve diagnosis tests which include:
- Upper endoscopy (esophagogastroduodenoscopy, or EGD): A procedure where a flexible tube with a camera is inserted through the mouth to examine the esophagus, stomach, and the duodenum. Most often, biopsies are taken and can detect inflammation or other abnormalities.
- Esophageal pH monitoring: This test measures the pH level in the esophagus to determine the severity of the acid reflux.
- Barium swallow: This test, also known as an upper GI series or esophagram, is a series of pictures of the throat, esophagus, stomach and the duodenum. These pictures are taken by x-ray after you drink a liquid that is called barium sulfate and tests your ability to swallow.
- Esophageal Manometry: Measures the function of the esophageal muscles to determine how well they are working.
How is it treated?
Lifestyle changes such as avoiding trigger foods, maintaining a healthy weight, elevating the head of the bed, and quitting smoking can help control reflux symptoms. Medications include proton pump inhibitors (PPIs), H2 blockers, and antacids which can help reduce stomach acid production and relieve symptoms. In severe cases or when medications and lifestyle changes are unsuccessful, surgery like TIF (transoral incisionless fundoplication) can be an option.
References
Mayo Clinic. (2023). Acid Reflux. https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940
National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Acid Reflux and GERD in Adults. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults
American College of Gastroenterology. (n.d.). GERD. https://gi.org/topics/gerd/
Mayo Clinic. (2023). Hiatal Hernia. https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/symptoms-causes/syc-20373379
Cleveland Clinic. (2023). Esophagitis. https://my.clevelandclinic.org/health/diseases/10138-esophagitis Mayo Clinic. (2022). Esophageal Manometry. https://www.mayoclinic.org/tests-procedures/esophageal-manometry/about/pac-20394000
