Division of Gastroenterology and Digestive Disorders
Heartburn may mask serious problem
Maybe it was the second slice of pumpkin pie, the glass of red wine or that extra cup of coffee after dinner. Whatever the cause, that uncomfortable feeling that’s moving upward from your stomach and leaving a bitter acid taste in the back of your mouth is probably just a little heartburn.
Or is it?
If you regularly experience heartburn, indigestion or an acidic taste in the back of your mouth, if these symptoms occur after meals and antacids provide only temporary relief, then you may have gastroesophageal reflux disease (GERD). It’s one of the most common gastrointestinal diseases, affecting up to 20 percent of the entire population. Other indications of GERD can include a persistent dry cough, trouble swallowing or chest pain. GERD occurs when a sphincter located between the esophagus and stomach relaxes at incorrect times, allowing acidic stomach contents to backflow into the esophagus. Unfortunately, many tempting holiday foods - chocolates, alcohol, fatty foods, carbonated beverages, red wine, nuts and acidic fruits and vegetables—are all culprits that can aggravate GERD symptoms. Stress alone, won’t cause acid reflux, but it can cause you to eat too quickly or to eat or drink too much of “comfort foods” that in turn lead to heartburn.
The initial approach to treating GERD usually involves lifestyle modifications, and if those prove unsuccessful, over-the-counter or prescription medications may be recommended. If you suspect that you may have symptoms of GERD, try these lifestyle changes:
- Eat smaller meals to avoid filling your stomach because a full stomach will exert upward pressure on stomach acids.
- Being overweight also increases this pressure.
- Avoid lying down or bending over after a meal.
- Finish eating meals and nighttime snacks two to three hours before bedtime.
- Take note of foods that seem to cause your heartburn and limit your consumption of them. (Contrary to popular belief, spearmint and peppermint will frequently make heartburn worse.)
- Sleep on your left side. This reduces the chance of acid backing up from the stomach.
- Raise the head of your bed four to six inches and use pillows or folded blankets to elevate the entire top half (not just the head) of your body. Elevating just your head will actually increase the likelihood of symptoms.
- Avoid over-the-counter medications, such as aspirin, ibuprofen and naproxen that can contribute to GERD symptoms. Instead, use acetaminophen for minor pain relief.
Although GERD is usually easy to control, it can lead to more serious complications, particularly among older individuals. About 20 percent of people with GERD end up with esophagitis, a chronic inflammation of the esophagus and a small number develop a pre-cancerous condition known as Barrett’s Esophagus.
If you’ve tried lifestyle changes and still end up reaching for the antacid bottle most nights, or if you experience a persistent dry cough, asthma-like symptoms or trouble swallowing, it’s time to talk to your physician about GERD.