If you like pizza, beer and wings, you’ll want to read on. Foods like those could be causing gastroesophageal reflux disease (GERD), or chronic acid reflux. It’s one of the most common conditions in the United States. About 20% of Americans have GERD, according to researchers.
If you don’t treat GERD, it can add to your risk of developing more serious health conditions, including certain types of cancer. So you’ll want to talk with your doctor if your symptoms persist.
Here are 7 important questions to ask about GERD and how it might be affecting you.
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1. What is gastroesophageal acid reflux?
Acid reflux has everything to do with your digestive system. Your esophagus’ main job is to move food from your mouth to your stomach, which extracts nutrients.
At the end of the esophagus, food passes through the lower esophageal sphincter, a one-way valve designed to keep the contents of your stomach from going up in the wrong direction (that is, refluxing).
Gastroesophageal reflux occurs when the sphincter lets your stomach’s contents move back toward your mouth. (“Gastro” refers to the stomach while “esophageal” refers to your throat.)
2. What’s the difference between acid reflux and GERD?
Besides being more bothersome than occasional reflux, GERD can lead to serious complications. These include ulcers and bleeding in the esophagus, breathing issues, chronic cough and hoarseness. They can also lead to a form of cancer called esophageal adenocarcinoma, which can affect your esophagus and stomach.
“Repeated acid reflux into the esophagus damages the fragile lining of those cells, and that’s how the cancer transformation can happen,” says David Catlett, M.D., a family doctor in Louisville, Kentucky. “If you let the acid reflux go untreated for several years, it can lead to esophageal cancer.”
3. What are the symptoms of GERD?
Heartburn and vomiting are the most common symptoms, but GERD can also cause chest pain, internal bleeding and weight loss. Those symptoms can also be caused by other health issues, so be sure to see your doctor if you have them or other unusual symptoms.
4. What factors contribute to GERD?
According to Dr. Catlett, a range of foods can trigger acid reflux. They include fatty foods, high-acid foods like tomato-based sauces, spicy foods and onions. Alcohol is another common culprit.
“Alcohol causes acid secretion by the stomach, and it also relaxes the sphincter between the esophagus and stomach,” says Dr. Catlett.
Another factor is excess pressure on the stomach, which can occur if you’re overweight, obese, or pregnant.
Some common medications — including anti-inflammatory medications like ibuprofen and blood-pressure medications called calcium channel blockers — may also contribute to GERD. Fortunately, Dr. Catlett says, “for most people, there would be alternative blood pressure meds that could be used.”
5. How is GERD diagnosed?
To determine whether you have GERD, your doctor will review your symptoms and health history. They may also prescribe a proton pump inhibitor — examples include over-the-counter medications such as Nexium, Prevacid and Prilosec — both to treat your symptoms and as a diagnostic test. You may also need to undergo an upper gastrointestinal endoscopy, where a doctor examines the lining of your esophagus with an endoscope (a flexible tube with a camera) and takes tissue samples for further study.
That’s not likely to happen after your first doctor visit, however. “Unless you have one of those red-flag symptoms like painful swallowing or food getting lodged in your throat or unintentional weight loss, we typically don’t start with doing a scope for the diagnosis,” Dr. Catlett says.
6. How is GERD treated?
Your doctor will probably start by recommending lifestyle changes, including limiting foods that might cause GERD, dropping pounds if you’re overweight or obese, and quitting smoking. Even small steps like eating meals at least 3 hours before bedtime can help.
Changing your sleep habits themselves can also help prevent GERD. “People can elevate the head of their bed by placing bricks under the headboard,” Dr. Catlett says. “That natural gravity helps relieve symptoms from occurring at night.” And avoid sleeping on your right side, which may be a cause of GERD.
If lifestyle changes aren’t enough, your doctor may prescribe the medications mentioned above. If nothing else works, surgery is an option. The most common surgery, called fundoplication, involves adding pressure to the lower esophageal sphincter by sewing the top of the stomach around the base of the esophagus.
7. Is it better to take medications or modify your lifestyle to beat GERD?
While medications like proton pump inhibitors are generally safe and effective, researchers have raised concerns about several potential side effects stemming from long-term use, including an added risk of developing pneumonia or experiencing a bone fracture.
It’s important to talk with your doctor about the risks and benefits of taking any medications.
And remember this: any of the lifestyle changes that fight GERD can also reduce your risk of developing chronic conditions such as high blood pressure, type 2 diabetes and heart disease.
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Centers for Disease Control and Prevention. April 28, 2021. Retrieved from https://www.cdc.gov/obesity/adult/causes.html
Harvard Health. September 30, 2021. Retrieved from https://www.health.harvard.edu/newsletter_article/proton-pump-inhibitors
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