It’s common to sometimes suffer from heartburn when stomach acids back up/reflux into the esophagus. Over-the-counter medicine and avoiding certain food triggers can help. But if you feel that irritating burn in your chest or throat after eating more than a few times a week, your heartburn has probably developed into gastrointestinal esophageal reflux disease (GERD). The condition affects people of all ages, including about two thirds of newborns.
Without specialized care, serious cases of GERD can cause inflammation of the esophagus (esophagitis), narrowing of the esophagus (strictures) and trouble swallowing, esophageal cancer or a condition called Barrett’s Esophagus, a permanent change in tissue lining the esophagus.
Symptoms & Diagnosis
GERD stems from a malfunction in the valve or sphincter at the lower end of the esophagus which should open to allow food and liquids to pass into the stomach and then close. If it doesn’t close or opens at random times, acids from the stomach can back up into the esophagus.
The first step in controlling GERD is identifying what has weakened the valve. The most common causes are increased pressure on the abdomen, certain foods and drinks and medication.
Increased pressure on the abdomen stem from:
- Being overweight
- Pregnancy
- Having a hiatal hernia causing part of the stomach to push through the diaphragm muscle into the chest cavity
Foods and drinks that can trigger GERD include:
- Chocolate
- Fried foods
- Citrus fruits
- Coffee
- Alcohol
- Carbonated drinks
Medications that can contribute to GERD include:
- Antihistamines
- Alpha blockers
- Anti-inflammatory painkillers
- Sedatives
- Anti-depressants
- Asthma medications
Smoking and regular exposure to second-hand smoke is also linked to GERD.
In addition to regular bouts of heartburn, GERD can cause such symptoms as:
- Chest pain
- Sour taste in the mouth
- Belching
- Trouble swallowing
- Asthma, wheezing or shortness of breath
- Feeling like you have a lump in your throat
- Chronic cough
- Pneumonia
- Abdominal pain
- Bad breath
- Tooth erosion
- Irregular sleep
- Laryngitis
To confirm you have GERD, your specialist will recommend one or more tests such as:
- Acid (pH) probe test – we place a monitor attached to a thin tube through your nose and into the esophagus. Attached to a small computer you wear on a strap or around the waist, the monitor tells us when stomach acid regurgitates and for how long. We can also get this information by placing a capsule in your esophagus during an endoscopy. The capsule passes in a bowel movement in a few days.
- Endoscopy (EGD) – allows us to see and evaluate the inside of the upper gastrointestinal system and take biopsies if needed to check for inflammation, infection or damage. We use a small telescopic camera sent through the mouth into the esophagus and stomach.
- Manometry – measures the strength and muscle coordination of your esophagus when you swallow.
- Transnasal esophagoscopy – we look for damage to the esophagus by putting a thin tube with a video camera attached through the nose, down the throat and into the esophagus.
- Upper GI X-Ray – with barium and a special X-ray machine called a fluoroscope, we take images of the esophagus, small intestine and stomach.
Treatment Options
Nutritionists on our team can help you ease the pain of mild cases of GERD through diet and lifestyle changes. With more advanced forms of the disease, surgery might be the best option. Related surgical interventions include:
- Fundoplication – to restore function to the valve at the end of your esophagus, the surgeon loosely wraps the upper part of your stomach around the lower esophagus. The minimally invasive procedure prevents acid reflux.
- Hiatal hernia repair – if your specialist determines a hernia is behind the pressure on your abdomen, surgery can move the part of the stomach pushing through the diaphragm back into place. The repair is minimally invasive done under general anesthesia.
- Linx – the implantable device, a circle of small titanium magnets placed around the lower part of the esophagus, prevents acid reflux by boosting the strength of the valve in that area. The procedure is also called magnetic sphincter augmentation.
Living with the Condition
Even though you’ve been diagnosed with GERD, there are ways you can change your diet and lifestyle to minimize its effect on your life. Our team is here to help you address habits that may trigger your GERD.
Our suggestions include:
- Quit smoking. Smokers have a 500% greater chance of developing esophageal cancer.
- Avoid trigger foods. Common culprits are citrus, spicy and fried foods.
- Maintain a healthy weight.
- Cut down on alcohol.
- Eat smaller meals. Leaving your stomach less full means it produces less stomach acid to process the food.
- Eat slowly. It takes up to 20 minutes for the brain to know there is food in your stomach that needs digesting. Give your brain time to catch up.
- Don’t lie down after eating. Gravity will help your body digest.