Feel the Burn… Heartburn, That Is

Millions of Americans suffer from heartburn and digestive discomfort, typically caused by excess stomach acid and related complications. But being in good company is small comfort when you’re uncomfortable or miserable. However, there are steps you can take to mitigate acid-related issues, and it’s important to pay attention to warning signs before untended stomach problems lead to more serious health issues.

Gastroesophageal reflux disease (GERD) is a chronic digestive disease. GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe (esophagus). The backwash (reflux) irritates the lining of your esophagus and causes GERD.

Both acid reflux and heartburn are common digestive conditions that afflict many people periodically. When these signs and symptoms occur regularly or interfere with your daily life, or when your doctor can see damage to your esophagus, you may be diagnosed with GERD.

What is GERD?

When we swallow, the lower esophageal sphincter — a circular band of muscle around the bottom part of our esophagus — relaxes to allow food and liquid to flow down into our stomach. Then it closes again.

However, if this valve relaxes abnormally or weakens, stomach acid can flow back up into our esophagus, causing frequent heartburn.

This constant backwash of acid can irritate the lining of our esophagus, causing it to become inflamed (esophagitis). Over time, the inflammation can wear away the esophageal lining, causing complications such as bleeding, esophageal narrowing or Barrett’s esophagus (a pre-cancerous condition).

GERD signs and symptoms include:

  • A burning sensation in the chest (heartburn), sometimes spreading to the throat, along with a sour taste in the mouth
  • Chest pain
  • Difficulty swallowing
  • Dry cough
  • Hoarseness or sore throat
  • Regurgitation of food or sour liquid (acid reflux)
  • Sensation of a lump in the throat

Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications, or even surgery, to reduce symptoms. Conditions that can increase risk of GERD include obesity, pregnancy, smoking, asthma, diabetes, regular constipation, and poor diet.

Over time, chronic inflammation in our esophagus can lead to complications, including narrowing of the esophagus (esophageal stricture), which can lead to the formation of scar tissue, narrowing the food pathway and causing difficulty swallowing. Another typical complication is the forming of an open sore in the esophagus (esophageal ulcer). This may cause bleeding, pain and make swallowing difficult.

Also, hiatal hernias, which are an opening between the stomach and the esophagus, can occur. If untreated, this can lead to pre-cancerous changes to the esophagus (Barrett’s esophagus). With this condition, the tissue lining the lower esophagus changes. These changes are associated with an increased risk of esophageal cancer; doctors will likely recommend regular endoscopy exams to look for early warning signs.

Managing and Reducing Acid Reflux

Lifestyle changes may help reduce the frequency of heartburn. Here are several helpful and simple steps to consider:

  • Maintain a healthy weight.Excess weight puts pressure on our abdomen, pushing up our stomach and causing acid to back up into our esophagus. If you are overweight or obese, work to slowly lose weight — no more than one or two pounds a week.
  • Avoid tight-fitting clothing.Clothes that fit tightly around our waist put pressure on our abdomen and the lower esophageal sphincter.
  • Avoid foods and drinks that trigger heartburn. Common triggers such as fatty or fried foods, tomatoes, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse.
  • Eat smaller meals.Avoid overeating by eating smaller meals.
  • Don’t lie down after a meal.Wait at least three hours after eating before lying down or going to bed.
  • Elevate the head of your bed.If you regularly experience heartburn at night or while trying to sleep, raise the pillow end of your bed by six to nine inches (can use wood or cement blocks). Or insert a wedge between your mattress and box spring to elevate your body from the waist up. Wedges are available at drugstores and medical supply stores. Raising your head with additional pillows is not effective.
  • Don’t smoke.Smoking decreases the lower esophageal sphincter’s ability to function properly.

Treatment for heartburn and other signs and symptoms of GERD usually begins with over-the-counter medications that control acid. If you don’t experience relief within a few weeks, your doctor may recommend other treatments, including medications and surgery.

There are a variety of stronger, prescription medications for managing GERD. Contact your doctor before taking any new medications or if symptoms are not relieved. Also, seek immediate medical attention if you experience chest pain, especially if you have other signs and symptoms, such as shortness of breath or jaw or arm pain. These may be signs and symptoms of a heart attack.

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!