Q: I suffer from heartburn several times a week. My friend has gastroesophageal reflux disease and I am wondering if I do also. How can I tell?
A: You are not alone in your struggle with heartburn. One in 10 Americans have heartburn symptoms at least once a week. Occasional heartburn is not unusual, however, if it is persistent you may indeed be suffering with gastroesophageal reflux disease (GERD).
GERD occurs when the lower esophageal sphincter doesn't close properly and stomach contents backup (reflux) into the esophagus. Stomach acid production is a normal and necessary function of the body, as it helps break down food. But, when the stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn.
So how do you know if you have GERD? There are a few classic symptoms to watch for, such as frequent heartburn, trouble sleeping, difficulty swallowing, throwing up when you lay down at night, or a persistent cough. These may also be signs of other serious conditions, so it is important to talk to your healthcare provider if you are experiencing any of these symptoms.
Questions to Ask Yourself
If you experience heartburn and wonder if you have GERD, ask yourself:
• Does heartburn disrupt my sleep?
• Has my heartburn become worse?
• Do heartburn symptoms occur regularly (more than once a week)?
• Do I have problems swallowing?
• Do over-the-counter medicines fail to provide complete relief or am I increasing dosage to control my symptoms?
• Am I ever hoarse or do I experience asthma symptoms after eating, exercising or when lying down?
• Does heartburn disrupt my day-to-day lifestyle?
GERD: More Than Heartburn
Occasional or infrequent bouts of heartburn are usually harmless and can generally be managed with lifestyle modifications and over-the-counter medicines. When the heartburn is chronic and severe, as with GERD, the situation becomes more serious.
If the esophagus is continually exposed to stomach acid, irritation and discomfort are not the only problems. The acid can inflame the esophageal lining and cause complications including narrowing of the esophagus, esophageal bleeding, ulcers and Barrett's esophagus - a potentially precancerous condition.
Lifestyle Changes
The first thing your healthcare provider may recommend to manage your heartburn or bouts with GERD is lifestyle changes. If making changes in your daily routine can eliminate heartburn, medication and/or surgery may not be necessary.
• Limit foods and beverages that trigger heartburn. These may include chocolate, peppermint, fatty foods, alcoholic beverages, citrus fruits and juices, garlic and raw onion, tomato sauce, vinegar, caffeinated and carbonated beverages.
• Eat smaller portions and eat earlier in the day. Decrease the size of portions at mealtimes and eat meals at least 2-3 hours before lying down.
• Exercise. Be more physically active through regular daily activity in addition to regular workouts.
• Lose weight. Even a few pounds can help.
• Stress. Relax as stress can cause acid production.
• Stop smoking. Smoking also may stimulate acid production and weaken the valve that prevents stomach acid from entering the esophagus.
• Elevate your bed. This can prevent acid from creeping up the esophagus while you sleep.
• Loosen up. Reduce abdominal pressure by not wearing tight belts or binding clothing.
• Eat slowly. Eating fast and eating too much can result in reflux and heartburn.
Surgery is necessary for GERD when:
• Symptoms are not controlled by medical or drug treatments.
• The sphincter muscle doesn't work as it should.
• Patients can't afford or tolerate medication to control heartburn symptoms.
• GERD results in esophageal cancer.
Minimally Invasive Surgical Option
Minimally invasive surgery has proven to be as effective as open surgery for many patients and it offers several additional benefits including less pain, faster recovery, shorter hospital stay and less scarring.
An alternative to open surgery, laparoscopic anti-reflux surgery is a minimally invasive procedure that results in an improved valve mechanism at the bottom of the esophagus. The surgeon, using specialized surgical instruments that pass through small incisions in the patient's body, creates a tight sphincter (band) to prohibit food and stomach acid from backing up into the esophagus. A tiny video camera called a "scope" is inserted through one of the incisions and transmits a live, magnified view of the patient's organs onto a television monitor to guide the surgeon.
Remember that heartburn may be an indication of a serious condition. Continue to talk to your healthcare provider about treatment options for ongoing heartburn or reflux issues. The best way to prevent future complications is to address the issue at its source as early as possible.
