1. What is GERD?
Just about everybody has experienced symptoms of GERD at one time or another. About 17 million people in the United States have heartburn and other symptoms of GERD. For seniors, the discomfort of GERD can be a daily ordeal causing some to avoid eating altogether. Gastroesophageal reflux disease, commonly called GERD, is a digestive disorder in which the stomach's juices flow backwards, into the esophagus. A muscular ring seals the esophagus from the stomach. Normally, this muscular ring opens when you swallow, to let food into your stomach. In between swallows or belches, it squeezes tight to prevent food and acid in the stomach from backing up into the esophagus. The symptoms are aggravated in the elderly because digestion is naturally slowed and the symptoms of GERD can persist longer during the day. It is important to tell your doctor about your symptoms in case they might be related to something more serious. Chronic GERD can lead to a precancerous condition of the esophagus called Barrett's esophagus.
2. What are the Symptoms of GERD?
Symptoms of GERD may include:
Sharp or burning chest pain behind the breastbone (also known as heartburn, the most common symptom of GERD), which may be worse when you eat, bend over or lie down. Tightness in your chest or upper abdomen, especially pain that wakes you up in the middle of the night. Regurgitation (backflow of stomach fluids into your mouth). Nausea. A recurring sour or bitter taste in the mouth. Difficulty swallowing. Hoarseness, especially in the morning. Sore throat. Coughing, wheezing or repeatedly needing to clear your throat.
3. Things to Avoid
GERD is another good reason to stop smoking. Some studies indicate that nicotine causes relaxation of the lower esophageal sphincter. Other studies show that smoking changes the saliva so acid isn't cleared from the esophagus quickly enough, resulting in damage to the esophagus.
Anyone with GERD should avoid certain foods that cause the esophageal sphincter to relax for an hour or more during their digestion. Avoid foods that trigger symptoms, such as citrus products, tomato sauces, peppermints, chocolate, onions, coffee, fried foods and carbonated beverages. Fatty foods take longer to exit the stomach, making reflux more likely.
Avoid drinking alcoholic beverages. Alcohol can relax the lower esophageal sphincter and cause erratic contractions of the esophagus that can allow acid to reflux into the esophagus and cause heartburn. Alcohol itself also irritates the esophagus and stomach lining.
4. Check Your Medications
Eight percent to 90 percent of patients improve after treatment with medication, but it can take weeks of treatment before symptoms begin to be relieved. Some medications commonly prescribed for seniors for other conditions may make GERD symptoms worse. But don't stop taking any without first consulting your health care professional. Common drugs that might have these effects include drugs to treat asthma and emphysema such as theophylline; anticholinergic drugs used to treat Parkinson's disease and asthma and found in some over-the-counter cold medications; hormones, such as progesterone, that may be found in birth control pills and some calcium-channel blockers, alpha-blockers and beta-blockers used to treat heart conditions or high blood pressure; certain drugs that affect the central nervous system; iron tablets and some osteoporosis medications. Be sure and mention your symptoms, and bring your medication diary to the doctor when you visit.
5. Other Things to Watch For
It is important to pay attention to GERD-like symptoms. A list of serious conditions that can masquerade as GERD include angina, ulcer disease, pneumonia, abdominal tumors, heart failure esophageal tumors and aortic aneurysm. This is why GERD should not be ignored without a work-up, especially in the elderly as all of the above are more common in seniors.
