To put out the fire, your healthcare provider may suggest you:
- quit smoking
- abstain from alcohol
- lose excess weight
- eat smaller meals
- wear loose-fitting clothes
- sit upright for three hours after a meal
- raise the head of your bed six to eight inches (extra pillows won’t do it)
- avoid trigger foods like citrus fruits, chocolate, caffeinated drinks, fatty or fried foods, garlic, onions, mint flavorings, spicy dishes and tomato-based foods such as pasta sauce, chili and pizza
Most of us suffer heartburn or acid indigestion from time to time, usually after overindulging in food and drink. But when it happens more than twice a week, the condition could be gastroesophageal reflux disease, or GERD, which requires a doctor’s attention. Over time, untreated GERD can lead to complications such as bleeding, ulcers, swallowing difficulties and even cancer of the esophagus.
GERD occurs when the lower esophageal sphincter, a ring of muscle at the esophagus’ lower end that works as a valve between the esophagus and stomach, doesn’t close properly. Stomach acid creeps back up into the esophagus, causing the burning sensation of heartburn. Some people with GERD don’t have heartburn, but instead they experience chest pain, hoarseness or difficulty swallowing. Other symptoms include a cough and bad breath. GERD can happen to anyone, but alcohol use, excess weight, pregnancy and smoking are contributing factors. The cancer connection
In an estimated 10 percent to 15 percent of people with GERD––typically middle-aged, white men who’ve had heartburn regularly for more than five years—changes occur in the esophagus’ lining, a condition called Barrett’s esophagus. Although these changes don’t cause additional symptoms and can only be detected with endoscopy, they can lead to esophageal cancer.
Barrett’s esophagus has no cure. Most patients try to keep the condition in check with acid-blocking drugs and undergo periodic biopsies to detect precancerous cells in the esophagus. Surgery is recommended only for people who have a high risk of developing cancer or who already have cancer. The risk of getting esophageal cancer is less than 1 percent per year for people with Barrett’s esophagus, but their lifetime risk is much higher than in the general population. That means you should take steps to cool your heartburn and prevent Barrett’s esophagus and cancer. If you’ve suffered GERD symptoms for years, your healthcare provider may suggest endoscopy, especially if you’re over age 40.Treating GERD
To avoid GERD’s complications, including the remote but real risk of esophageal cancer, you’ll need to stop your stomach acid’s repeated assault on the delicate esophagus tissue. Treating GERD usually involves a combination of lifestyle changes and medication.
Your healthcare provider may prescribe one or more over-the-counter and prescription remedies such as:
- Antacids. These remedies that neutralize stomach acid are often the first course of action against heartburn and mild GERD. Antacids like Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids and Riopan are usually a combination of three basic salts (magnesium, calcium and aluminum) and hydroxide or bicarbonate ions. Calcium carbonate antacids include Tums, Titralac and Alka-2.
- H2 blockers. Available either by prescription or over the counter, these drugs (Tagament HB, Pepcid AC, Axid AR and Zantac 75) impede acid production.
- Proton pump inhibitors. Drugs like Prilosec, Prevacid, Protonix, Aciphex and Nexium (most available by prescription only) block acid production and help heal damaged esophageal tissue.
If you suffer heartburn and acid indigestion regularly, it’s time to put aside the Rolaids and get formal evaluation and treatment from your healthcare provider.