We're only a few days from Thanksgiving, and you're probably ready for the possibility of heartburn and acid reflux. But some people get acid reflux much more frequently, and GERD Awareness Week is dedicated to educating people about it. Gastroesophageal reflux disease (GERD) is a chronic condition involving persistent acid reflux over a longer period of time.
Both GERD as well as infrequent acid reflux or indigestion are common, although influenced by diet and lifestyle:
- 20 percent of Americans suffer from GERD.
- Over 60 million Americans experience heartburn once a month.
- Over 15 million Americans experience heartburn every day.
- Westerners experience acid indigestion with greater frequency: 10-20% weekly versus 5% of Asian citizens.
Signs and Symptoms of GERD
Distinguishing GERD from infrequent reflux can be challenging. Many people get heartburn and attribute it to something they ate, even if it happens repeatedly. As we head into the holidays, defined by unhealthy snacks and family fest, here are some symptoms to watch out for:
- Heartburn that occurs 2 or more times per week or increases in severity.
- Heartburn that interrupts sleep.
- Infrequent heartburn that occurs over months or years.
- Difficulty or pain when swallowing.
- Chronic sore throat or throat irritation.
- Water brash: excess production of saliva, sometimes regurgitated.
- Erosion of tooth enamel.
- Gum inflammation.
- Dysphagia: the sensation of food sticking in the esophagus.
- Vomiting or regurgitation of acid.
- Belching, sour taste, or bad breath.
The presence of GERD is distinguished not just by heartburn, but by the tissue damage that might be caused by the esophageal lining being exposed repeatedly to stomach acid. This can cause a number of complications, including:
- Esophageal stricture: a narrowing of the esophagus due to scar tissue buildup.
- Esophageal ulcer: open sores that can lead to pain, bleeding, and problems swallowing.
- Barrett's Esophagus: A precancerous condition in which the esophageal lining becomes abnormal and more like intestinal lining.
- Esophageal cancer.
Causes of GERD
Reflux, the flow of stomach contents back into the esophagus, is due to a muscle called the lower esophageal sphincter (LES), a ring that keeps the top of your stomach closed. When the LES is weakened, compromised, or relaxes at the wrong moments, stomach acid can travel back upward and cause damage to the esophagus.
This simple mechanism, though, has many potential causes. Among the many risk factors for GERD are:
- Being overweight or obese.
- Eating large meals.
- Eating too soon before going to bed.
- Lying flat after eating.
- Hiatal hernia: a hernia that occurs where your stomach and esophagus join.
- Certain medications: aspirin, some drugs for asthma, high blood pressure, allergies, depression, sleep disorders, and pain.
- Certain foods and drinks, detailed in the next section.
Whether you suffer from GERD or just want to avoid the pain of heartburn, there are a number of steps you can take. The easiest, and most directly relevant to the upcoming holidays, is to limit your intake of certain foods and drinks that contribute to acid reflux. Among these are:
- High-fat foods: fried foods, gravies, desserts, fatty meats, full-fat dairy products.
- Oily or greasy foods.
- Citrus fruits and tomatoes.
- Chocolate: it relaxes the LES muscle.
- Spices: garlic, onions, other spicy foods.
You probably see most of your holiday meal on this list, but there's no reason to despair: many holiday favorites, such as turkey, chicken, fish, vegetables, and non-citrus fruits are not only safe, but may help manage reflux symptoms. Particularly important is increasing your fiber intake, which helps fight GERD symptoms and has a host of other benefits, including helping to control blood sugar, reducing cholesterol, and preventing hemorrhoids and other bowel issues.
There are other lifestyle changes you can make to manage not only GERD but occasional indigestion:
- Portion control: don't overeat.
- Weight loss: losing weight via diet and exercise reduces incidences of reflux.
- Stop smoking.
- Antacids: calcium carbonate or magnesium hydroxide medications that neutralize stomach acidity.
- Proton Pump Inhibitors: medications that reduce stomach acid production.
- Ranitidine Syrup: a medication that reduces stomach acid production.
- Sleep changes: don't eat for 3 or 4 hours before bed, and sleep with your head elevated.
Different foods may affect individuals to different degrees. What bothers one person's stomach may not do the same to another. Moderation and a generally healthy lifestyle is just as important as food choice. So when you're at the Thanksgiving table, pay attention to not just what you're eating, but how many helpings you take in.