Javelyn Wilson, 62, loves tomato-based foods but has to steer clear of them because whenever she eats pizza or pasta with marinara sauce, she pays dearly for it. “After eating tomato-based sauces, fried, or spicy foods, I can feel my stomach and throat reacting to them. 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,” Javelyn admits. The Milford, CT., graphic illustrator suffers from gastroesophageal reflux disease or GERD, and it has 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
- Wearing tight clothing around the abdomen
What are the symptoms of GERD?
The number one complaint from GERD sufferers is a painful, burning sensation, usually after eating that can worsen at night when lying down. It is that uncomfortable burning feeling or pain in your chest that can move up to your neck and throat.
Not everyone with GERD has symptoms. Nearly half of all patients with GERD don’t have any symptoms, which means it’s possible to have abnormal reflux and not even know it. Those that do have GERD symptoms most frequently report heartburn and a bitter taste in their mouth.
Other common GERD symptoms include:
- Bad breath
- Trouble swallowing
- Sore throat and hoarseness
- Respiratory issues
- Sensation of a lump in the throat
- Backwash (regurgitation) of food or sour liquid
When should you seek medical help for GERD?
You should see a doctor if you have persistent GERD symptoms. 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 (gut specialist) 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:
- Upper gastrointestinal (GI) endoscope: a tube with a camera attached used to inspect the esophagus; a small sample of tissue may also be taken at the same time in a biopsy
- Upper GI series: a type of X-ray that shows specific physical abnormalities that might cause GERD
- Esophageal manometry: measures muscle contractions in the esophagus during swallowing; can measure the strength of the sphincter
- Esophageal pH and impedance monitoring and Bravo wireless esophageal pH monitoring: measure esophagus pH levels via a thin tube through the nose or mouth into the stomach. Patient is sent home with a monitor that measures and records the pH as they eat and sleep. The esophageal pH and impedance monitor is worn for 24 hours while the Bravo system is worn for 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, think again! GERD isn’t life-threatening or dangerous in itself. But long-term untreated GERD can lead to more serious health problems:
- Strictures: sometimes the damaged lining of the esophagus becomes scarred, causing narrowing of the esophagus. These strictures can interfere with eating and drinking by preventing food and liquid from reaching the stomach.
- Breathing problems (even without lung issues)
- Tooth decay
- Esophagitis: the irritation and inflammation the stomach acid causes in the lining of the esophagus. Esophagitis can cause ulcers in your esophagus, heartburn, chest pain, bleeding and trouble swallowing.
- Barrett’s esophagus–precancerous changes in cells lining the esophagus
- Esophageal cancer
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
- Proton Pump Inhibitors: stronger acid blockers that help heal damaged esophagus tissue
- Baclofen: prescription drug used to reduce the relaxation of the lower esophageal spincter which allows acid backwash
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:
- Laparoscopic antireflux surgery (or Nissen fundoplication) is the standard surgical treatment. It’s a minimally invasive procedure that fixes your acid reflux by creating a new valve mechanism at the bottom of your esophagus. The surgeon wraps the upper part of the stomach (the fundus) around the lower portion of the esophagus. This reinforces the lower esophageal sphincter so food won’t reflux back into the esophagus.
- LINX device implantation is another minimally invasive surgery. A LINX device is a ring of tiny magnets that are strong enough to keep the junction between the stomach and esophagus closed to refluxing acid but weak enough to allow food to pass through.