1. Heartburn is Only Part of It
Acid reflux disease, GERD, acid reflux or whatever you prefer to call it, can cause an entire spectrum of symptoms. Most people are quite familiar with good old fashioned "heartburn," but GERD can also cause a chronic cough, laryngitis, difficulty swallowing, wheezing and even ear fullness. Acid reflux symptoms depend on how high the reflux goes and how acidic it is. The patient with ear fullness, for example, has reflux that goes all the way into the middle ear.
2. A Weak LES Makes GERD Worse
LES stands for lower esophageal sphincter. This circular muscle sits at the bottom of the esophagus and is crucial for proper swallowing and prevention of reflux. The LES should relax during the process of swallowing and then contract to keep food from coming back up. Some people have an LES that doesn't cut the mustard, literally or figuratively. Others eat so much that the LES is equally dysfunctional. The most common cause of GERD is obesity, which causes the stomach contents to return up the esophagus.
3. Be Kind to Your LES
What you eat can have a profound influence on your LES. Tomatoes, coffee, chocolate, citrus juice and alcohol will all relax the lower esophageal sphincter. The sales of antacids always go up when tomatoes come into season. Certain medications have a similar effect. These include calcium channel blockers, nitrates, beta blockers and hormones like progesterone. When these medications are necessary, for heart disease for example, it may be necessary to add a treatment for GERD along with the offending medication.
4. Long Term GERD Can Cause Big, Big Problems
The esophagus does not tolerate constant exposure to the acidity of stomach contents. It lacks the protective surface present in the lining of the stomach. Thus, when a person has relatively constant reflux, the esophagus can erode. Basically, it develops a chemical burn. This can become pre-cancerous.
5. Make it Better
There are some simple ways to improve GERD. These include weight loss, avoidance of offending foods, if possible, changing from offending medications, elevating the head of your bed so gravity helps keep stomach contents where they should be, eating small meals and staying upright for at least two hours after eating. Antacids are the classic medical treatment for GERD, but recently, medications called histamine receptor agonists, like Zantac, Pepcid, Tagamet, and their cousins, have gained popularity. They inhibit acid production. Proton pump inhibitors, the newest class of medication for GERD, are even more powerful.
