Understanding Acid Reflux, aka Heartburn
Do you avoid certain foods because you know they will make you uncomfortable sometime later in the day? Perhaps you prop yourself up to sleep to avoid that burning sensation in the middle of the night. Or it could be that you rely on antacids to get you through the day without too much pain. If any of these scenarios apply to you, you aren’t alone. Heartburn, or acid reflux, is a very common health issue in the United States, affecting about 40 percent of the population. If you haven’t experienced it yourself, you probably know someone who has.
Even so, one person’s experience with acid reflux can be quite different from the next. Most people experience the classic “heartburn” in the mid-upper abdomen, but symptoms may also include a dry cough, hoarse voice, bitter taste in the mouth, wheezing, belching, bad breath, and even chest pain.
What Causes the Symptoms of Acid Reflux?
Acid reflux is a medical condition called gastroesophageal reflux disease, or GERD, by medical professionals. It arises when the acidic digestive secretions in the stomach flow backward into the esophagus. The esophagus, which connects the mouth to the stomach, becomes irritated by the acid. This irritation is responsible for the symptoms of GERD.
How is GERD Diagnosed?
GERD is normally a “clinical diagnosis,” which means it is diagnosed based on the symptoms the patient is experiencing and the physical exam. There isn’t specific lab work or an imaging study like an MRI that will make the diagnosis. However, your physician may order some tests to rule out other diseases. For example, difficulty swallowing, anemia, or weight loss in addition to the typical symptoms of GERD may make your doctor want to investigate further.
When this is the case, a test called esophagogastroduodenoscopy, or EGD, is commonly used. In this test, a gastroenterologist uses a small camera to visualize the upper digestive tract, including the esophagus, stomach, and a bit of the small intestine. They will look for abnormalities like ulcers or lesions that should be biopsied to determine if they are cancerous.
What is the Treatment for GERD?
The main treatment for GERD involves lifestyle changes. By changing your habits and diet, the symptoms of GERD can be lessened or even completely resolved.
- Avoid foods that trigger the symptoms of acid reflux. You may have already noticed a relationship and started doing this. But to get the best results, keep a diary of the foods you eat and the timing of symptoms. Over time it will become clear which foods are problematic for you
- Lose any excess weight you are carrying. There is a clear relationship between an increase in body mass and the incidence of GERD. If you are overweight, losing the extra pounds can offer relief.
- Raise the head of your bed. For many people the symptoms of GERD are worse at night when they lie down to sleep. A slight angle can help reduce the backflow of acid and result in fewer nighttime symptoms and a better night sleep, which offers its own set of health benefits.
- Use over-the-counter medications sparingly to relieve your symptoms. These drugs are called proton-pump inhibitors and include brand names such as Prevacid and Prilosec They lower the acid levels in the stomach and most people find they get relief when using them.
Remember that proton-pump inhibitors are no substitute for lifestyle changes. That’s because long-term use of these drugs may have negative health effects. These can include poor absorption of nutrients, an imbalance of bacteria in the gut, kidney disease, and even dementia. The research at this point only shows an association with these disorders, and not a cause and effect relationship. But it is enough for the FDA to recommend using the lowest dose for the shortest amount of time possible – up to three times a year for no more than 14 days. Think of these drugs as symptom relief while you make the necessary diet and lifestyle changes to eliminate the symptoms yourself.
Many Americans struggle with the symptoms of acid reflux. If you are one of them, talk to your doctor. They can rule out more serious health issues and help you make a plan to eliminate the symptoms once and for all.