Anyone who’s ever reached for an antacid tablet after a really good meal or been abruptly awakened from a restful slumber will say acid reflux is a killjoy. When it becomes a chronic condition, it is known as GERD or gastroesophageal reflux disease. GERD is the more severe form of acid reflux, which can cause great discomfort. This serious condition can also lead to precancerous changes in the lining of the esophagus.
Gastroesophageal reflux (GER) happens when your stomach contents come back up into your esophagus. Gastroesophageal reflux disease (GERD) is a more severe and long-lasting condition in which GER causes repeated symptoms or leads to complications over time. The American College of Gastroenterology says that one in five people in the United States experiences heartburn every day. GERD is one of the most common gastrointestinal diseases affecting up to 20% of the U.S. population and is predominantly found in the elderly, obese and pregnant women.
The most common symptoms of GERD are heartburn and regurgitation. Heartburn is a burning sensation in the chest behind the breastbone. Regurgitation is a feeling of fluid or food coming up into the chest. Many people experience both symptoms, however, some patients can have one without the other. During an episode of nighttime acid reflux, you may find yourself choking or coughing uncontrollably when that acid finds its way up. Difficulty swallowing or the sensation of a lump in your throat are also common symptoms. Ignoring persistent symptoms of GERD can damage the esophagus since the constant backwash of acid irritates the lining and can cause scar tissue to form over time.
Most people can manage the discomfort of GERD with over-the-counter medications and lifestyle changes such as:
- Avoid certain foods. Fried and fatty foods cause trouble. Foods with greater fat content can take longer to digest. The longer that food stays in the stomach, the more likely it is to be refluxed back into your esophagus. Carbonated beverages can also cause acid reflux by expanding the stomach which can cause relaxation or lowering of lower esophageal pressure. Other foods are direct irritants, such as citrus fruits. Alcohol has a low pH and irritates the esophagus and stimulates acid production. Coffee can also be on the acidic side. If you drink something and it burns going down, it’s a good hint that it will bother you if you have too much. It’s also been shown that people take longer to consume acidic foods. They take smaller bites, so the acid is in the esophagus much longer.
- Eat regularly and drink water throughout the day. An empty stomach can cause problems as stomach acid can collect. Nocturnal acid reflex is a real concern. Wait at least two to three hours after eating before you go to bed. And watch how you sleep. Liquid and gas want to go to the path of least resistance. Elevate your head six to eight inches in bed. Some research suggests that lying on your left side can reduce acid reflux.
- Drop some pounds. Obesity or overeating can up your chances of having GERD by increasing your stomach pressure. Even a ten percent reduction in weight can reduce symptoms.
- Being active can help with reflux as well. The muscles around the lower esophagus can strengthen when you exercise, making the area tighter. When you have acid in your stomach, there’s more of a barrier so it doesn’t go up into your esophagus.
If lifestyle tweaks don’t work, there is medication. Over-the-counter antacids neutralize stomach acid and offer fast relief. For moderate to severe acid reflux, H2-receptor blockers reduce the production of acid in your stomach. The next choice is proton pump inhibitors which block stomach acid secretion giving damaged esophageal tissue time to heal. Many of these medications are over-the-counter, but a doctor can prescribe them in higher doses.
While GERD usually reacts to medication, if the problem is persistent, your doctor may suggest a medical procedure or surgery. Laparoscopic fundoplication is a minimally invasive procedure in which a surgeon wraps the top of your stomach around the lower esophageal sphincter to tighten the muscle and prevent reflux.
If left untreated, severe chronic heartburn/GERD has been linked with esophageal cancer and should not be ignored. If you are having heartburn two or more times a week, see a physician. The preventative strategy is to treat GERD. If it goes untreated and cancer does develop, the survival rate for esophageal cancer is dismal.
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