In 1999, the U.S. National Health Observances calendar was updated to designate the week of Thanksgiving as Gastroesophageal Reflux Disease (GERD) Awareness Week. What is this condition, and why does it merit a national awareness week, especially one that includes America’s holiday centered on eating?
GERD is a digestive disorder that affects the lower esophageal sphincter (LES), the muscle that connects the esophagus with the stomach. When functionally properly, the LES opens briefly when you swallow food and quickly closes after allowing food to pass from the esophagus to the stomach. In GERD, the LES malfunctions and allows food and stomach acid to flow back (reflux) into the esophagus.
Heartburn is a classic symptom of GERD. Most everyone gets heartburn from time to time, and many diners will experience this uncomfortable burning sensation in their chest after overindulging at Thanksgiving. However, when heartburn occurs more than once or twice per week or persists over a long period of time, it may indicate a more serious condition, such as GERD.
Other potential symptoms of GERD include a sour-tasting fluid backing up into your mouth; symptoms that get worse after eating, bending over or lying down; difficulty or pain when swallowing; hoarseness; pain in the chest or upper abdomen; bad breath; or dental erosion.
Lifestyle changes and medications are typically the first line of treatment for GERD. If these methods aren’t effective, surgery may be required.
Over-the-counter medications include: antacids to neutralize stomach acid (e.g., Tums, Rolaids, Maalox); medications to reduce acid production (Tagamet and Zantac); and proton pump inhibitors (Prevacid and Prilosec) to block acid production and allow time for damaged esophageal tissue to heal. If you are taking one of these medications more than twice per week or if they are not providing relief, see your physician to determine if a prescription-strength medication may be right for you.
Lifestyle changes are effective for many individuals. In honor of GERD Awareness Week, the International Foundation for Functional Gastrointestinal Disorders offers these tips to help reduce GERD symptoms:
- Schedule an earlier meal. It’s best not to eat late at night if you suffer from GERD.
- Serve light appetizers. Fatty foods like chips, dips and cheeses are slow to empty from the stomach and more likely to aggravate symptoms.
- Stay active. Stick with your exercise routine during the holidays, as weight loss can help alleviate GERD symptoms.
- Don’t smoke. Nicotine weakens the muscles within your food pipe that prevent back flow (reflux) of stomach contents.
- Nix the juice. Citrus fruits and juices, like grapefruit, orange and tomato, are acidic and can worsen GERD symptoms.
- Season lightly. Spicy foods, as well as things like onions and garlic, often bother people with GERD and make heartburn worse.
- Limit your drinks. Whether wine at dinner or beer during the game, alcohol can worsen reflux.
- Pass on deep frying your turkey. Fried foods are known to exacerbate GERD symptoms.
- Use smaller plates. Eating large meals can trigger symptoms, so try smaller meals spread throughout the day.
- Substitute water for soda. Caffeinated and carbonated beverages are both notorious heartburn aggravators.
- Watch the desserts. Chocolate might be a favorite, but it often bothers people with GERD.
- Skip the after-dinner mint. Peppermint is another heartburn irritant.
- Slow down. Physical exertion after a meal can lead to reflux.
- Stay awake! While the turkey might make you sleepy, fight the urge take a nap. Lying down within three hours after eating can cause GERD symptoms to flare up.
- Talk to your doctor. An accurate diagnosis is the first step to receiving the most effective treatment.
To that list, I would add the following:
- Raise the head of your bed. Elevate the head of your bed by securing six-inch blocks under the headboard bedposts or frame, allowing gravity to keep acid and food contents in your stomach. Don’t try propping yourself up on extra pillows, as this will only increase pressure on your stomach.
- Watch your weight. Shed some pounds if needed. Losing weight can help relieve symptoms.
- Loosen your belt. Don’t wear tight fitting clothing or belts around your stomach area, as they can increase reflux.
While heartburn may seem like a trivial problem, chronic heartburn should not be taken lightly. In addition to negatively impacting quality of life, constant acid irritation to the lining of the esophagus can lead to more serious problems.
About one in 10 patients with GERD are also found to have Barrett’s esophagus, a condition in which the cells in the lining of the esophagus transform into tissue similar to the type that lines the stomach. The transformation occurs when the esophagus tries to protect itself from erosion caused by chronic acid reflux. This tissue alteration results in a greater risk of developing esophageal adenocarcinoma, a dangerous cancer that is becoming more prevalent.
If you are struggling with persistent heartburn or other symptoms of GERD, schedule an appointment to see your GI physician so that you can get to the “heart” of your problem. Because symptoms often progress slowly over many years, patients are amazed at how much better they feel when they finally get relief. And for some, treatment means much more than quality of life. It can mean saving a life.