GERD: What Do You Need to Know?
If you regularly have a burning feeling in your chest or throat, you may have GERD, which stands for gastroesophageal reflux disease. GERD can occur in adults, kids, and even babies. It is often painful and can lead to serious health problems. The good news is that GERD is treatable with medicine or surgery. Even making a few simple changes to your diet and lifestyle can help to control the symptoms of this condition.
What Is GERD?
With GERD, the muscle that controls the opening at the top of the stomach doesn't close properly, which allows stomach acid to leak into the esophagus, which often leads to a burning feeling in the chest. Most people experience heartburn occasionally, but if you experience reflux more than twice a week, you might want to see your doctor about the possibility of GERD. Roughly 20% of Americans have GERD.
Here are some key terms you should know to understand the condition:
- Esophagus: The tube that carries food from the mouth to the stomach.
- Heartburn: A burning sensation in the chest or throat.
- Acid reflux: The leaking of stomach contents into the esophagus.
- Antacids: Medications that neutralize the acid in your stomach.
Stages and Types of GERD
The American Association of Family Physicians defines five stages of GERD:
- Stage 1 can be managed with lifestyle changes like losing weight, eating smaller meals, and waiting at least three hours after a meal before lying down.
- Stage 2 requires over-the-counter medicines like antacids.
- Stage 3 requires you to take prescription medicines for a few weeks.
- Stage 4 requires ongoing treatment with prescription medicines.
- Stage 5 often requires surgery if symptoms are severe.
If you don't get suitable treatment for GERD, you could develop Barrett's esophagus, which can lead to permanent damage to the lining of the esophagus. People who have Barrett's esophagus risk the development of esophagus cancer that is 30-125 times higher than normal.
Symptoms and Causes
GERD occurs when the muscle at the top of your stomach is too weak to keep food and acid inside the stomach. Being overweight can cause this muscle to weaken by putting a lot of pressure on it. Smoking and some medications can also weaken the muscle.
Another cause of GERD is a hiatal hernia, where the top part of the stomach moves up into the chest. Usually, the stomach sits below the diaphragm, which is the muscle at the bottom of the chest that controls your breathing.
Symptoms of GERD:
- Stomach acid in the throat
- Nausea and vomiting
- Bad breath
- Trouble swallowing
- Dry cough
Prevention and Risks
Losing weight and quitting smoking are both excellent ways of preventing GERD. You can protect your children from GERD by not smoking around them.
These medicines put people at risk of GERD:
- Medicines used to treat asthma
- Calcium channel blockers used to treat high blood pressure
- Antihistamines (allergy medications)
- Sedatives (sleeping pills)
- Pregnancy can also increase the risk
Ask your doctor for advice about preventing GERD if you think you might be at risk.
Diagnosis and Tests
If you have persistent symptoms that are associated with GERD, your doctor might suggest seeing a gastroenterologist. When diagnosing GERD, doctors look for the most common symptoms, which are heartburn and a feeling of acid coming up into your throat. Not everyone has these symptoms, however. Doctors also look for nausea, coughing, or chest pain.
If your doctor thinks you have GERD, they might tell you to take a drug called omeprazole for 14 days. If this drug reduces your symptoms, you probably have GERD. If it doesn't help, the doctor may recommend more tests.
One very accurate test for GERD is pH monitoring. A doctor places a monitoring device in your esophagus, which measures the acidity over a 24-hour period while you keep a diary of your symptoms. If you have symptoms at the same time as the monitor detects high levels of acid, you probably have GERD.
Treatment, Procedures, and Medication
There are four types of medications that can help to treat GERD:
- Antacids neutralize acid in your stomach.
- H2 blockers reduce the amount of acid that your stomach produces. Your doctor might recommend that you take H2 blockers for a few weeks to let your esophagus recover from acid damage. You can also take them whenever you have heartburn.
- Proton pump inhibitors (PPIs) reduce acid production. Doctors prescribe PPIs as a long-term treatment for GERD. They're more effective than H2 blockers, but they can cause side effects, for instance, a higher risk of bone fractures.
- Prokinetics make your stomach empty more quickly after you eat, which can reduce GERD symptoms.
Your doctor may recommend a combination of medicines for your GERD.
If medications don't help, your doctor might recommend surgery to sew around the top of your stomach to help keep it closed after you eat.
Healthy Lifestyle Tips
Follow these healthy living tips to reduce GERD symptoms:
- Eat small, low-fat meals.
- Eat your last meal of the day at least 2-3 hours before bedtime.
- Stop smoking.
- Cut back on alcohol consumption.
These tips may help you to lose weight, which can also reduce GERD symptoms.
Some other lifestyle tips that may help you feel better:
- Raise the head of your bed by 6-8 inches by placing blocks under the legs.
- Wear loose-fitting clothing.
- Sit upright, stand or walk for three hours after eating.
- Avoid spicy, acidic and high-fat foods.
Lifestyle changes and medications help most people with GERD. Take the time to read about foods that can make GERD symptoms better or worse. Remember to keep your meals small and eat your last meal early in the evening. If you regularly experience GERD symptoms, visit your doctor for help. Your physician can give you medicines and advice to help you feel better.
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