Heartburn: Don’t Ignore GERD if It Happens Regularly

At one time or another, you probably have experienced heartburn — the uncomfortable, mild burning sensation in the middle of your chest and sour taste in your mouth or throat.  It often occurs when you overeat, eat something that disagrees with you or when you go to bed.  

But when heartburn becomes a frequent occurrence, it should not be ignored.

What Is Acid Reflux?

Heartburn most often is a symptom of acid reflux, which is when the stomach acid that breaks down your food travels back up the esophagus. Normally, a valve that connects the stomach and esophagus only opens when you swallow food or liquids. But there are several factors that can cause it to reopen or stay open all the time, allowing reflux to occur.

These include:

• Certain foods and drinks, such as coffee, tomatoes, alcohol, chocolate and fatty or spicy foods
• Consuming too much food
• Being overweight
• Smoking
• Pregnancy
• Stress and anxiety
• Increase in some types of hormones, such as progesterone and estrogen
• Medicines, such as anti-inflammatory painkillers (like ibuprofen)
• Hiatal hernia or a “lax valve”

What Is GERD?

GERD (gastroesophageal reflux disease) is a more severe form of acid reflux. With GERD, the backflow of stomach acid occurs chronically and causes damage to the body over time. Symptoms of GERD include:

• Heartburn
• Sore throat and hoarseness
• Choking sensation
• Regurgitation (food comes back into your mouth from the esophagus)
• Feeling like food caught in your throat
• Unexplained coughing
• Chest pain
• Problem swallowing
• Vomiting
• Hoarseness
• Shortness of breath – “asthma-like” presentation
• Erosion of tooth
• Disturbed sleep

Diagnosing GERD

If you have mild acid reflux that occurs at least twice a week or severe acid reflux at least once a week, you have met the standards to be diagnosed with GERD. To confirm that diagnosis, your doctor likely will want to do an endoscopy.

An endoscopy is a simple procedure that is done when you are asleep under anesthesia. Your doctor will insert a thin, flexible tube equipped with a light and camera down your throat. This allows your doctor to see inside your esophagus and stomach to spot inflammation or diagnose and treat any complications. Your doctor also can collect a sample of tissue, called a biopsy, to be tested. In some instances, if a narrowing is seen in the esophagus, it can be stretched or dilated during this procedure to improve trouble swallowing.

Treating GERD

There are four approaches for GERD treatment: lifestyle and dietary changes, medication, endoscopic therapy and surgery. Most people have improvement with a combination of dietary changes and medication. Some need just endoscopic therapy to cure GERD and also to come off the long term medication use. Some need a combination of endoscopy and surgery, both of which involve wrapping a portion of the stomach around the esophagus to create a tighter valve between the stomach and esophagus to control the acid leak. Another surgical option is the LINX, a magnetic band that is placed around the weakened valve to prevent acid reflux.

Dangers of Leaving GERD Untreated

GERD isn’t life-threatening, but long-term GERD can lead to more serious health problems such as Barrett's Esophagus. About 10 percent of people who have long-term GERD develop Barrett's esophagus, which is when the cells in the lining of the esophagus change and can lead to cancer. Cancer that begins in the esophagus is divided into two major types. Adenocarcinoma usually develops in the lower part of the esophagus. Squamous cell carcinoma begins in the cells that line the esophagus, usually in the upper and middle parts.

Tips for Enjoying the Holidays with GERD

Just because you have GERD doesn’t mean you can’t enjoy your favorite foods and drinks during the holidays. If you make smart choices, you are less likely to experience the unpleasant symptoms. Try these tips:

• Eat slowly
• Eat smaller but more frequent meals
• Drink more water
• Minimize carbonated beverages and alcohol
• Avoid chocolate and peppermint
• Have an antacid ready
• Don’t lie down too soon. Wait at least two hours after eating.

If you do overindulge, you may be able to ease your symptoms by taking an antacid, drinking extra water and milk, and raising the head of your bed.