Smoking cigarettes, eating fatty foods, or downing caffeinated drinks can all contribute to a health problem shared by more than 15 million Americans: gastroesophageal reflux disease. Commonly known as acid reflux, GERD is a condition in which stomach acids back up into the esophagus, causing a warm or burning sensation in the lower chest and upper stomach.
While that sensation of heat in the chest may be dismissed as simple heartburn, it can actually signal more serious problems. If left untreated, the constant backup of stomach acid can damage the lining of the esophagus, causing bleeding, ulcers and possibly esophageal cancer.
Anyone experiencing heartburn twice a week or more may have GERD. But while heartburn is the most common symptom, it is not the only one; some people may have GERD without any heartburn at all. A chronic dry cough, laryngitis, asthma, nausea, belching or difficulty with swallowing can also indicate the presence of GERD.
Infants with this condition may spit up or arch their backs in pain more frequently than babies without it. Most infants outgrow these problems in the first year, but if GERD persists, it can cause repeated vomiting, coughing or respiratory problems, and older children may complain of abdominal or chest pain.
Weak Muscle vs. Strong Acid GERD can develop when a muscle ring at the end of the esophagus -- the lower esophageal sphincter -- becomes weak. This muscle is designed to act as a one-way valve that allows food to flow through the esophagus into the stomach. If this sphincter muscle contracts or relaxes improperly, then the strong acids from digested food in the stomach can push past it and move back up toward the esophagus and chest, causing heartburn and other problems associated with GERD. Weakness in the muscle is also viewed as one cause of the acid reflux experienced by about 75 percent of pregnant women. When a woman is carrying a full-term baby, the uterus pushes against the stomach and chest and that puts more pressure on the esophageal sphincter so it cannot function properly. Hiatal hernias, in which the upper portion of the stomach protrudes into the chest cavity, can also interfere with the ability of the muscle to prevent acid reflux. A hernia can displace the muscle from its proper position and the hernia sac can also trap stomach acids too close to the esophagus. While a majority of patients with GERD have hiatal hernias, not all do; and not every person with a hiatal hernia has GERD. Change Habits, Not Prescriptions Over-the-counter and prescription medications can often relieve symptoms of GERD. Antacids, such as Tums or Rolaids, work quickly but provide relief for only 30 to 40 minutes. Taking too many antacid tablets can cause diarrhea because they contain magnesia; and, while post-menopausal women may take Tums for calcium, they should not ingest more than three tablets per day.
Histamine or H2 blockers such as Zantec, Pepcid and Tagamet can relieve GERD, as can proton pump inhibitors such as Prilosec, Nexium, Prevacid, Protonix and Acifex. In cases of severe acid reflux, patients may be given a short-term prescription for a medication called Reglan. Surgery may be advised for a small minority of patients. But by far, the most common and effective treatment plan requires patients to make these lifestyles changes to minimize the impact of acid reflux on their health: Quit smoking, because smoking substantially reduces the clearance of acid from the esophagus, and this effect can last for up to six hours after the last cigarette. Avoid chocolate, peppermint and alcohol as well as fatty foods. Also stay away from spicy or acid-containing foods such as citrus juices, carbonated beverages and tomato juice. Limit the intake of coffee, black tea, sodas or other caffeinated beverages; drink them with meals since food neutralizes acid, or switch to decaffeinated products. Try chewing gum after meals -- it stimulates the production of saliva and increases the rate of swallowing, which can neutralize acid in the esophagus. To reduce inter-abdominal pressure, eat small, frequent meals; wear loose-fitting clothes; avoid constipation; and, if possible, do not lift heavy items. Lose weight if necessary. Wait at least three hours before laying down after a meal. Those with GERD can also use gravity to reduce acid reflux at night by sleeping in a slanted position. Beds should be elevated by putting at least six inches of wood under the head area; simply sleeping on more pillows will not be as effective. Dr. Adler is chief of staff of Eden Medical Center in Oakland, Calif. He specializes in gastroenterology and can be reached at (510) 357-8180. Source: Oakland Tribune. Provided by ProQuest Information and Learning. Powered by YellowBrix.