Hello everyone! Happy Thanksgiving week to you all! It is hard to believe that the holiday season is now upon us. Did you know that the week of Thanksgiving is GERD Awareness Week? It makes sense given the way that we normally overindulge on Thanksgiving!
So, what is GERD? GERD stands for gastroesophageal reflux disease. GERD is extremely common and may otherwise be known as “heartburn”. I will talk a little more about what GERD is and how it is treated.
Overview of GERD
Gastroesophgeal reflux occurs when stomach contents reflux or back up into the esophagus or mouth. The esophagus is an approximately 10 inch tubelike structure that connects the mouth to the stomach. Some degree of reflux from the stomach to the esophagus is normal in children and adults. However, GERD occurs when reflux causes bothersome symptoms or damage to the esophagus.
Symptoms of GERD
The most common symptom of GERD is heartburn which is a burning sensation in the middle of the chest which may also spread to the throat and cause an unpleasant acid taste.
Other symptoms can include:
- Upper abdominal pain
- Difficulty swallowing foods and pills
- Painful swallowing
- Worsening dental disease
- Hoarseness of voice
- Persistent sore throat
- Chronic cough
- Sensation of a “lump in the throat”
- Recurrent pneumonia
- Recurrent sinus infections
Of course, many of these symptoms are associated with other health problems. Your provider will be able to make an accurate diagnosis based on your history.
Symptoms usually make the diagnosis. However, more invasive testing may be considered in the presence of serious symptoms. An endoscopy is one example of testing performed for GERD. During an endoscopy, the esophagus, stomach, and small intestine are viewed by a long, flexible tube with a camera inside. The doctor is able to see if these structures are damaged and can take biopsies if appropriate.
Complications of GERD
Longstanding GERD can cause many complications. See them listed below.
- Ulcers can form in the stomach or esophagus as a result of acid. These ulcers can sometimes cause bleeding.
- Esophageal stricture (narrowing) can occur as a result of scar tissue, making swallowing more difficult
- Pneumonia from acid entering the lungs (aspiration pneumonia)
- Throat problems such as sore throat, inflammation to vocal cords, or hoarse voice
- Barrett’s esophagus occurs when normal cells in the esophagus are replaced by abnormal cells as a result of acid damage. The risk of esophageal cancer is greater in those with Barrett’s esophagus. People with Barrett’s esophagus are monitored closely with periodic endoscopies.
Treatment of GERD
People with minor symptoms of GERD should try lifestyle modifications first. These include:
- Weight loss
- Raising the head of the bed 6-8 inches. Use bricks, books, or foam wedges under the mattress to achieve this. Commercial products are also available. Do not use pillows as this may cause an unnatural bend in the body.
- Avoid foods that trigger acid reflux such as chocolate, fried foods, peppermint, tomatoes, oranges, alcohol, and caffeine. Drinking milk can help neutralize stomach acid.
- Quit smoking! Smoking provokes coughing and reduces the amount of saliva in the mouth and throat. Saliva helps to clear stomach acid.
- Avoid lying down or sleeping after eating (think gravity).
- Avoid tight fitting clothing. Tight clothes can increase the amount of pressure in the stomach.
- Antacids such as Tums, Maalox provide short-term relief when symptoms occur
- Histamine blockers reduce stomach acid production. Pepcid and Zantac are examples.
- Proton pump inhibitors (PPIs) are stronger and more effective than histamine blockers to reduce production of stomach acid. Prilosec, Protonix, Nexium, and Prevacid are examples. You should take the lowest dose for the shortest amount of time to control symptoms and prevent complications. Long-term use of PPIs can be associated with things like nutritional deficiencies and low bone density. Always consult with your provider when taking these drugs.
Many people struggle with GERD. If you are often experiencing bothersome symptoms, consider speaking with your healthcare provider to get appropriate treatment.
Have a wonderful and safe Thanksgiving!
Disclaimer: Information contained in this post should not be substituted for medical advice. If you think you are having a problem, contact your own provider who knows your health history.