The American College of Gastroenterology (ACG) says that at least 15 million Americans, or 20 percent of the American population, experience heartburn every day. Heartburn is the manifestation — the symptom — of acid reflux, or stomach contents coming back up in your esophagus.
You can often pinpoint a reason for the burn (that five-alarm chili, perhaps?), but if heartburn happens often — defined as a couple of times a week — it could be a symptom of a more serious condition called gastroesophageal reflux disease (GERD).
While it may seem that GERD is just a fancy name for heartburn, they are more like close cousins than identical twins.
What is heartburn or Acid Reflux?
After you swallow food, it makes its way down the esophagus and into the stomach, where a ring of muscle, called the lower esophageal sphincter (LES), closes to keep the food in. But sometimes the LES is weak or doesn’t properly close, allowing stomach acid to backup, which irritates the lining of the esophagus. That’s acid reflux and you may experience the symptom of heartburn.
- A burning sensation in the center of your chest that lasts from several minutes to an hour or two
- A feeling of chest pressure or pain that is worse if you bend over or lie down
- A sour, bitter, or acidic taste in the back of your throat
- A feeling that food is “stuck” in your throat or the middle of your chest
You can generally avoid occasional bouts of heartburn with some lifestyle modifications. Your doctor will likely suggest you try to treat heartburn by making the following lifestyle changes before medication comes into play.
- Avoid foods that trigger reflux for you. Spicy, acidic, and fried or fatty foods are more likely to trigger reflux. So can caffeine and alcohol.
- Stay upright after eating a big meal to allow for optimal digestion. Do not eat for several hours prior to bedtime.
- If you’re overweight or obese, losing some weight can help. Obesity is a factor in the weakening of the lower esophageal sphincter, and can increase abdominal pressure to facilitate reflux.
- If you smoke, do your best to quit.
When Acid Reflux is Chronic: What Is GERD?
According to the ACG, GERD is acid reflux that occurs more than a couple of times per week. That said, it’s not the case that a person who has occasional heartburn will necessarily progress toward having GERD. Gastroesophageal reflux disease is a condition where stomach acid persistently and regularly flows up into the esophagus.
The esophagus may also be referred to as the food pipe or gullet and is the tube that transports food from the mouth to the stomach.
The acid in the esophagus causes heartburn and other symptoms, as well as possible tissue damage.
The symptoms are the same as those of acid reflux, such as the burning feeling in your chest and the sensation that your stomach contents are in your throat. You may also have a dry cough or trouble swallowing.
Diagnosing the condition can usually be done by a gastroenterologist by simply evaluating symptom frequency and severity. Your GI doctor may also insert a probe into your esophagus to measure how frequently reflux happens. Knowing how often reflux occurs is another way (beyond symptoms) to confirm a diagnosis.
Treatment for GERD starts with lifestyle modifications. The medication most often prescribed for GERD is a proton pump inhibitor (PPI), such as:
- Prevacid (lansoprazole)
- Nexium (esomeprazole)
- Prilosec (omeprazole)
- Aciphex (Rabeprazole)
- Protonix (Pantoprazole)
PPIs work to decrease the amount of acid your stomach produces. The ACG notes that there’s strong evidence that an eight-week course of a PPI eases symptoms and can heal the lining of the esophagus that’s been damaged by stomach acid. Other drugs called H2 blockers, such as Zantac (ranitidine) or Pepcid (famotidine) may also be effective in lowering stomach acid. Most of these medications are available over the counter.
Delaying Treatment May Lead to Complications
If GERD goes untreated, it can lead to more serious complications. One such issue is esophagitis, which is inflammation in the esophagus. Hagan says if that’s not treated, you may develop strictures, which is a narrowing of the esophagus that can lead to esophageal pain and affect proper swallowing.
Another complication of GERD is a condition called Barrett’s Esophagus (BE). Over time, the stomach acid causes cells in the lining of the esophagus to look more like the stomach lining. These changes, which happen on a cellular level, may in rare cases lead to a form of esophageal cancer called esophageal adenocarcinoma. BE is more common in:
- Caucasian males
- People older than age 50
- People who are overweight
The bottom line: If you’re experiencing heartburn at an increased frequency, talk to a doctor at Hunterdon Gastroenterology Associates about testing to uncover the underlying issue. If you learn to treat GERD with lifestyle changes or medication, you can avoid more serious complications.
MacGill, Markus. Jan.18, 2018. Everything you Need to Know about GERD. Medical News Today.
Shipani, Denise. Jan. 12, 2018. What is the Difference between Acid Reflux and Gerd. Everyday Health.