Does stomach acid back up into your esophagus after meals, causing a burning in your chest? You could have gastroesophageal reflux disease (GERD) — and you're not alone.
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About one in five U.S. adults experiences GERD, according to National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
The Lowdown on GERD
As stomach acid comes up and goes back down, it can irritate the lining of your esophagus. This irritation can lead to what people commonly describe as heartburn because the pain occurs in the center of the chest behind the breastbone.
"Frequent irritation of the esophageal lining also can lead to scarring and narrowing of the esophagus, resulting in foods getting stuck, precancerous changes and even esophageal cancer," says Brooks Cash, MD, chief of gastroenterology, hepatology and nutrition at the University of Texas Health Science Center, in Houston. That's why it's important not to ignore GERD.
You can make lifestyle changes that can help protect your esophagus and prevent acid from refluxing upward, says the NIDDK. In addition, your doctor may prescribe medications that suppress stomach acid.
And if these remedies don't work, you may be a candidate for a surgical procedure that strengthens the muscular valve — the lower esophageal sphincter (LES) — which is the gatekeeper that prevents stomach contents from backing up, explains NIDDK.
Read more: GERD: Its Signs and Symptoms
Treating GERD With Lifestyle Changes
Because every patient is different, Dr. Cash says, "treatment options should be individualized." A combination of treatments benefits many. Consider making some lifestyle changes as a good way to start, such as:
Losing weight. Fat around your stomach puts pressure on your lower esophageal sphincter, weakening it and causing it to malfunction. Even a small-to-moderate amount of weight loss can make you feel better, notes the International Foundation for Functional Gastrointestinal Disorders (IFFGD).
Avoiding trigger foods. Not everyone is affected by the same foods in the same ways, Dr. Cash says. But there are foods that commonly cause GERD in many people, including alcohol, coffee, citrus fruits and juices, tomatoes, carbonated beverages, chocolate, peppermint, garlic, onions and fatty, fried or spicy foods, according to the American Society for Gastrointestinal Endoscopy.
Keep a food diary. It's a good way to determine which foods bother you and which you should eliminate from your diet, the society suggests.
Eating smaller meals. When you eat big meals and fill your stomach, it puts pressure on your on the LES. Pressure on the valve can allow stomach acid and juices to get back up and irritate your esophagus, according to the Cleveland Clinic. Also, eat those smaller amounts more frequently. That helps too.
Stopping smoking. The nicotine in cigarettes relaxes the valve that keeps stomach acids where they belong — in your stomach digesting your food, according to University of Michigan Medicine. And when the valve is relaxed, stomach acid and juices can get back up and irritate your esophagus, it says. Seek help to quit smoking if you need it.
Raising your head. Acid can flow from your esophagus while you sleep. If you raise the head of your bed 6 to 8 inches, it will help stop the flow at night, says Cleveland Clinic. Raise the bed by placing blocks under the frame or use a foam wedge under the head of your mattress. Both are firmer and more reliable than extra pillows. Also, wait at least three hours after you eat to lie down, Cleveland Clinic suggests.
Other Ways to Heal
In addition to making lifestyle changes, here's what else may help heal your esophagus:
Take medication. Medications are available over the counter and by prescription. "The most proven of these medications are called proton pump inhibitors, and these medicines are both safe and effective," Dr. Cash says.
Roughly 80 to 90 percent of patients find long-term healing with proton pump inhibitors, according to the IFFGD. Another medication, H2 blockers, can also reduce the amount of acid your stomach produces. About 50 percent of patients find that when they take prescription-strength H2 blockers, their esophagus heals, adds IFFGD.
Consider surgery. If lifestyle changes and medicine don't help or stop working after a while, surgery may be an option for you, says Cleveland Clinic. It strengthens your LES so it goes back to being a "one-way" valve, meaning acid reflux can't escape. Talk to your doctor about whether you're a candidate for this procedure.
Is This an Emergency?
- National Institute of Diabetes and Digestive and Kidney Diseases: "Definition & Facts for GER & GERD"
- Brooks Cash, MD, chief of gastroenterology, hepatology and nutrition, University of Texas Health Science Center, Houston, Texas
- American Society for Gastrointestinal Endoscopy: "Diet and Gastroesophageal Reflux Disease"
- Cleveland Clinic: "GERD (Chronic Acid Reflux)"
- University of Michigan Medicine: "GERD: Controlling Heartburn by Changing Your Habits"
- International Foundation for Functional Gastrointestinal Disorders: "Diet and Lifestyle Changes"
- National Institute of Diabetes and Digestive and Kidney Diseases: "Treatment for GER and GERD"
- National Institute of Diabetes and Digestive and Kidney Diseases: "Symptoms and Causes of GER and GERD"
- Cleveland Clinic: "GERD (Chronic Acid Reflux): Prevention"
- International Foundation for Gastrointestinal Disorders: "Medications"