What is GERD?
Do you take over-the-counter medicine for heartburn? If you’re taking antacids or H2 blockers more than once a week to ease your pain, there may be a better, long-term solution for your symptoms.
Heartburn, or acid indigestion, is a symptom of acid reflux. Acid reflux occurs when stomach acid backs up into the esophagus, irritating the tissues. Heartburn gets its name from where you feel the burning sensation caused by the stomach acid – just behind the heart, where the esophagus lies.
Gastroesophageal reflux disease (GERD) is a chronic, more severe form of acid reflux.
Gastroesophageal reflux disease (GERD) is common, accounting for more than 5.6 million physician visits each year. From 10% to 20% of adults experience GERD symptoms at least weekly. GERD is defined as a condition that develops when reflux of stomach contents causes troublesome symptoms with or without complications. Typical symptoms that lead to the diagnosis of GERD are regurgitation and heartburn.
GERD is more likely to appear in younger patients under the age of 65. It can be especially prevalent when laying down after meals.
OTC Medicines for Heartburn
If your heartburn is infrequent or moderate, over-the-counter medicines, which include antacids such as Tums and Alka-Seltzer, H2 blockers such as Zantac and Pepcid, or proton pump inhibitors such as Prevacid and Nexium may work.
Antacids work by neutralizing the acid in your stomach, while H2 blockers and proton pump inhibitors work by suppressing stomach acid production.
Over-the-counter medicines can work quickly and are safe for intermittent problems, along with lifestyle changes such as eating smaller meals, avoiding late-night eating or avoiding lying down after eating. Weight loss, quitting smoking and elevating your head when sleeping are other lifestyle changes you can make to help eliminate GERD.
The Role of Stomach Acid
Over-the-counter medicines that get rid of stomach acid are not a long-term solution to constant heartburn. You may be making the symptoms go away with medicine, but not addressing an underlying problem.
Gastric acid is part of our natural makeup. The acid helps you to digest food and protects you against infection. When you suppress acid, you can be affecting your health by affecting the digestive process.
When Is It Time to Talk to Your Doctor?
If you experience heartburn or regurgitation more than once a week, it’s time to talk with your doctor.
If medications do not provide relief, further options include procedures intended to evaluate the stomach and valve that connects the stomach and esophagus. These options may include:
- Upper endoscopy. Your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat, to examine the inside of your esophagus and stomach. Test results can often be normal when reflux is present, but an endoscopy may detect inflammation of the esophagus (esophagitis) or other complications. An endoscopy can also be used to collect a sample of tissue (biopsy) to be tested for complications such as infection and a precancerous condition called Barrett’s esophagus.
- Bravo Capsule test. This test involves inserting a capsule the size of a long gel cap into the esophagus to measure the pH environment. Higher levels of pH in the esophagus indicate the presence of acid reflux. Throughout the test period, which lasts 48 hours, the Bravo capsule will measure the pH in your esophagus and transmit this information to the Bravo reflux recorder, a small device that you will wear on your belt. The capsule communicates with the recorder wirelessly, meaning that no tube or wire remains in your nose or throat. Your doctor will analyze results from the Bravo test to determine what is causing your symptoms and which treatment to prescribe for you.
- Esophageal manometry. This test measures the rhythmic muscle contractions in your esophagus when you swallow. Esophageal manometry also measures the coordination and force exerted by the muscles of your esophagus.
- X-ray of your upper digestive system. X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of your digestive tract. The coating allows your doctor to see a silhouette of your esophagus, stomach and upper intestine. You may also be asked to swallow a barium pill that can help diagnose a narrowing of the esophagus that may interfere with swallowing.
The physicians at Hunterdon Gastroenterology are available to assist you with finding out if you have GERD and help you manage this condition. Give us a call at 908-483-4000!
References:
Bravo Reflux Testing. Medtronic. 2020
Cleveland Clinic: GERD, a Practical Approach. Feb. 2020
Health@UH. How to Know When You Need More than Medicine. Jan. 2020
Mayo Clinic: GERD. Jan 2020
