Heartburn is known medically as Gastroesophageal Reflux Disorder, or GERD. Often, what we notice is a bitter, sour or acidic taste in our mouths. At times, we may feel as if partially-digested food or liquid is moving from our stomach back toward our mouth.
GERD is a daily occurrence for about 10 percent of Americans and up to 50 percent of pregnant women. It’s an occasional nuisance for 30 percent of the population.
Causes of GERD
Food travels down the thin pipe known as the esophagus and into the stomach. A valve at the end of the esophagus (called the lower esophageal sphincter, or LES), prevents the contents of the stomach from going back up the esophagus. One cause of GERD is a mechanical disorder where the sphincter muscle weakens or doesn’t close correctly.
This causes the contents of the stomach to go back into the esophagus. Smoking can lead to reflux because it relaxes the LES; certain foods commonly relax the LES as well, including those high in fats or oils, tomatoes, citrus fruits, garlic, onions, chocolate, coffee, caffeinated products and peppermint. Finally, overeating can also lead to reflux, simply due to the bulk of food eaten.
Symptoms
• A burning feeling in the chest that occurs after eating and lasts a few minutes to several hours.
• Chest pain, especially after bending over, lying down or eating.
• Burning in the throat – or hot, sour, acidic or salty-tasting fluid at the back of the throat.
• Difficulty swallowing.
Heartburn may also cause chronic cough, sore throat or chronic hoarseness.
Treatment
To avoid heartburn, don’t overeat. Decrease the size of the portions at meal times or try to eat four or five small meals.
Avoid lying down right after eating. Eat meals at least two to three hours before lying down to give food time to digest and empty from your stomach.
Avoid heartburn triggers. Stay away from foods and beverages that trigger your heartburn symptoms. A good way to figure out what foods cause your symptoms is to keep a heartburn diary.
If you experience acid reflux at night, elevate your head or the head of your bed 4-6 inches. Raise the head of your bed so that your head and chest are higher than your feet. You can do this by placing six-inch blocks under the bed posts at the head of the bed. Don’t use piles of pillows to achieve the same goal. You will only put your head at an angle that can increase pressure on your stomach and make your heartburn worse.
If you are overweight, begin a diet and exercise program to help you shed a few pounds.
If you are taking prescription medications or suffer from a peptic ulcer, discuss your concerns with your doctor to help you rule them out as the true cause of your acid reflux.
Most doctors advocate diet and other lifestyle modifications along with antacids for occasional heartburn.
Sometimes, more potent or long-term antacid prescription medications may be needed. Occasionally, surgery is recommended to prevent reflux and heartburn.
Dr. Siddiq, an internist, is a co-founder of the UMMA Clinic and currently serves on its advisory board. He is medical director of St. Jude Heritage Medical Group in Anaheim, CA.