-Nicholas Maxwell, MD, FACS, is Board Certified in general surgery
A: You are not alone in your struggle with heartburn. One in 10 Americans have heartburn symptoms at least once a week. Occasional heartburn is not unusual, however, if it is persistent you may indeed be suffering with gastroesophageal reflux disease (GERD).
GERD occurs when the lower esophageal sphincter doesn't close properly and stomach contents backup (reflux) into the esophagus. Stomach acid production is a normal and necessary function of the body, as it helps break down food. But, when the stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn.
So how do you know if you have GERD? There are a few classic symptoms to watch for, such as frequent heartburn, trouble sleeping, difficulty swallowing, throwing up when you lay down at night, or a persistent cough. These may also be signs of other serious conditions, so it is important to talk to your healthcare provider if you are experiencing any of these symptoms.
Questions to Ask Yourself
If you experience heartburn and wonder if you have GERD, ask yourself:
• Does heartburn disrupt my sleep?
• Has my heartburn become worse?
• Do heartburn symptoms occur regularly (more than once a week)?
• Do I have problems swallowing?
• Do over-the-counter medicines fail to provide complete relief or am I increasing dosage to control my symptoms?
• Am I ever hoarse or do I experience asthma symptoms after eating, exercising or when lying down?
• Does heartburn disrupt my day-to-day lifestyle?
GERD: More Than Heartburn
Occasional or infrequent bouts of heartburn are usually harmless and can generally be managed with lifestyle modifications and over-the-counter medicines. When the heartburn is chronic and severe, as with GERD, the situation becomes more serious.
If the esophagus is continually exposed to stomach acid, irritation and discomfort are not the only problems. The acid can inflame the esophageal lining and cause complications including narrowing of the esophagus, esophageal bleeding, ulcers and Barrett's esophagus - a potentially precancerous condition.
Lifestyle Changes
The first thing your healthcare provider may recommend to manage your heartburn or bouts with GERD is lifestyle changes. If making changes in your daily routine can eliminate heartburn, medication and/or surgery may not be necessary.
• Limit foods and beverages that trigger heartburn. These may include chocolate, peppermint, fatty foods, alcoholic beverages, citrus fruits and juices, garlic and raw onion, tomato sauce, vinegar, caffeinated and carbonated beverages.
• Eat smaller portions and eat earlier in the day. Decrease the size of portions at mealtimes and eat meals at least 2-3 hours before lying down.
• Exercise. Be more physically active through regular daily activity in addition to regular workouts.
• Lose weight. Even a few pounds can help.
• Stress. Relax as stress can cause acid production.
• Stop smoking. Smoking also may stimulate acid production and weaken the valve that prevents stomach acid from entering the esophagus.
• Elevate your bed. This can prevent acid from creeping up the esophagus while you sleep.
• Loosen up. Reduce abdominal pressure by not wearing tight belts or binding clothing.
• Eat slowly. Eating fast and eating too much can result in reflux and heartburn.
Surgery is necessary for GERD when:
• Symptoms are not controlled by medical or drug treatments.
• The sphincter muscle doesn't work as it should.
• Patients can't afford or tolerate medication to control heartburn symptoms.
• GERD results in esophageal cancer.
Minimally Invasive Surgical Option
Minimally invasive surgery has proven to be as effective as open surgery for many patients and it offers several additional benefits including less pain, faster recovery, shorter hospital stay and less scarring.
An alternative to open surgery, laparoscopic anti-reflux surgery is a minimally invasive procedure that results in an improved valve mechanism at the bottom of the esophagus. The surgeon, using specialized surgical instruments that pass through small incisions in the patient's body, creates a tight sphincter (band) to prohibit food and stomach acid from backing up into the esophagus. A tiny video camera called a "scope" is inserted through one of the incisions and transmits a live, magnified view of the patient's organs onto a television monitor to guide the surgeon.
Remember that heartburn may be an indication of a serious condition. Continue to talk to your healthcare provider about treatment options for ongoing heartburn or reflux issues. The best way to prevent future complications is to address the issue at its source as early as possible.
-Nicholas Maxwell, MD, FACS, is Board Certified in general surgery
