GERD (Gastroesophageal Reflux Disease) and Heartburn
You’ve just had a large meal, turkey and gravy, potatoes, rolls, dessert – the works! You settle down to watch the ballgame and it hits you – a burning sensation starts to build in your upper abdomen, behind the breastbone, your chest feels like it’s on fire. The chest pain and burning sensation might travel from your diaphragm all the way to your throat, you may have a sour taste in your mouth and the feeling that food is re-entering your mouth.
You're suffering from severe heartburn.
Despite the name, heartburn has nothing to do with the heart. Heartburn is a digestive problem that occurs when stomach acid comes into contact with the lining of the esophagus, causing irritation. Most people suffer from occasional heartburn, usually after a meal. This is particularly prevalent around the holidays when we eat larger meals than normal.
When should you be concerned about your heartburn and how often it occurs?
If you have heartburn once a month, it's considered mild. If you have heartburn once a week, it's moderate. It's when your heartburn occurs daily that it's considered to be severe.
About 20% of all adults experience heartburn symptoms at least once a month. For those who suffer from occasional or even moderate heartburn symptoms can usually be managed with a change in diet, over-the-counter antacids and weight loss. But for five to fifteen percent of adults, their heartburn is severe and the remedies above only provide partial or temporary relief.
Causes of Heartburn
Heartburn is caused when stomach acid refluxes--backs up--into the esophagus. This can occur for a number of reasons:
- The most common symptom of GERD is when the lower esophageal sphincter (LES), the valve that keeps stomach acid in the stomach, is weakened or relaxed and doesn't do its job properly.
- Certain foods, such as chocolate, fried and fatty foods, peppermint, coffee, alcohol, sugars, can weaken or relax the LES.
- Eating large meals or eating large meals shortly before bedtime.
- A hiatal hernia. Pressure on the stomach, including frequent bending over, tight clothes, lifting, obesity.
- Certain medications.
- Stress can increase acid production and slow down the emptying of the stomach.
Mild or occasional heartburn may be considered more of a nuisance than a condition. But if you suffer from chronic heartburn, episodes occurring from several times a week to several times a day, and it's left untreated it can lead to severe complications.
People who suffer from Gastroesophageal Reflux Disease (GERD) experience chronic, severe heartburn. This can cause scarring of the esophagus, which narrows the esophagus and makes it difficult to swallow. It can also lead to Barrett's esophagus, a condition where cells similar to those of the stomach lining develop in the lower esophagus. Severe damage to the esophagus increases your risk of developing cancer of the esophagus.
Managing Your Heartburn
You can find relief from your heartburn with a few lifestyle and diet changes.
Here are a few suggestions:
- Eat frequent smaller meals instead of three larger ones. This will help prevent excessive production of stomach acid.
- Eat slowly. One way to help you slow down while eating is to put your fork or spoon down between bites.
- Don't go to bed with a full stomach. Stay up at least three hours after eating your last meal or large snack before going to bed. This gives acid levels a chance to decrease before your body is in a position where heartburn is more likely to occur.
- Raise the head of your bed several inches. With your head elevated, it will help prevent reflux during the night.
- Avoid your heartburn triggers. Examples of foods and beverages that can trigger heartburn are coffee (including decaf), alcohol, fatty foods, caffeinated beverages and foods, onions, peppermint, chocolate, citrus fruits or juices, tomatoes. Click here for a heartburn diary to track what triggers your heartburn.
- Stop smoking. Nicotine can weaken the lower esophageal sphincter, the muscle that controls the opening between the esophagus and stomach and prevents the acid-containing contents of the stomach from entering the esophagus.
- Wear looser-fitting clothes. Tight clothing squeezes the midsection and tends to push stomach contents upward.
- Lose weight. If you are overweight, losing weight can help relieve your symptoms.
- Chew gum. Chewing gum can provide short-term heartburn relief by stimulating the production of saliva, which dilutes and flushes out stomach acid.
- Drink warm liquids. Drinking a glass of lukewarm water or herbal tea after a meal can dilute and flush out stomach acid.
Seeking Treatment for Heartburn
When heartburn occurs frequently or becomes severe, you should consult your doctor.
Call your doctor if you have any of the following symptoms:
- Persistent or severe heartburn.
- Medication does not relieve heartburn.
- Heartburn interferes with your ability to fall asleep or it wakes you at night.
- Discomfort from heartburn interferes with your lifestyle or daily activities.
- Difficulty swallowing or pain when swallowing.
- Sensation of food caught in your chest or throat.
- Heartburn is causing you to vomit.
- You vomit blood or have black stools (from digested blood).
- Excessive saliva.
- Drastic weight loss.
- Persistent hoarseness or sore throat.
- Episodes of choking, coughing or wheezing.
If you do not have a physician, call our Physician Referral Service at (561) 263-5737 to find a qualified gastroenterologist.