How Do I Know If I Have Heartburn or GERD?
Have you noticed an uncomfortable feeling lately after eating at some of your favorite spots? Maybe you feel bloated after eating. Or, after your last night out on the town, which included your favorite barbeque joint and drinks with friends, you began to experience a slightly uncomfortable warmth in your esophagus leaving you wondering what is going on.
If you are experiencing a burning sensation in your stomach or esophagus or the unpleasant experience of acid rising into your throat, you may be experiencing heartburn or gastroesophageal reflux disease (GERD).
What is Heartburn?
Heartburn and GERD share the same food-related symptoms connected to the type and timing of food consumption or the ingestion of certain medications. Heartburn, also known as gastroesophageal reflux (GER) occurs when the band of muscle at the lower end of the esophagus, the lower esophageal sphincter (LES), fails to properly close or stay closed. As a result, the stomach’s hydrochloric acid and other stomach contents flow backward, or reflux, into the esophagus resulting in irritation. The stomach has a mucous lining that protects it from the acid it produces, but the esophagus does not. This lack of lining is what causes the burning pain when stomach acid rises into the esophagus. Reflux pain rises to the chest, near the heart, which explains why people commonly refer to it as ‘heartburn.’
A variety of medicines and supplements can irritate the esophagus contributing to either version of reflux. These potential irritants include antibiotics, iron supplements, Quinidine, Ibuprofen, potassium supplements, anticholinergics, tricyclic antidepressants, calcium channel blockers, statins, narcotics, sedatives, and tranquilizers.
How is GERD different from Heartburn?
The difference between heartburn and GERD has to do with the frequency of symptoms. Where you might experience heartburn on an occasional basis, GERD is the chronic version of the condition which makes its painful presence felt more than two times per week.
Common Signs of GERD:
- Repeated heartburn- after eating, while bending over, or while lying down
- Trouble swallowing (dysphagia)
- Bloating
- Upper abdominal or chest pain
- Nausea
- A sensation of pressure in the esophagus, or feeling as if you have a lump in your throat
- Repeated throat clearing
- Repeated burping
- Sore throat, hoarseness, or laryngitis
- Backwash- (regurgitation) of food and stomach acid into the esophagus
Those experiencing nighttime reflux may develop a constant dry cough, new or increasing asthma symptoms, laryngitis due to swollen vocal cords, or damaged tooth enamel.
Can dietary and lifestyle changes help?
Reflux is a frustrating disease because it can be extremely uncomfortable and takes a level of management that many would prefer to avoid. It has a direct impact on enjoying the so-called trivial things in life around which a significant amount of our culture’s socializing revolves—food and drink. There are several diet and lifestyle-related changes you can make to help manage or even alleviate your GERD symptoms and it’s important to understand what can trigger them.
Heartburn and GERD-triggering foods:
- Alcohol
- Spicy and deep-fried foods
- Peppermint and spearmint
- Caffeine
- Carbonated drinks
- Whole dairy products
- Chocolate
- Tomatoes and tomato-based sauces
- Coffee
- Acidic foods and drinks
- Spices like chili powder, pepper, cayenne
- Citrus fruits
- Fatty foods like fast food and meats like bacon and sausage
- Cheese and pizza
- Potato chips and other processed snacks
How much of these triggering foods you eat and how often can really affect how you feel because they can relax the LES, slow and make digestion take longer, or increase stomach acid production.
Carefully selecting food and lifestyle changes can help with discomfort, like avoiding exercise or bending over or just after eating or eating smaller meals. Eating your final meal of the day within 3 to 4 hours of bedtime prevents a full stomach from pressing against the LES causing nighttime reflux.
How Can I Manage GERD?
- Lose weight: The best thing you can do to alleviate symptoms, if applicable, is to lose weight because extra weight puts excess pressure on the stomach adding to reflux issues. GERD symptoms have been known to resolve after the loss of 10-15 pounds.
- Wear loose clothing: Avoiding constriction of the waist due to pressure on the stomach from tight-fitting clothes can help alleviate reflux.
- Reduce Stress: Exercise/walk/meditate
- Stop Smoking: Tobacco products contain chemicals that weaken the LES.
- Sleep with your head raised about six inches: Placing blocks under the legs of the head of your bed or using a wedge-shaped pillow under your mattress will elevate your head above your stomach helping prevent digested food from backing up into your esophagus. Simply using extra pillows is not the best solution because your torso will not lay flat causing increased pressure on your stomach and LES.
If the previous remedies do not provide sufficient relief, these over-the-counter medicines may help:
- Antacids, like Maalox, Mylanta, or Tums help neutralize stomach acid.
- H2 blockers, like Pepcid AC, Tagamet HB, and Axid AR reduce stomach acid production.
- Proton pump inhibitors, like Prilosec OTC (omeprazole), Prevacid 24 HR, Nexium 24 HR, and Zegerid OTC stop nearly all stomach acid production.
A study in 2010 concluded that melatonin and omeprazole can be used together for a short time to help alleviate the symptoms of GERD. Consult with your doctor for assistance.
When Should I See My Doctor?
While it may seem like you can manage your symptoms and flare-ups on your own, it’s a good idea to have your doctor confirm for sure that GERD is what’s bothering you. Having a correct diagnosis will help a lot, especially if attempts at self-care have not resolved your symptoms. GERD is diagnosed according to symptoms, but when certain symptoms are present, such as trouble swallowing, your doctor may request an upper gastrointestinal (GI) endoscopy to check the health of your esophagus.
Untreated aggravation and inflammation of your esophagus can cause serious harm to the lining of the esophagus including bleeding and ulcers leading to swallowing issues. Repeated incidences of reflux can cause scar tissue to form which leads to esophageal stricture, or a narrowing of the esophagus and increased trouble swallowing.
Over time, acid damage can cause precancerous changes in the tissue lining of the lower esophagus (Barrett’s esophagus) which leads to an increased risk of esophageal cancer, underscoring the importance of medical supervision as you seek relief.
Visit AFC Urgent Care Dalton with your reflux issues for professional care any day of the week.
