Gastroesophageal Reflux Disease (GERD) — often called acid reflux — is a common digestive disorder that occurs when stomach acid or contents flow back into the esophagus. The resulting “reflux” irritates the lining of the esophagus and causes the GERD.
Heartburn is a common problem that people may experience every so often. But, if you start having symptoms more frequently – two or more times a week – or they interfere with your daily life, you may have GERD.
The following symptoms are most common to GERD:
- Heartburn – a frequent burning sensation in the middle of your chest and stomach;
- Bad breath;
- Pain in your chest or upper abdomen;
- Difficulty (or painful) swallowing;
- Breathing issues;
- Vomiting; and
- Wearing down of your tooth enamel.
The main cause of GERD is when the Lower Esophageal Sphincter (LES) weakens or relaxes when it shouldn’t. The LES is a muscle in between your esophagus and stomach that opens and closes to allow the passage of food. If the LES doesn’t work properly, then stomach contents can reflux back into the esophagus.
Some reasons the LES may weaken or relax are
- Being obese or overweight, or even pregnant – all of which increases pressure on your stomach;
- Taking certain medications, like those to treat asthma, high blood pressure, allergies, and depression;
- Smoking or being exposed to second-hand smoke; and
- Having a hiatal hernia – the upper part of your stomach can move through an opening in your diaphragm into your chest, lowering pressure in the LES.
Prevention is key in dealing with GERD. Below are some tips:
- Maintain a healthy weight – extra weight increases abdominal pressure;
- Wear loose-fitting clothing to avoid pressure on your abdomen;
- Avoid trigger foods or drinks – common ones are fatty and fried foods, alcohol, chocolate, tomato-based foods, garlic and onion, and caffeine;
- Eat smaller meals;
- Avoid lying down after eating for at least three hours;
- Elevate the head of your bed by six to nine inches if you experience nightly heartburn; and
- Quit smoking – smoking decreases the LES’s functionality.
Treatment includes a variety of medications – both over-the-counter (OTC) and prescription – and surgical options. Most people start with OTC medications, but if you don’t experience symptom relief from them within two to three weeks you need to contact your doctor.
Antacids are OTC medications that work quickly and are short-acting. They are often the first type of medication recommended for mild GERD symptoms. Some examples include:
H2 Receptor Blockers block acid production and come as OTC and prescription medications. They’re longer acting, but they also take longer to work. Some examples include:
Proton Pump Inhibitors (PPIs) are a stronger form of acid blockers, and are also both OTC and prescription. They’re usually reserved for long-term treatment because they can heal most people’s esophageal lining. However, long-term or high-dose usage can lead to bone fractures. Some examples include:
- Dexlansoprazole (Dexilant);
- Esomeprazole (Nexium 24Hr);
- Lansoprazole (Prevacid 24Hr);
- Omeprazole (Prilosec, Zegerid);
- Pantoprazole (Protonix); and
- Rabeprazole (Aciphex).