It’s that time of the year…holiday parties, celebrations with friends and family, and a time to indulge! This is a time of the year when hearty meals bring us together, drinks are flowing and we all get a little lax about weight gain. Unfortunately, it can be a perfect recipe to cause or worsen gastroesophageal reflux disease (GERD).
GERD is one of the most common gastrointestinal problems worldwide and a common reason to see a gastroenterologist. GERD affects approximately 20% of people in the United States. Anyone at any age can develop GERD. If left untreated, it can sometimes cause serious complications such as Barrett’s Esophagus (a precancerous condition of the esophagus or food pipe) and even Esophageal Cancer.
What Causes GERD?
GERD occurs when acid that is typically in your stomach backs up into your esophagus. There is a valve at the end of your esophagus called the lower esophageal sphincter (LES) and when that valve is relaxed and doesn’t close well, food and acid in your stomach can back up into the esophagus and cause irritation. Acid reflux can happen to everyone but when it occurs more than twice a week over several weeks or over the counter antacids are no longer helping, you may have developed GERD.
What Are the Symptoms of GERD?
The most common symptoms of GERD are heartburn (feeling a burning sensation in your chest) or regurgitation (feeling acid or undigested food come into your throat or mouth). Some people may have atypical symptoms that can include abdominal pain, chest pain, trouble swallowing, nausea, vomiting, sore throat, cough, or hoarseness.
What Are the Diagnostic Tests For GERD?
If you have classic symptoms of GERD, you may not need any additional testing and can be directly treated.
If you have atypical symptoms or are at risk for Barrett’s Esophagus (males, Caucasian ethnicity, age more than 50, having heartburn for more than 5 years, hiatal hernia, having a family history of Barrett’s esophagus or esophageal cancer, tobacco use, alcohol consumption, and obesity), you may need additional testing which can include:
- Upper endoscopy
- Barium swallow
- Ambulatory acid (pH) probe test or BRAVO test
- Esophageal manometry
How is GERD Treated?
To manage GERD, we first discuss lifestyle modification. This can include the following:
- Avoid trigger foods. This can be different for everyone but common triggers include spicy foods, fried foods, tomato-based sauces, citrus fruits, caffeine, carbonated beverages, chocolate, and peppermint.
- Avoid large, heavy meals in the evenings.
- Wait a few hours after eating to lie down.
- Elevate the head of your bed when sleeping if having nighttime reflux.
- Maintain a moderate weight. Lose weight if you are overweight or obese.
- Quit smoking tobacco.
- Use alcohol in moderation.
Medications to treat GERD can include the following:
- Over the counter antacids like TUMS, Mylanta, or Rolaids
- Histamine 2 blockers like Famotidine (Pepcid), Cimetidine (Tagamet), and Nizatidine (Axid)
- Proton Pump Inhibitors like Omeprazole (Prilosec), Esomeprazole (Nexium), Lansoprazole (Prevacid), Pantoprazole (Protonix), Rabeprazole (Aciphex) and Dexlansoprazole (Dexilant)
If lifestyle modification and medications are ineffective for GERD, your doctor may discuss several Endoscopic or Surgical options to treat your GERD. These can include a newer endoscopic therapy called transoral incisionless fundoplication (TIF), a surgically implanted device called LINX, or a traditional surgical option called Nissen’s fundoplication.
Don’t ignore your symptoms of reflux! Gastroenterology Associates provides complete diagnostic and therapeutic services for patients with GERD. Please call us at 864-232-7338 or request an appointment online.
Hiren Vallabh, MD
Gastroenterology Associates
Greenville, SC