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Do you experience heartburn after eating a meal? Some people dismiss this as simple indigestion, but if you have it frequently, you may have a common condition called gastro-esophageal reflux or GERD. GERD affects more than 19 million Americans, some of whom never realize they have it. That’s not a good thing since years of untreated reflux can cause inflammation and damage to the lining of the esophagus. This damage in rare cases can lead to strictures and scar tissue around the esophagus that make it hard to swallow or even lead to esophageal cancer.
What is GERD?
There’s a flap that separates your esophagus from your stomach. When you swallow, this flap opens up to allow food to pass from the esophagus into the stomach. It then closes to prevent the backflow of food and gastric acid back into the esophagus. In people who have acid reflux, this flap is weak, allowing the backflow of acid. The most common symptom of GERD is heartburn, usually after eating a meal.
Some people also experience heartburn-like symptoms when they lie flat in bed. Lying flat makes it easier for the flap to open and allow stomach contents to move back into the esophagus. Not only does this lead to burning and chest discomfort, it can cause an acid taste in your mouth or regurgitation of food. Not fun!
Heartburn Isn’t the Only Symptom of GERD
The strange thing about GERD is it can masquerade as other problems. Have a persistent nighttime cough? It could be GERD. The backflow of acid into the esophagus can trigger coughing, especially at night. There are cases of people being diagnosed with asthma, and it turned out reflux was causing the cough and wheezing. Unexplained hoarseness? GERD could be the culprit. The backflow of acid can irritate your vocal cords and even cause a sore throat.
Other possible symptoms are nausea, difficulty swallowing, or feeling like you have a lump in your throat when you swallow. GERD can also cause chest pain that mimics a heart attack. More than a few people have shown up in emergency rooms believing they’re in the throes of a heart attack only to find out they have reflux. Of course, with chest pain you always have to assume it’s coming from your heart and get it checked out before assuming it’s reflux.
What Causes GERD?
No one knows why some people have a weak esophageal flap and others don’t. Being overweight or pregnant increases the risk of reflux since increased abdominal girth puts pressure on the esophageal flap, causing it to open. It’s also been linked with smoking and alcohol use. People who have a hiatal hernia where a portion of their stomach extends above the diaphragm, are also at greater risk for GERD.
The good news is GERD can usually be controlled through diet and lifestyle changes. In Eat to Treat Acid Reflux, we talk about some of the dietary changes that can help relieve the symptoms. Other tips:
Elevate your bed so your upper body, not just your head, is at a more upright angle. The best way to do this is to use a foam rubber wedge. These are available online.
Don’t eat within 3 hours of bedtime, and keep your portions small at every meal. Overeating causes stomach distension, and puts pressure on the esophageal flap.
Avoid alcohol, smoking and caffeinated beverages. These can all worsen the symptoms of GERD.
Lose weight if you’re overweight.
Skip the tight jeans and other tight clothing that constricts your mid-section and puts back pressure on your esophageal flap.
Chew sugar-free gum. Chewing gum increases the flow of saliva. This helps to neutralize the acid that enters your esophagus. Avoid peppermint gum or mints since peppermint can worsen reflux.
Improve your posture. Slumping over puts pressure on your mid-section and can worsen reflux. Stand up straight and tall!
The Bottom Line?
If lifestyle and dietary changes fail to make a difference, there are medications that can help. But lifestyle changes should be a priority since medications used to treat acid reflux are not without side effects. Most importantly, if you’re having symptoms, see your doctor to make sure they’re not related to your heart.