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What is GERD?
 
 
The ring-like muscles of the lower esophagus that prevent foods you swallow from returning from the stomach back into the esophagus is called the lower esophageal sphincter (LES). When your stomach is full, a tiny amount of food can sneak back into the esophagus when you swallow — that’s normal. But in people with GERD, substantial amounts of stomach acid and digestive juices backwash into the esophagus.

Heartburn and “acid indigestion” are the most common result. A burning pain is typical, and when it’s accompanied by burping or bloating, it points to GERD as the cause. But there are “hidden” signs of GERD that are noticed in the lungs, mouth, and throat:

Mouth and throat symptoms

  • A sour or bitter taste in the mouth
  • Regurgitation of food or fluids
  • Hoarseness or laryngitis, especially in the morning
  • Sore throat or the need to clear the throat
  • Dental erosions
  • Feeling that there is a “lump in the throat.”

Lung symptoms

  • Persistent coughing without apparent cause, especially after meals
  • Wheezing, asthma.

Causes

Poor function of the LES is responsible for most cases of GERD. A variety of substances can make the LES relax when it shouldn’t, and others can irritate the esophagus, making the problem worse. Other conditions can simply put too much pressure on the LES. Some of the chief culprits in GERD are shown below.

Common causes of GERD symptoms

Foods

  • Garlic and onions
  • Coffee, cola, and other carbonated beverages
  • Alcohol
  • Chocolate
  • Fried and fatty foods
  • Citrus fruits
  • Peppermint and spearmint
  • Tomato sauces

Medications

  • Alpha blockers (used for the prostate)
  • Nitrates (used for angina)
  • Calcium-channel blockers (used for angina and high blood pressure)
  • Tricyclics (used for depression)
  • Theophylline (used for asthma)
  • Bisphosphonates (used for osteoporosis)
  • Anti-inflammatories (used for arthritis, pain, and fever)

Other causes

  • Smoking
  • Obesity
  • Overeating
  • Tight clothing around the waist
  • Hiatus hernia (part of the stomach bulges through the diaphragm muscle into the lower chest)
  • Pregnancy

Therapy: Lifestyle

Some people with GERD need to turn to medications to relieve symptoms and prevent possible long-term damage to the esophagus. But simple lifestyle modifications can control heartburn and other GERD symptoms. Here are eight tips:

  1. Don’t smoke. It’s the first rule of preventive medicine, and it’s as important for GERD as for heart and lung disease.
  2. Avoid foods that trigger GERD (see “Common causes of GERD symptoms,” above).
  3. Consider your medications. If you are taking certain painkillers, antibiotics, or other medications that can irritate the esophagus or contribute to GERD, ask your doctor about alternatives, but don’t stop treatment on your own.
  4. Avoid large meals and try to be up and moving around for at least 30 minutes after eating. (It’s a good time to help with the dishes.) Don’t lie down for two hours after you eat, even if it means giving up that bedtime snack.
  5. Use gravity to keep the acid down in your stomach at night. Propping up your head with an extra pillow won’t do it. Instead, place four- to six-inch blocks under the legs at the head of your bed. A simpler (and very effective) approach is to sleep on a large, wedge-shaped pillow. Your bedding store may not carry one, but many maternity shops will, since GERD is so common during pregnancy. And because GERD is also so common in general, you won’t be the only man or woman looking for a pillow in a maternity shop.
  6. Chew gum, which will stimulate acid-neutralizing saliva.
  7. Lose weight.
  8. Avoid tight belts and waistbands.

For more information on digestive disorders, order our Special Health Report, The Sensitive Gut, at .

 

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