Everyone has an episode of acid reflux now and then after overeating or eating too many spicy foods. McLeod Gastroenterologist Terri Jaggers, MD, describes when you need to see a doctor about GastroEsophageal Reflux Disease (GERD) and what you can do.
Here are highlights from Dr. Jagger’s comments:
GERD is when the contents of the stomach, usually food with acid involved, flows upward into our esophagus or even up into the mouth sometimes when it’s severe. Nausea can be a symptom as well.
GERD is very common. Most people, if you talk to them long enough, will have at least some symptoms of GERD. We as physicians worry about it when it becomes persistent and occurs several times a week. Then, it rises to a much higher level of severity and concern.
We don’t know the actual cause but there are some common associations with it. One is diet. If you eat a lot of spicy foods, caffeine or chocolate – especially late at night — you are more likely to suffer reflux or GERD. Another common trigger is a hiatal hernia, which is a weakness of the muscle between the esophagus and the stomach. Normally, this muscle it is nice and tight. But as we age muscles can relax and allow contents to come up into the esophagus.
You should worry when it happens several times per week no matter what you eat or drink. If you’ve tried over-the-counter medicines for a couple of weeks and it doesn’t go away or goes away and comes back, then you should see a gastroenterologist. It’s most dangerous when food starts sticking in your throat after you eat. The fancy word for that is dysphasia, but basically it means you have trouble swallowing. It can be a very dangerous sign.
Alcohol can make it worse. Cigarette smoking makes it worse. Eating late at night and then laying down commonly triggers reflux. Sometimes, people need to lose a little weight. When you are overweight, a person is more prone to reflux.
Quite a few treatments are available. We start with simple over-the-counter anti-acids, such as TUMS or Rolaids. The next level includes what we call the “H2 blockers,” such as Zantac and Tagamet. The ultimate medical treatment is the PPI (Proton Pump Inhibitor). Some are over-the-counter, some are prescription medications and this group includes Prilosec, Nexium and Protonix.
The next step would be to use an endoscope to look down in the esophagus. Sometimes that’s even done before the medicines have been tried.
There is surgical treatment for GERD. The surgeons do what they call a Nissen wrap, where they wrap the esophagus and almost make like a little gate or barrier to prevent reflux from occurring. It is effective. Yet, it is surgery and fairly invasive. However, if the other mechanisms don’t work then that can certainly be considered.