March 02, 2023
Most people have experienced heartburn at one time or another, often after a heavy meal. But for some people, that burning pain in the chest can be a frequent occurrence.
Gastroesophageal reflux disease, or GERD, is a chronic and more severe form of acid reflux, in which the contents in the stomach move back up into the esophagus, the tube that carries food and liquid from the throat to the stomach.
About 20% of Americans have GERD, according to the National Institute of Diabetes and Digestive and Kidney Diseases. People who are obese or pregnant, and those who smoke, are more prone to reflux. It can be caused by overeating, too.
Studies also have suggested that heavy drinkers and people who frequently use nonsteroidal anti-inflammatory drugs, like aspirin, have an elevated risk for GERD. Conditions like anxiety, asthma and irritable bowl syndrome often occur alongside it.
Health experts say that it is important not to ignore symptoms, because GERD can lead to complications, including esophagitis, inflammation in the esophagus. Another complication, Barrett's esophagus, when the lining of the esophagus heals abnormally, increases the risk for esophageal cancer.
People with GERD also suffer from dental problems such as tooth enamel erosion, cavities and gum disease.
Both lifestyle changes and medication can help people manage their symptoms.
Symptoms may include:
• Experiencing acid reflux more than twice a week
• A frequent sour or bitter taste at the back of the mouth
• Bad breath
• Nausea
• Chest pain
• Difficulties swallowing, including pain when swallowing
• Chronic cough and sinusitis
• A hoarse voice
For many people with GERD, lifestyle changes are enough to manage symptoms. Depending on their situations, doctors may recommend people make several changes:
• Lose weight, if a person has obesity
• Quit smoking
• Avoid eating big meals in the evening
• Wait several hours after eating to lie down
• Keep your head elevated while sleeping by raising the head of the bed by 6 to 8 inches
• Reduce alcohol and soda consumption
• Limit consumption of fried food, foods with high fat content, citrus fruits and juices, tomatoes and tomato sauce, onions and mint
Doctors also may recommend medication to provide some relief. There are various over-the counter medications that can ease symptoms, but they also may cause side effects. Higher doses require a prescription.
The medications each work differently. Antacids, like Tums, neutralize the acid in the stomach by stopping the enzyme responsible for creating acid to break down food for digestion. H2 receptor blockers, like Pepcid AC, compete with histamine for H2 receptors on the stomach's parietal cells, decreasing the production of hydrochloric acid. And proton pump inhibitors, like Prilosec, target the proton pumps in the stomach to reduce acid.
Doctors emphasize that it is best to not self-diagnose GERD or self-medicate. They advise people to consult a doctor before beginning new medications. GERD is usually diagnosed through esophageal pH monitoring or via an upper endoscopy, a procedure in which a flexible tube with a tiny camera is inserted into the throat to allow a doctor to examine the esophagus and take tissue samples.
In more severe cases, when there is a lot of damage to the esophagus, doctors may recommend surgery. One procedure involves sewing the top of the stomach around the esophagus.