Gastroesophageal reflux disease, also known as GERD, is a condition in which the base of esophagus allows an unusually large amount of stomach acid to move up into the throat. Nearly everyone has a small amount of gastric acid come up occasionally, but in GERD the volume of burning stomach juices is larger and more frequent. Once acid gets up into the throat, it can travel into the mouth, nasal passages, and even the ears, doing corrosive damage wherever it travels.
There are three symptoms that are expected with GERD:
- Heartburn, the intense heat and inflammation felt when stomach acid comes up into the throat,
- Regurgitation, effortless vomiting of food and stomach acid that won't stay down, and
- Dysphagia, difficulty swallowing.
About 30 percent of people who have GERD don't have any of those three symptoms. And about 70 percent of people who have GERD have one or more atypical symptoms, which may include:
- Erosion of the enamel on the teeth,
- Ear pain,
- Eye irritation, and
- Asthma, which often occurs without any obvious gastrointestinal symptoms even though it is caused by GERD.
Everyone who has GERD is told to avoid certain problem foods, such as:
- Peppermint tea and peppermint candies,
- Tomato juice, tomato paste, ketchup, and whole tomatoes, and,
- Vegetables in the Onion Family, including onions, garlic, chives, and leeks.
Chili peppers, oddly enough, are not on the list, and a few studies have found that they even help with inflammation in the stomach.
Just avoiding problem foods, however, usually does not do a lot of good. It's also imperative to:
- Correct overweight, so there is less pressure on the stomach to force its contents upward.
- Avoid eating large meals, which stretch the valve at the base of the esophagus that keeps acid from coming up.
- Avoid lying down within three hours of eating a meal, when the stomach is full. Diabetes who have developed a condition called gastroparesis may have to wait four or five hours.
- Sleep with the head of the bed elevated. Just sleeping on extra pillows will not slant the esophagus and stomach so that acid stays down.
These measures usually don't eliminate GERD, either, but they may greatly help with symptoms. Beyond that, the standard treatments are:
- Antacids, such as TUMS, which neutralize stomach acid with calcium or aluminum compounds.
- H2 receptor antagonists such as ranitidine (Zantac), cimetidine (Tagamet), famotidine (Pepcid), and nizatidine (Axid).
- Proton pump inhibitors such as omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), and esomeprazole (Nexium),
The important thing to understand about all of these medications, even the antacids, is that anything that reduces or relieves the production of stomach acid also reduces the amount of nutrients released from your food. Even calcium-rich TUMS won't replace other mineral nutrients that your body can extract from food, including most of the minerals and vitamin B12. If you take any of these products, you may need a balanced mineral supplement to help replace the minerals you don't get from your food. Just avoid taking more than 400 mg of calcium in a single tablet. Your body simply cannot absorb more calcium than that in a three to four hour period even if you have normal digestion.
When acid reflux diet and lifestyle changes don't help, and drugs don't help, doctors may try surgery. Women who have osteoporosis, children whose parents don't want them to have to take nutritional supplements for life, and anyone whose GERD symptoms occur outside the gastrointestinal tract (asthma, ear problems, dental erosion), and anyone who wants to "get it over with" may be offered surgery. The benefits of surgery usually don't last forever, but they may last as long as 10 years.
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