Heartburn is its most common symptom, but there are others. My friend Lorinda discovered she had GERD when her dentist pointed out that something was eroding the enamel on her teeth-namely, the backwash of stomach acid. Other typical symptoms include water brash (that sour acid taste in the back of the throat) and mild regurgitation. Atypical symptoms, as in my mother’s case, can include hoarseness, coughing, tooth burns, and even asthma. “When the acid goes so far up the esophagus that it spills over into the windpipe, it can actually cause asthma,” explains Eugene Cho, MD, an assistant professor of surgery at the University of Maryland Medical Center in Baltimore.
A Risk of Cancer?
The symptoms seem mild compared with the risks you face when you have GERD. A study by researchers at the University of Miami School of Medicine found that the risk of esophageal cancer is more than seven times higher among people who regularly suffer acid reflux (Digestive Diseases and Sciences). According to the Society of Thoracic Surgeons in Chicago, that risk group may include 10 to 20 million Americans who have a weakness or malfunction of the lower esophageal sphincter (LES) valve that joins the stomach and the esophagus. Its function is to allow food to pass but prevent acid from returning. “GERD is like having a leaky lid on a top-loading washing machine, only instead of foam building up over the washer, you have acid boiling up into the esophagus,” explains Dr. Cho.
Watch What You Eat
GERD sufferers are encouraged to avoid chocolate, peppermint, alcohol, caffeine, and carbonated beverages, because these may interfere with the proper function of the LES valve. In addition, citrus fruits and juices, tomato products, chili, mustard, and raw onions are thought to irritate the lining of the esophagus. Some physicians encourage their patients to avoid fatty or fried meals. Although there’s some controversy over whether fat promotes heartburn or GERD, it certainly promotes other diseases, so it’s good advice all-around. Not everyone reacts to every food. To understand what causes your symptoms, keep a diary of your meals and episodes of intolerance, suggests Teresa Rispoli, PhD, founder and director of the Complete Health Institute in Agoura Hills, CA. Here are other put-out-the-fire options:
Stop smoking. (Smoke relaxes the esophageal sphincter, which can lead to GERD.) Lose weight, if you are overweight. Eat smaller meals.Don’t lie down for 3 hours after you eat.Raise the head of your bed 6 to 8 inches.Switch to acetaminophen in place of aspirin, ibuprofen, and other over-the-counter (OTC) painkillers.
Going the Drug Route
Both prescription and nonprescription medications have been proven effective for occasional heartburn. But if you experience chronic heartburn or other GERD symptoms one or more times a week, you should seek the advice of a physician. Your Over-the-Counter Choices:
Antacids. Medications such as Maalox and Mylanta help neutralize the acid in the stomach.Acid blockers. Pepcid AC, Zantac 75, Tagamet HB, Tums, and others can decrease the production of acid in the stomach for several hours. You can take these before a meal as well as after.
If OTC drugs don’t work, your doctor can prescribe a number of medications to control GERD. “The sound bite you want to remember is that GERD can be managed,” says Nancy Norton, president and founder of the International Foundation for Functional Gastrointestinal Disorders in Milwaukee. Your Prescription Choices:
H-2 blockers. Pepcid, Zantac, and Tagamet are all available in prescription strength.Proton pump inhibitors (PPIs). Medications such as Prilosec, Prevacid, Aciphex, Protonix, and Nexium reduce acid secretion by turning down the pump that produces acid in the stomach. They provide symptom relief in the majority of patients who have chronic reflux symptoms. According to Norman Goldberg, MD, clinical professor of medicine at the University of California, San Diego, “You get a patient who’s had severe chronic heartburn and start him on a proton pump inhibitor, then he phones you in a few days and says, ‘It’s unbelievable!’ " A study found that you may not need to stay on PPIs forever. Researchers at the University of Michigan Medical School in Ann Arbor were able to wean more than half of 71 GERD patients from their daily dose of PPIs, substituting less expensive and less powerful drugs to be taken as needed. And 15% of the patients needed no medication at all, because they remained symptom-free.
What about Surgery?
Although a number of surgical options have been tested, as of 2002 most physicians believe that fundoplication is the best alternative for chronic GERD patients who can’t get relief from medication or diet and lifestyle changes. In this operation, the upper portion of the stomach (the fundus) is wrapped (plicated) around the lower portion of the esophagus, which increases lower esophageal sphincter (LES) valve pressure. Eugene Cho, MD, an assistant professor of surgery at the University of Maryland Medical Center in Baltimore, says that more than 9 out of 10 patients with heartburn and other typical GERD symptoms can be cured by this procedure. Use of a laparoscope (a tiny video camera) enables smaller incisions and decreases recovery time. More from Prevention: Simple Ways To Prevent Heart Disease
