By Richard Benetti, M.D.
Preventive Medicine, Hypertension, and Diabetes Management in Malden and Stoneham, MA
If you frequently suffer from heartburn, it can be a symptom of gastroesophageal reflux disease (GERD).
Uh-oh — you knew you shouldn’t have eaten that extra-spicy burrito, but you just couldn’t resist. And now you’re paying for it. Your chest hurts, and your throat is burning and raw. It looks like it’s going to be a long night.
Nearly everyone has heartburn at some point in his or her life, and it’s often treatable with antacids or by avoiding certain foods. But if you frequently suffer from heartburn, it can be a symptom of gastroesophageal reflux disease (GERD).
GERD is more serious than the occasional twinge of pain after a spicy meal. If it’s not treated, GERD eventually can lead to serious complications — including cancer. That’s why it’s important to get your GERD under control before it becomes something more dangerous.
What is heartburn, and what is GERD?
Normally when you eat, your food travels from your mouth through your esophagus and down to your stomach. This is supposed to be a one-way trip, but sometimes your stomach contents go back up into your esophagus.
Your stomach contains a powerful acid known as gastric acid to help it break down the food you eat into the nutrients your body needs. You have a muscle called the lower esophageal sphincter that’s supposed to keep your esophagus closed after food passes through to the stomach. If the muscle doesn’t close tightly enough, gastric acid can go back into your throat. This process is called acid reflux.
Your stomach cells can withstand this acid — but the cells of your esophagus can’t. When you have heartburn, you’re actually feeling the stomach acid burn the lining of your esophagus. That’s when you feel the pain of heartburn.
Having heartburn once in a while is fairly common. But if you have symptoms two or more times per week, you could have GERD. Some people can have GERD without noticeable heartburn symptoms. Instead, they have other symptoms associated with GERD, such as a chronic cough, wheezing, or a sore throat from frequent damage to the esophagus from exposure to gastric acid.
How can I relieve GERD symptoms?
Lifestyle modification is a big factor in relieving and preventing GERD symptoms. The main lifestyle modification I recommend to patients with GERD is to lose excess weight. GERD is especially common among people who are overweight or obese. Multiple scientific studies have confirmed that weight loss is probably the most effective way patients can reduce or eliminate their GERD symptoms.
I also work with patients to find their triggers — the things they eat or drink that set off their heartburn. This process is person-specific, meaning that one person’s triggers may be very different from another person’s.
In general, I recommend that patients with GERD avoid:
- Acidic foods, like tomato sauce and orange juice
- Alcohol, tobacco, and peppermint (these relax the lower esophageal sphincter)
- Caffeine (it’s very acidic and also relaxes the lower esophageal sphincter)
- Carbonated drinks, like soda
- Spicy foods
For some of my patients with wheezing, coughing, sore throat, and other symptoms caused by GERD, I recommend they elevate the heads of their beds about six or eight inches to reduce the chance of reflux while they’re asleep. You can use concrete blocks from your local home-improvement store to do this.
Who gets GERD?
GERD is a prevalent problem nationwide. One study noted that GERD affects about 20 percent of the U.S. population.
GERD affects patients of all ages, from babies to older adults and everyone in between. In fact, infants are at higher risk for GERD than adults because their lower esophageal sphincters often aren’t as strong or well-developed. Another study pointed out that two-thirds of 4-month-old infants have symptoms of GERD.
Personally, I probably see more men than women with GERD in my practice. Men are more likely to be overweight, as noted in this study conducted by the Centers for Disease Control and Prevention and the National Health Interview Survey. Men also tend to eat more unhealthy diets than women, and they tend to drink more alcohol and coffee.
What happens if I don’t treat my GERD?
Maybe you’re OK with chewing a bunch of antacids after every meal. Maybe you don’t have a problem with waking up with heartburn night after night. Even so, you still should talk to your doctor about your symptoms and a treatment plan — GERD can lead to much more serious problems if it’s not treated.
One such problem is esophagitis, or an inflammation or irritation of the esophagus from repeated exposure to gastric acid. Esophagitis can lead to pain or discomfort when you swallow (odynophagia) or food and liquids actually getting stuck in your throat (dysphagia).
In some cases, your esophageal cells may morph over time into cells similar to those found in your intestines. While that may sound like a good defensive move for your body, it’s actually dangerous. This morphing process can lead to a disease called Barrett’s esophagus. And anytime cells of one kind try to turn themselves into cells of another, cancer can develop — in this case, a type of cancer called esophageal adenocarcinoma. That’s why it’s so important to seek treatment for ongoing heartburn or GERD symptoms before they become worse.
You shouldn’t just learn to “toughen up” or deal with your chronic heartburn. If you have heartburn two or more times a week, talk to your doctor about GERD and a treatment plan that’s right for you.
Tags: family health, family medicine, gastroenterology, internal medicine, men's health, women's health