Lifestyle changes can ease complications
The name is almost as long as the list of symptoms attached to the condition, and if left untreated, gastroesophageal reflux disease can lead to very significant health complications.
As defined by the National Institute of Health, GERD is a disease in which contents from the stomach leak back upward into the esophagus, which can irritate the tube that connects the mouth to the stomach and cause a number of symptoms.
While heartburn is one of the most common symptoms, feeling as if food is stuck behind the breastbone and nausea after eating are common as well.
“[Other] symptoms of [GERD] are burning in the chest or throat or acidic taste in the mouth, stomach or chest pain, difficulty swallowing, sore throat or hoarseness and a persistent cough,” said Dr. Donna Wyatt with Primary Care Associates, an extended provider of CHRISTUS Health.
Symptoms may get worse when bending over or lying down, when eating or at night, according to the NIH.
The muscle fibers in the lower esophagus prevent swallowed food from traveling back up from the stomach, but when they don’t close all the way the contents of the stomach are able to leak upward, causing gastroesophageal reflux. The stomach acids may even damage the lining of the esophagus.
“Reflux occurs when acid enters the esophagus from the stomach because of a weakness in the esophagus or distention of the stomach,” Wyatt said. “Symptoms occur when this becomes bothersome and can be caused by a hiatal hernia [a weakness of the diaphragm], or H Pylori infection of the stomach.”
The symptoms caused should be warning signs of a possible problem, but the intensity and duration are key factors for when to contact a health-care professional.
“Significant symptoms that should prompt you to see your doctor include [the previously identified symptoms mentioned] that do not improve or resolve with treatment, symptoms lasting longer than six months, difficulty swallowing liquids or solids, associated weight loss, chest pain, choking when eating, vomiting blood or coffee ground substances, or blood or tar-like stools,” Wyatt said.
There are certain lifestyles that put some at a greater risk of developing GERD than for others, including being overweight, pregnancy, having a poor diet, smoking and drinking alcohol. Wyatt said those risk factors, also including eating large meals and certain types of food will put you at risk for making the symptoms of GERD worse.
According to the NIH, pregnancy can either bring on gastroesophageal reflux or worsen the condition as can certain medications. Some of those medications include anticholinergics (for seasickness), beta-blockers for high blood pressure or heart disease, bronchodilators for asthma, dopamineactive drugs, sedatives and others. It’s important to consult a doctor before stopping or changing medication if you believe it’s causing heartburn or other GERD symptoms.
Wyatt said GERD can be treated, but that there are certain lifestyle changes that can significantly help with easing symptoms.
“You can improve symptoms and treat reflux by avoiding [smoking, alcohol and large meals, losing weight, avoiding acidic, spicy or greasy foods, avoiding triggers like coffee, chocolate, peppermint, avoid late and large meals, avoid tight clothing and raising the head of your bed at night.”
The NIH also suggests avoiding particular drugs such as aspirin, ibuprofen and naproxen. If a pain reliever is needed, Tylenol, or acetaminophen, is recommended. When taking any medication, it’s also recommended to drink them with plenty of water and to ask a doctor if a new medication will worsen any heartburn.
Treatment for GERD may vary depending on severity and circumstance; however, many patients tend to improve with lifestyle changes. For some, overthe-counter antiacids can be taken after meals and before bed, but for others stronger medications might be necessary.
“You can take medications like antacids for mild symptoms, histamine blockers (like Pepcid) or stronger medications like proton pump inhibitors like Prilosec or Nexium,” Wyatt said. “There are also prescription medications that can help.”
Proton pump inhibitors decrease the amount of acid that is produced in the stomach. In more severe cases, anti-reflux surgery may be an option. Surgery may only be necessary for when medications and lifestyle changes don’t help with symptoms, though medicine for heartburn may still be needed.
In any circumstance, consultation with a physician is needed to determine the extent of treatment needed.
“There are blood and breath tests that can diagnose H. Pylori infections and procedures like upper endoscopy that can determine if there are any other serious complications that need to be addressed,” Wyatt said.
It’s important to discuss with your healthcare provider the options available for GERD. For more information about the disease, visit www.nlm.nih.gov.
