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What most people commonly know as “heartburn” is a symptom of Gastrointestinal Esophageal Reflux Disease, or GERD. Heartburn—a sharp, burning feeling in the chest—can be an occasional problem that doesn’t require anything more than symptom relief with an over-the-counter (OTC) antacid. But if heartburn becomes a persistent problem, it could be a symptom of a more serious issue requiring medical attention. This is especially true if it is accompanied by difficulty swallowing or by weight loss.
GERD occurs when the acidic contents of the stomach flow backwards (reflux) into the esophagus. This happens when the lower esophageal sphincter separating the lower end of the esophagus from the stomach becomes weak or doesn’t close properly. The lining of the esophagus is not meant to withstand stomach acid, which leads to inflammation and pain.
There are several possible causes that can underpin reflux:
- An overly full stomach, which may push some of the acidic contents back up into the esophagus
- A hiatal hernia
- Pregnancy, as the growing uterus presses on the stomach and pregnancy hormones cause digestion to slow
- Drugs that may cause the valve to remain relaxed—these include beta-agonists (used for treating asthma), calcium channel blockers (for treating high blood pressure), some antihistamines (such as Benadryl), and sedatives
- Being obese or overweight
GERD should be taken seriously, especially if you experience symptoms often, since it can lead to other conditions. Too much acid in the esophagus can cause esophagitis (inflammation of the lining of the esophagus), a condition that may lead to esophageal bleeding or ulcers. Also, acid can scar the esophagus, causing it to narrow and make swallowing difficult.
A small percentage of people with long term exposure to GERD develop a condition called Barrett’s esophagus, which can lead to esophageal cancer.
Persistent recurring heartburn is the main symptom of GERD—if heartburn occurs more than twice a week, GERD is the most likely reason. However, older adults may not experience as many symptomatic episodes.
Other symptoms of GERD include chest pain, trouble swallowing, and difficulty keeping food down after meals. Some people taste the stomach acid in the back of their mouth: It has a metallic taste and may cause bad breath. GERD also can cause a sore throat, dry cough, hoarseness, or a repeated need to clear the throat. Some experts believe that GERD may be a cause of sinusitis (inflamed or infected sinuses) and dental erosions.
Because GERD can cause chest pain that may be similar to the chest pain caused by heart problems, it’s important for anyone at risk for heart disease to be checked to rule out a heart-related cause for the discomfort before attributing it to GERD. Risks for heart disease include a personal or family history of heart disease, high total cholesterol, high LDL (“bad” cholesterol), low HDL (“good” cholesterol”), high blood pressure, being overweight or obese, diabetes, smoking, physical inactivity, and being age 65 or older.
Lifestyle Measures for GERD
Certain foods can weaken the lower esophageal sphincter, triggering GERD symptoms. These include chocolate, peppermint, fatty foods, caffeine, and alcohol. If you experience GERD after eating these foods, eliminating them from your diet should relieve the symptoms.
In addition to modifying your diet, there are other strategies you can try to alleviate your symptoms. For example, eat small meals frequently, rather than large ones less often. Don’t eat or drink anything after 7 p.m., and don’t lie down for at least an hour after eating any meal. Also, stop smoking, and lose weight, if you are overweight. Do not wear tight-fitting clothing or belts, and avoid strenuous exercises that increase abdominal pressure, such as sit-ups. To help alleviate heartburn during the night, elevate the head of your bed on six- to eight-inch blocks, or put a foam-rubber wedge below the mattress under your shoulders and upper back. This may help the acid remain in your stomach.
For additional GERD treatments and information on other digestive problems, purchase Digestive Diseases & Disorders from www.UniversityHealthNews.com.