You just ate a big meal with lots of different foods and drinks. You seem tired, sit on your comfy chair and watch TV. Suddenly, you feel a progressive pain creeping up from your stomach area to your upper chest. Is it a heart attack or is it heartburn? Unless you have cardiac issues, those symptoms are caused by the foods you ate. You may be in a class that 20% of Americans share. You may have GERD.
Once upon a time, about 60 years ago, it was believed that highly stressed people were more likely to develop an ulcer, an acidic deterioration of a stomach lining. As time went on, and gastrointestinal doctors found new methods of detecting those simple post food binge eating, GERD became the cause of heartburn. Gastro-esophageal reflux (GERD) disease occurs when the amount of gastric juice that refluxes into the esophagus exceeds the normal limit. GERD is a normal physiologic phenomenon experienced intermittently by most people, particularly after a meal. If you are GERD sensitive, the results can be painful and frightening. GERD has replaced ulcer as the most common digestive disorder.
GERD is a dysfunction of the muscle that keeps the stomach closed (sphincter). When that happens, a passage is opened that can allow stomach acid to leak into the esophagus (acid reflux), causing irritation. In most cases, the sphincter malfunction is rare so the irritation is minimal. When it is less rare, and you eat irritable foods, GERD may evolve into requiring more medically invasive procedures. Visiting a gastroenterologist doctor is vital if heartburn is a frequent disturbance.
GERD is an irritation. It is sometimes misdiagnosed. Esophagitis may be similar to GERD but is inflammation that damages tissues of the esophagus, the muscular tube that delivers food from your mouth to your stomach. Unlike GERD, it may also be caused by bacterial and fungal infections. If left untreated, esophagitis may change the structure and function of the esophagus. The armory of dugs and procedures to treat esophagitis is different than GERD. It is vital to discuss this distinction with your health care professional. There are GERD overlaps but there are subtle distinctions.
Certain foods are associated with bringing about GERD symptoms. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse. Citrus fruits and peppermint may trigger many symptoms. The foods that irritate more or less are often individual specific. GERD is classed as a common disease, almost as prevalent as a common cold. GERD symptoms include:
•Hoarseness, sore throat
•Chest pain that isn’t heart-related (heartburn)
•Dental (teeth) enamel erosion
•Dysphagia – Difficulty swallowing
•Regurgitation – Vomiting
Per US government statistics, in 2004, 1 out of 5 Americans have weekly symptoms of GERD. It is so common that pharmacy shelves are filled with different over-the-counter medications to help control GERD symptoms. Large numbers of Americans use over-the-counter (OTC) drugs to treat minor gastrointestinal problems such as infrequent heartburn, according to the American College of Gastroenterology (ACG). In fact, OTC medicines are often among the initial treatments for heartburn, acid reflux, and other symptoms of GERD. In many cases that are mild or age-related, OTC is a recommended regimen by many doctors. Diet and lifestyle changes may be beneficial but, in practical terms, taking a pill is simpler.
You already may be using Alka-Seltzer, Maalox, Pepto-Bismol, Rolaids, and Tums. These are the most common OTC GERD symptom reducers. OTC GERD symptom relievers are different in the way they treat the problems. One may be more suitable for you than another. Ask your physician about preferences in treating your type of GERD problem. Every pill is a risk-benefit balancing act and you should be aware of them before using. GERD OTC are to be used by adults and side-effects and contraindications must be read carefully. There are 3 classes of GERD OTC:
Antacids, such as Mylanta and Tums – Antacids neutralize stomach acid and relieve heartburn. If you want to take medicine only when your symptoms bother you, antacids are a good choice.
H2 blockers, such as Cimetidine (Tagamet) and Famotidine (Pepcid) – H2 blockers reduce the amount of acid in the stomach. Most are available in both nonprescription and prescription strength. If nonprescription H2 blockers don’t relieve your symptoms, talk to your doctor about trying prescription-strength medicine.
Proton pump inhibitors, such as lansoprazole (Prevacid) and omeprazole (Prilosec) – Proton pump inhibitors (PPIs) reduce the amount of acid in the stomach. This is the most recent FDA approved class and is considered the strongest OTC available.
There are lots of OTC meds for GERD. They aren’t the only ways to manage GERD but are the simplest. GERD is an irritation and there are lifestyle changes that may help reduce and possibly heal symptoms:
Remove irritant foods and replace with soothing foods. This isn’t easy. Most foods Americans favor are GERD irritants. It can be extremely difficult.
It is not advisable to go to sleep directly after eating a meal. If you do, sleep with your upper body elevated. It helps prevent gravity from moving food into the esophagus while asleep.
Red wine seems to exacerbate GERD-related heartburn. Carbonated drinks and caffeine can also prompt reflux. Water is seen as the best beverage. Non-acidic drinks may be used to avoid flavor withdrawal symptoms.
Manage your weight – While not all overweight people have GERD, those who eat a lot of foods that may cause heartburn are likely to be overweight. Fat adds pressure to your stomach. Setting goals to trim down helps manage GERD. Not always easy.
Do not eat in tight clothing – Wearing looser clothes can also help relieve some of the pressure on your stomach and, in turn, gastric pressure within your stomach. Fashion may rule but, if you have GERD, you have to suffer for your style.
Fried foods are staples of the American diet. like Fried Chicken, Fried Fish, French fries or onion rings. GERD sufferers have to leave them alone. In many areas of the USA, this may be downright masochistic. How many can you avoid?
Studies are generally inconclusive about the benefits of alternative medicine at treating GERD symptoms. No alternative medicine therapies have been proved to treat GERD or to reverse damage to the esophagus. Tread delicately here. If you choose this route, find a very qualified holistic practitioner to help you.
There are some old-time remedies that were used for upset stomach. The belief was that dark toasted bread had carbon or charcoal. Charcoal was used to treat poisonings and to reduce intestinal gas (flatulence). It is still claimed to do so as a dietary supplement. Ginger is an herb that is found in the produce departments of many supermarkets. Ginger is also available as crystalized candy, and as supplements. Ginger is commonly used as a home remedy to treat various types of stomach problems, including motion sickness, morning sickness, colic, upset stomach, gas, diarrhea, and nausea. Using ginger in a diet may help some digestive symptoms but may not necessarily be effective as routine treatment for chronic GERD.
According to some studies and surveys, stress may very well be another trigger for heartburn. Stress causes anxiety and some believe that anxiety causes heartburn. A response to chronic “Fight or Flight” stress is an increase in stomach acids and gases. Added pressure may irritate GERD sufferers as the sphincter may shift and release gases into the esophagus. The relationship is more indirect. Exercise has been shown to help reduce anxiety levels.
GERD and heartburn are closely related. It is usually the primary complaint. Hoarseness and repetitive throat clearing is also common. Some of the symptoms experienced by GERD suffers may actually come from other sources. You might have GERD or you might have something else. Try to find a doctor that is willing to speak with you about concerns and possibilities. Unfortunately, insurance systems may make those types of doctors more scarce.
Abdominal pain comes from organs within the abdomen or organs adjacent to the abdomen. In GERD the pain seems to be at a higher location. It’s in the esophagus that also passes adjacent to the heart cavity. That is why it is called heartburn.
When the foods you eat seem to linger and produce unwanted physical effects, you might have GERD. An exam at your gastroenterologist will let you know. If you have GERD, you are joining a large group that comprises 20% of the USA population. You are not alone. There’s a lot of information available on websites and social media for learning and sharing.