Gastroesophageal Reflux Disease: What is it and how to prevent it

That burning sensation you feel in your chest may be a sign of acid reflux. (photo credit from http://www.health.com/)

Years ago, I thought I was so terribly sick that I stopped working for about two months. I was coughing non-stop, and no expectorants could ever silence my hound-like condition. Suppressants would work during the day, but I’d be coughing the next day. As someone who is employed in the customer service industry, coughing is a no-no and in as much as I was excused from working, I hated the idea of having to stay home the whole day not knowing my condition.  Who would want to be coughing sporadically?

I’d go out in the malls and people would look at me like I’m carrying the plague when I cough, even with my mouth covered. It didn’t help that I was reed-thin. Wherever I go, people thought I am afflicted by Tuberculosis. The doctor had actually requested to have sputum done, which to my relief,  came out negative.

That burning sensation you feel in your chest may be a sign of acid reflux. (photo credit from http://www.health.com/)

Then the doctor ordered endoscopy (where a flexible tube was inserted from one of my nostrils all the way down to my esophagus), and that started my five-year struggle with Gastroesophageal Reflux Disease. GERD, also known as gastro-oesophageal reflux disease (GORD), gastric reflux disease, or acid reflux disease, is a condition in which the esophagus becomes irritated or inflamed because of acid backing up from the stomach. The esophagus or food pipe is the tube stretching from the throat to the stomach

I was coughing non-stop because the acid that was being expelled from  my stomach irritates my throat. What I’ve experience is actually a very mild symptom. Others actually suffer GERD by throwing up (or the sensation of throwing up), by difficulty in swallowing and some even experience a burning sensation or pain in the lower part of your mid-chest, behind your breast bone, or in the mid-abdomen,or what’s commonly known as heartburn.

Other symptoms of GERD can include bloating, black stools, blood in the stools or when vomiting, blood or black stools or bloody vomiting, burping, hiccups that don’t let up, nausea, weight loss for no known reason, wheezing, dry cough, chronic sore throat, and a narrowing feeling in the esophagus, which creates the sensation of food being stuck in one’s throat.

What happens with reflux?

At the entrance of our stomachs is a ring of muscles called the lower esophageal sphincter (LES) which normally close as soon as food passes through it. If it doesn’t fully close or if it opens too often, acids produced in our stomachs and other stomach contents  may move up from our esophagus, which then causes the heartburn. It could happen once in a but if this phenomenon becomes too often (like more than twice a week), then it becomes GERD.

How does one acquire or get sick of the Gastroesophageal Reflux Disease?

Why the acid goes up is still unclear but there are instances that triggers the acid reflux, but the following are common risk factors for acid reflux disease:

  • Lifestyle – smoking,poor posture (slouching)
  • Medications – taking aspirin, ibuprofen, antihistamines, nitrates and blood pressure medications
  • Diet – Fatty and fried foods; chocolate, garlic, and onions; alcohol, drinks with caffeine; acidic foods such as citrus fruits and tomatoes;  spicy foods; food with mint flavorings.
  • Eating habits – Eating heavy meals after depriving oneself for a period of time; eating soon before bedtime, lying down after a meal or bending over the waist after a meal.
  • Being overweight or obese.
  • Medical conditions like hiatal hernia (when the upper part of the stomach protrudes up above the diaphragm (the strong muscle that separates the organs of the chest from those of the abdomen), pregnancy and diabetes
How is it treated and is it reversible? 
GERD is easily curable and highly reversible. Certain medications or combinations of them can ease or stop the symptoms of GERD. Over the counter antacids will stop the acid production or help the muscles that empty your stomach.  Many brands on the market use different combinations of three basic salts-magnesium, calcium, and aluminum-with hydroxide or bicarbonate ions to neutralize the acid in your stomach. But be sure to consult a doctor first before taking antacids as some can have side effects. Magnesium salt can lead to diarrhea, and aluminum salt may cause constipation.

Foaming agents will cover your your stomach contents with foam to prevent reflux. An example of such is Gaviscon.

H2 blockers, such as cimetidine, famotidine, nizatidine, and ranitidine will decrease acid production and will  provide short-term relief and are effective for about half of those who have GERD symptoms. They come in prescription and over-the counter strength.

Proton pump inhibitors like omeprazole, lansoprazole, pantoprazole,  rabeprazole,  and esomeprazole are available only thru prescriptions. Proton pump inhibitors are more effective than H2 blockers because they can relieve symptoms and also heal the esophageal lining in almost everyone who has GERD.

Prokinetics such as  bethanechol and metoclopramide, will work on strengthening the LES and make the stomach empty faster but they have known side effects like fatigue, depression, anxiety, and problems with physical movement.

Although the availability of medications make it easier for someone who has GERD, I say, based from experience, that the best relief from the symptoms of GERD would be through lifestyle modification and change of habits.

 Aside from refraining from eating food that triggers reflux, practicing the following may greatly reduce acid reflux:
  • Try not to eat within 3 hours of bedtime to allow your stomach to empty  and thus decreasing the acid production.
  • Don’t lie down or bend over right after eating at any time of day.
  • Keep your head elevated for about 6 inches with the use of pillows or install blocks in your headrest. Gravity helps prevent reflux.
  • Don’t eat large meals. Eating a lot of food at one time increases the amount of acid needed to digest it. Eat smaller portions but more frequent throughout the day.
Not only are the effects permanent, but lifestyle modification is, certainly, the least expensive.
Web References:
http://en.wikipedia.org/wiki/Gastroesophageal_reflux_disease#Signs_and_symptoms
http://www.emedicinehealth.com/acid_reflux_disease_gerd/page2_em.htm
http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/
http://www.webmd.com/heartburn-gerd/guide/what-is-acid-reflux-disease