Jenese Anderson, 62, loves tomato-based foods but has to steer clear of them because whenever she eats a slice of pizza or a bowl of pasta and sauce, she pays dearly for it. “After eating tomato-based sauces or spicy foods, my stomach churns, and I feel a hot liquid slowly make its way up my throat. As much as I love these types of foods and citrus fruits as well, I had to kiss them all goodbye. My digestive system just can’t handle my food indulgences,” Jenese says. The Milford, CT., graphic illustrator suffers from gastroesophageal reflux disease or GERD, and it has certainly put a damper on her eating habits.
Some 35 percent of African Americans are GERD sufferers according to the National Institute of Diabetes and Digestive and Kidney Diseases. GERD is the most common upper gastrointestinal disorder seen in those aged 65-plus and is oftentimes confused with acid reflux. “Acid reflux and GERD don’t mean the same thing. GERD is the regurgitation of any type of food contents back up into the esophagus, while acid reflux means the stomach’s acid contents are being regurgitated,” explains Philip Jaffe, M.D., a gastroenterologist, and director of clinical and endoscopy services at the Digestive Health Institute in Kalispell, Montana.
What causes GERD?
Anyone can develop GERD, some, for reasons that are not quite understood. Here are a few things that can contribute to GERD:
- Being overweight
- A hiatal hernia (part of the stomach protrudes into the diaphragm muscle)’’
- Eating tomato sauce-based foods and chocolate
- Drinking carbonated beverages, alcohol, caffeine
- Consuming foods that contain peppermint
- Eating spicy, greasy, fatty, fried foods, citrus fruits
- Taking meds like Calcium channel blockers, certain sedatives, painkillers and asthma drugs
- Cigarette smoking
- Overeating
- Wearing tight clothing around the abdomen
What are the symptoms of GERD?
The number one complaint from GERD sufferers is a painful, burning feeling in the middle of your chest, behind your breastbone, and in the middle of your abdomen. It is important to note that NOT all adults with GERD have heartburn.
Other common GERD symptoms can include:
- Bad breath
- Nausea
- Chest pain or discomfort in the upper part of your abdomen
- Problematic or painful swallowing
- Respiratory issues
- Vomiting
- The wearing away of teeth
When should you seek medical help for GERD?
You should see a doctor if you have persistent GERD symptoms that do not go away with OTC meds (antacids like Pepcid or Omeprazole) and with lifestyle/dietary changes. Seek help immediately if you:
- Vomit regularly or if it is forceful (projectile)
- Vomit fluid that is green, yellow, looks like coffee grounds or contains blood
- Have trouble breathing after vomiting
- Experience pain in the mouth or throat when eating
- Have difficulty or pain when swallowing
- Unexplained coughing
How is GERD diagnosed?
Anyone experiencing symptoms of GERD should see their physician who may refer them to a gastroenterologist, a specialist in all matters of the gut for further evaluation.
The specialist will have you undergo testing in order to provide you with the correct diagnosis for your symptoms. Testing for GERD can include any of the following:
- Esophageal pH and impedance monitoring: This measures the amount of acid in the esophagus while the body is in different states, such as while eating or sleeping.
- Upper gastrointestinal (GI) endoscope: This is a tube with a camera attached, which is used to inspect the esophagus. A small sample of tissue may also be taken at the same time in a biopsy.
- Upper GI series: This is a type of X-ray that shows specific physical abnormalities that might cause GERD.
- Esophageal manometry: This measures muscle contractions in the esophagus during swallowing. It can measure the strength of the sphincter.
- Bravo wireless esophageal pH monitoring: In this test, a small temporary capsule is attached to the esophagus. This measures the acidity continuously for around 48 hours.
What happens when GERD is ignored?
If you are experiencing GERD and decide to ignore it, or think you can self-diagnose by continuously gulping down OTC antacids, then think again! Untreated GERD symptoms can lead to a host of very serious health complications such as:
- Esophagitis (irritation/swelling of the esophagus)
- Esophageal stricture (a consequence of esophagitis where scar tissue narrows the esophagus making swallowing difficult)
- Hoarseness, coughing, sore throat
- Breathing problems (even without lung issues)
- Tooth decay
- Esophageal ulcers
- Barrett’s esophagus (precancerous changes in cells)
- Esophageal cancer (oftentimes deadly)
Treatment for GERD
In order to possibly alleviate your GERD symptoms, you might also be advised by your physician to make lifestyle and behavioral changes such as:
- Avoid triggers–caffeine, alcohol, tomato sauces, fried and spicy foods
- Stop eating 2 to 3 hours before you go to bed
- Quit smoking
- Lose weight
- Avoid tight clothing around the abdomen
- Sleep with your head slightly elevated
- Don’t overeat
Your health practitioner may put you on one, or a combination of meds to control your GERD symptoms. Proton pump inhibitors are one of the primary pharmaceutical treatment options for people with GERD. They decrease the amount of acid produced by the stomach. Other types of meds can include:
- H2 blockers: help decrease acid production
- Antacids: counteracts the acid in the stomach with alkaline chemicals
- Prokinetics: help the stomach empty faster
- Erythromycin: an antibiotic that also helps empty the stomach
If all else fails, your doctor might recommend surgery to treat your GERD symptoms. Complications from GERD surgery are more likely to arise than with more conservative treatments:
- Fundoplication is the most common surgery for GERD. In most cases, it leads to long-term reflux control.
- Endoscopic techniques, such as endoscopic sewing and radiofrequency, help control GERD in a small number of people but the results may not be as good as those for fundoplication. Doctors don’t use endoscopic techniques often.
