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Mar 29, 2013 | 1274 views | 0 0 comments | 5 5 recommendations | email to a friend | print

Stop the burn by making simple changes

By DR. D. Rayburn MOORE


GERD, more commonly referred to as heartburn, occurs when acidic contents in the stomach flow back into the food pipe (esophagus). This phenomenon occurs because the valve between the stomach and the esophagus (the lower esophageal sphincter) inappropriately relaxes, allowing acid to travel back into the esophagus. 


What are symptoms of GERD?

Heartburn and acid indigestion are the most common symptoms. However, when acid bathes the esophagus, the problem can manifest as other less-classic symptoms. These can include a sour or bitter taste in the mouth, involuntary regurgitation of food or fluid into the mouth, hoarseness, sore throat or the need to clear the throat, dental erosions, wheezing, dental erosions, or unexplained cough.


What causes GERD?

Temporary relaxation of the lower esophageal sphincter, which allows the backflow of stomach acid into the esophagus, is influenced by a variety of conditions. Large meals as well as certain foods contribute to these episodic relaxations. Obesity, tight clothing around the waist and pregnancy can also contribute by increasing pressure in the abdomen, which can allow acid to overcome the barrier between the stomach and the esophagus. Smoking, excessive alcohol use, and hiatal hernias can also induce GERD.


What harm can occur?

The stomach has a tough lining that is made to resist acid, but the esophagus does not. Thus, the most common complication of heartburn is esophagitis, or inflammation of the esophagus, which can cause ulcers or bleeding. Sometimes the inflammation can lead to scarring or narrowing of the esophagus. Pre-malignant changes, which can progress to cancer, can occur due to changes in the cells that line the esophagus. This is commonly referred to as Barrett’s esophagus and should be followed closely to ensure cancer does not develop.


How do you treat GERD?

The first step in treating GERD is dietary and lifestyle modification. Avoid fatty or spicy foods, tomato-based products, citrus drinks, chocolate, coffee, and peppermint. It is also recommended to eat smaller meals, lose weight, stop smoking, and abstain from alcohol. Nighttime symptoms can be improved by not eating within three hours of sleeping, or propping up the head of the bed. If symptoms persist, then over-the-counter antacids can help for a short period of time. More potent prescription medications can also be used under the direction of your doctor. Surgery is an option for patients who don’t respond fully to medical therapy or for those with severe GERD. 


When should I see a doctor about GERD?

See a doctor if your classic symptoms are not controlled with dietary and lifestyle modifications or if you are using over-the-counter medications more than twice a week. You should seek immediate medical attention if you have chest pain, unexplained weight loss, food that sticks in your chest after swallowing, bloody vomit, or black, tarry bowel movements.


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