By Richard Benetti, M.D.
Preventive Medicine, Hypertension, and Diabetes Management in Malden and Stoneham, MA
GERD symptoms can be painful, but your doctor can help you manage them successfully.
There’s nothing like heartburn to ruin your favorite meal. But for people who have been diagnosed with gastroesophageal reflux disease (GERD), it’s more than an inconvenience – it interferes with their daily lives.
It sometimes can be a challenge to treat GERD symptoms, which often are uncomfortable and painful. I talk to patients all the time about how they can better manage their symptoms and improve their quality of life. Even if you’re currently on medication for GERD, you can take these three steps to reduce or eliminate your symptoms — and maybe even the need for medication.
1. Lose weight
I said this in my previous post about GERD, and I can’t stress it enough: The best thing you can do to manage your GERD is to lose weight.
Researchers in multiple studies have proven the positive effects of weight loss on GERD symptoms. In a 2014 study, researchers worked with patients on a structured weight-loss program that included changes to their diets and an exercise routine. Nearly all of the patients on this program — 81 percent — saw their GERD symptoms improve, and most of the patients eliminated their symptoms altogether.
When my patients ask me how they can change their diets to lose weight and better manage their GERD symptoms, here’s what I tell them:
- Reduce saturated fats
- Eat smaller portions
- Avoid foods that are high in carbohydrates (sugar, processed flours, potatoes, bread, pasta, etc.)
- Exercise regularly
Talk to your doctor about an exercise program. Regular exercise will help you lose weight faster and more effectively than dietary changes alone.
2. Avoid foods that trigger heartburn and GERD symptoms
Certain foods are more likely to trigger heartburn and other symptoms associated with GERD, including sharp chest pain, a burning or sore throat, and even wheezing or coughing. Triggers are person-specific, which means what causes GERD symptoms in one person may not cause them in another.
Generally, I recommend that my patients avoid:
- Acidic foods, such as tomatoes and oranges
- Alcohol, tobacco, and peppermint
- Soda and other carbonated drinks
- Spicy foods
Patients with GERD also can relieve or reduce their symptoms by decreasing the amount of fatty foods they eat and by eating smaller, more frequent meals instead of three large meals a day.
3. Take medication – but make sure you need it
There are medications out there to treat chronic heartburn and other GERD symptoms, such as proton-pump inhibitors (PPIs). When you have heartburn, the burning sensation occurs when the acid your stomach uses to break down food backs up into your esophagus. PPIs block the production of gastric acid, so less of it is there to potentially cause heartburn and other GERD symptoms.
PPIs are very effective, but we’re starting to see that patients who take them long term may experience side effects. The Food and Drug Administration (FDA) has issued several safety warnings since 2010 about risks patients may face if they take PPIs for a long time, such as:
- Increased risk of bone fractures
- Lowered levels of magnesium, which your body needs for healthy teeth and bones, as well as your metabolism
- Diarrhea associated with a bacterium called Clostridium difficile
There are reports of other side effects associated with PPIs. Research shows that people who take PPIs are at greater risk of developing pneumonia and weight gain.
PPI usage also may be linked to cardiac events such as heart attacks, food poisoning from salmonella infection, and chronic kidney disease.
Researchers continue to study PPIs and their potential side effects. But these results raise an important question: Should everyone with GERD be on a PPI? In my opinion, the answer is no. There are people on PPIs and other medications for GERD symptoms who probably don’t need to be.
If you take medication for GERD, it’s important for you and your doctor to discuss:
- How long you’ve taken the medication
- How severe your symptoms were when you started the medication
- How well your symptoms are currently controlled
If possible, I’d recommend working with your doctor to set up a “vacation” from your GERD medicine to see if your symptoms return. If they do, that’s an indication that you may need to continue your medication. If your symptoms don’t return, you may be able to stop taking it — especially if you make lifestyle modifications to improve your condition.
Bonus tip: Don’t ignore symptoms that could be heart-related
Pain that seems like GERD or heartburn may actually signal a more serious condition — like a heart attack. Pay particular attention to these symptoms:
- Pain on the left side of your chest
- Chest pain that radiates into your jaw and/or left arm
- Palpitations, or a feeling that your heart is racing or pounding in your chest, throat, or neck
Make sure you go to the emergency room right away if you have these symptoms. Any or all of these could be symptoms of a heart attack.
You could be at greater risk of a heart attack if you:
- Have a strong family history of heart issues
- Have high blood pressure
- Have high cholesterol
GERD is a challenging condition to treat. But with the right lifestyle modifications and your doctor’s help, you don’t have to “feel the burn” of heartburn and GERD forever.
Tags: family health, gastroenterology, internal medicine, men's health, women's health