Heartburn Holding You Hostage? 7 Tips To Break Free

heartburn, GERD

[© Atholpady | Dreamstime.com] Acid reflux occurs when stomach acid or its contents flow back and irritate your esophagus lining. Over time, the inflammation can cause complications. Healthy lifestyle choices (like avoiding tight clothing and eating smaller meals) can make a big difference in your symptoms.

Gastroesophageal reflux disease (GERD) or acid reflux disease is a chronic digestive disease that occurs when stomach acid or other stomach contents flow back into the esophagus irritating the lining. Over time, the inflammation can wear away the esophageal lining, causing complications such as bleeding, esophageal narrowing or Barrett’s esophagus (a precancerous condition).

What are common causes?
Causes include an abnormal weakness or relaxation of the lower esophageal sphincter — a circular band of muscle around the bottom part of your esophagus that allows food and liquid to flow into your stomach — or structural problems, e.g., hiatal hernia, which weaken the mechanism that prevents acid reflux into the esophagus.

What are signs and symptoms?
Symptoms vary and include:

  • Burning in the chest, throat or upper abdomen (heartburn)
  • Acid reflux into the throat causing voice hoarseness, cough, throat irritation; and/or angina or chest pain

How is it diagnosed?
Your doctor may be able to diagnose GERD based on frequent heartburn and other symptoms. Other tests include pH testing, endoscopy and X-rays of the upper digestive tract.

What sort of lifestyle changes can help?
Maintain a healthy weight.
Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus. If you are at a healthy weight, maintain it. If you are overweight or obese, work to slowly lose weight.

Avoid tight-fitting clothing. This puts pressure on your abdomen and the lower esophageal sphincter.

Avoid food and drink triggers. Everyone has specific triggers. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion and caffeine may make heartburn worse.

Eat smaller meals. Too much food in your stomach may put pressure on your esophageal sphincter and not allow it to close.

Don’t lie down after a meal. Wait at least three hours after eating before lying down or going to bed.

Elevate the head of your bed. If you regularly experience heartburn at night, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by six to nine inches. If it’s not possible to elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up. Wedges are available at drugstores and medical supply stores. Raising your head with additional pillows is not effective.

Don’t smoke. Smoking decreases the lower esophageal sphincter’s ability to function properly.


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How is it treated?
Most people can manage GERD with lifestyle changes and over-the-counter medications that neutralize stomach acid. Antacids alone won’t heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects, such as diarrhea or constipation.

Medications to reduce acid production, called H-2-receptor blockers, don’t act as quickly as antacids, but they provide longer relief and may decrease acid production from the stomach for up to 12 hours. Stronger versions of these medications are available in prescription form.

Proton pump inhibitors are stronger blockers of acid production than are H-2-receptor blockers and allow time for damaged esophageal tissue to heal.

If you don’t experience relief within a few weeks, you may need stronger medications, or even surgery, to reduce symptoms. New surgical options are offering promising results.

Are there any new treatments available in the management of GERD?
In situations where medications aren’t helpful or you wish to avoid long-term medication use, your doctor may recommend surgical options to relieve your symptoms.

Rudy Rai, M.D., is a gastroenterologist in Columbia. To schedule an appointment, call 410-290-6677.