You’ve experienced it before – that burning sensation in your chest. Occasional heartburn can be a nuisance, but it typically doesn’t indicate a significant problem. You pop an antacid and go on with your day, forgetting that it even happened. Until next time.
When that time comes the next day, or even later that same day, you may find yourself wondering whether it could be something more than just occasional heartburn. You’re right to worry!
Heartburn that occurs twice a week or more may be an indication of a clinical condition known as gastroesophageal reflux disease or GERD.
Keep reading to learn more about this condition includingwhat it is, common symptoms, treatment options, and how to manage it.
Acid Reflux – Understanding the Basics
Heartburn is another name for acid reflux, something that occurs when the contents of your stomach flow backwards through the opening between your stomach and your esophagus. When stomach acid hits the tender lining of your esophagus, it causes that burning sensation you may know all too well. But why does reflux happen and what are the other symptoms?
The first thing you need to know is that there is a ring of muscle at the base of your esophagus that controls the opening into the stomach – it is called the gastroesophageal sphincter. This ring of muscle acts as a valve, allowing food to flow from the esophagus into the stomach and preventing the contents of the stomach from backing up into the esophagus. At least, that’s what it is supposed to do.
Acid reflux occurs when the gastroesophageal sphincter relaxes or fails, allowing stomach contents (including stomach acid) to be regurgitated into the esophagus. A burning sensation is the telltale sign of acid reflux, but you may also experience a sour taste in your mouth, bloating, upset stomach, or general symptoms of indigestion.
When other symptoms like difficulty swallowing, sore throat, hoarseness, dry cough, and asthma symptoms are thrown in the mix, it could be time to worry.
What is GERD, Exactly?
Gastroesophageal reflux disease or GERD is a chronic condition that results from a dysfunctional gastroesophageal sphincter (GES). According to the American College of Gastroenterology, this condition affects roughly 20% of the American population, or about 15 million people.
The underlying cause of GERD is a dysfunctional GES, but there are a number of things that can contribute to that dysfunction. People who have a higher risk for GERD include the following:
- People who are overweight or obese
- Women who are pregnant
- People taking certain medications
- Smokers and people exposed to secondhand smoke
- People with hiatal hernias
People who are overweight or obese (and pregnant women) are more likely to develop GERD due to increased pressure on the abdomen which can cause the GES to malfunction. Certain medications like calcium channel blockers, antihistamines, antidepressants, sedatives, and asthma medications can also cause the GES to relax. Smoking and exposure to secondhand smoke is another risk factor, as is a condition known as hiatal hernia in which an opening in the diaphragm allows the stomach to move upward into the chest.
The primary symptom of GERD is frequent heartburn, though you may also experience nausea and vomiting, bad breath, respiratory issues, difficulty swallowing, and tooth decay. When left untreated, GERD can lead to some serious complications including esophagitis, esophageal stricture, breathing problems, and a condition known as Barrett’s esophagus. Frequent reflux can also wear away at the tissue in the esophagus, causing an ulcer to develop – esophageal ulcers can be very painful.
Esophagitis is characterized by inflammation in the esophagus and esophageal stricture makes the esophagus narrow, affecting your ability to swallow. Breathing problems caused by inhaling stomach acid into the lungs may include asthma, hoarseness, chest congestion, laryngitis, and even pneumonia. Barrett’s esophagus is a condition in which precancerous changes occur in the cells lining the esophagus and it can later develop into cancer.
How Do You Manage It?
If you have severe gastroesophageal reflux disease, your doctor may want to put you on medication to mitigate the damage. One of the main medical treatments for GERD is proton pump inhibitors – drugs that reduce acid production in the stomach. H2 blockers have a similar effect and over-the-counter antacids can help counteract stomach acid in the short-term. Prokinetics are drugs that help the stomach empty faster, reducing the risk for reflux, and erythromycin is an antibiotic that performs a similar function.
In severe cases of GERD, medical treatment may not be adequate.
When surgery is required, there are two primary options: fundoplication and insertion of a LINX device. Fundoplication is a surgical procedure in which the surgeon wraps the top of the stomach around the GES to tighten the muscle and reduce reflux. This procedure is usually done laparoscopically which makes it minimally invasive. Another option is to wrap a ring of magnetic beads around the GES to keep the valve closed. The magnetic attraction is strong enough to keep the valve closed but not too strong to prevent food from flowing normally thorough the esophagus into the stomach.
In addition to taking medications to reduce stomach acid and speed stomach emptying, you should also try to avoid certain things that might trigger reflux. Here are some examples of diet and lifestyle changes you should make to manage GERD:
- Avoid eating large quantities of food all at once
- Thoroughly chew your food before swallowing
- Limit your intake of spicy, fatty, and fried foods
- Do not lie down or go to bed within 2 to 3 hours of eating
- Quit smoking and avoid secondhand smoke
- Achieve and maintain a healthy bodyweight
- Avoid wearing clothing that is tight around the abdomen
- Sleep with your head slightly elevated
If you experience occasional heartburn, an over-the-counter antacid may be all you need to mitigate your symptoms. When heartburn becomes severe or frequent, however, you should talk to your doctor because it could be something more serious – it could be GERD.
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