GERD

Gastroesophageal reflux disease (GERD) can be thought of as chronic heartburn. The term refers to the frequent backing up (reflux) of stomach contents (food, acid and/or bile) into the esophagus. GERD also refers to the array of medical complications, some serious, that can arise from this reflux.

Though it causes discomfort, occasional heartburn is not harmful. About 20% of adults in the U.S. experience GERD symptoms such as heartburn and acid regurgitation at least once a week. But if you have heartburn frequently and it is untreated, your stomach’s acid may inflame the lining of your esophagus or swallowing tube, potentially narrowing it.

Stomach acid may also change the cells of your esophagus. This change, called Barrett’s esophagus, increases the likelihood of cancer of the esophagus. Only a small percentage of people with GERD develop Barrett’s esophagus. Your stomach’s contents can also move into your throat and be drawn past your vocal cords and into your lungs, where they can cause damage, along with hoarseness, a chronic dry cough, or asthma.

Anyone can develop GERD at any age. You are more likely to develop it as you get older. Nearly one out of every 10 American adults has heartburn daily. Pregnant women are especially prone to GERD; nearly one out of every four pregnant women has heartburn every day.

GERD and Heart Disease

GERD can cause a crushing pain in your chest identical to the pain of a heart attack. Sometimes medical professionals diagnose GERD after treating a patient for repeated episodes of chest pain that are not caused by heart disease.

IMPORTANT! Never ignore pain in your chest. If you think you are having a heart attack, any delay in getting help may be fatal. If your doctor says you have GERD, ask what you should do when you have chest pain.

Esophagitis, Barrett’s Esophagus, and Cancer of the Esophagus

Esophagitis, or inflammation of the esophagus, is a complication of GERD. If GERD is left untreated, esophagitis can cause bleeding, ulcers and chronic scarring. This scarring can narrow the esophagus, eventually interfering with your ability to swallow.

One major complication which occurs in about 10% of people with chronic or longstanding GERD is Barrett’s esophagus. Barrett’s esophagus results when the normal cells of the esophagus are replaced with cells similar to those of the intestine. It is a precancerous lesion that increases the risk of esophageal cancer. Developing Barrett’s esophagus does not mean you will get cancer, but your chances of getting cancer will be greatly increased. Your doctor will want to check you on a regular basis in order to detect any cancer in its early stages. People who have Barrett’s esophagus may require periodic endoscopies with biopsies to check for cancer.

Asthma and Other Complications

Pulmonary, or lung, damage is a complication of GERD. GERD can lead to the reflux of fluid into the lungs; this can result in choking, coughing or even pneumonia. Some cases of adult-onset asthma, especially in those with no history of allergies or childhood asthma, can be traced to GERD. In some patients reflux may worsen asthma symptoms. Treating GERD may help improve asthma symptoms.

GERD can also lead to chronic hoarseness, sleep disturbance, laryngitis, halitosis (bad breath), growths on the vocal cords, a feeling as if there is a lump in your throat, earaches, and dental problems.

What Causes It?

When you swallow, a muscular valve known as the lower esophageal sphincter, or LES, which is located where the esophagus joins the stomach, opens to let food into your stomach and then closes to keep your stomach contents from coming back up. The major cause of GERD is that this valve that does not function the way it should — either because it is weak or because it relaxes inappropriately. Hiatal hernia is a common cause of a weak LES.

Diet and lifestyle also play a role. Fatty foods, mints, chocolate, alcohol, coffee, and tea all relax the LES. So does nicotine, from cigarettes or chewing tobacco. Hormonal changes associated with pregnancy can temporarily weaken the LES, too. Obesity can lead to GERD because the pressure of extra weight pushing on your abdomen may “overpower” the LES, allowing reflux to occur. The same mechanism explains reflux that may occur when you bend over at the waist.

What Can You Do To Prevent It?

1 . BED BLOCKS - Elevate the head of your bed 2-6 Inches with wood blocks or bricks.  Using extra pillows is NOT a good substitute.  Use of a foam wedge beneath the upper half of the body is an alternative.

2. AVOID FOODS IF THEY CAUSE SYMPTOMS – Foods that may aggravate symptoms include: spicy and fatty foods, tomato and citrus juices (such as grapefruit and orang juices), chocolate, mints, coffee, tea, colas, and alcoholic beverages.

3. DO NOT LIE DOWN FOR 2 HOURS AFTER EATING – Allow gravity to work.  Also, avoid bending over at the waist to pick up things; instead bend at the knees.

4. STOP SMOKING – If you cannot stop, decreasing the number of cigarettes you smoke may help.

5. LIMIT COFFEE – Limit coffee to 2-3 cups per day.  Limiting consumption of other caffeine-containing beverages (tea, soft drinks) may also be helpful.

6.  AVOID TIGHT CLOTHING – Tight belts, tight pants or girdles can increase the pressure on the abdomen.

7. ANTACIDS – Antacids can be taken at bedtime and 30-60 minutes after each meal or as directed by your physician.

8. EAT SMALLER MEALS – Don’t overfill your stomach.

9. LOSE WEIGHT – Excess weight increases the amount of pressure constantly placed on your stomach.  Even small amounts of weight loss may help.