By Ns1ghter Provider: Traci L French MD

Heartburn is a common and annoying problem which affects most of us at some point in time. Overindulging in fatty, spicy foods combined with alcohol can be a recipe for the burning pain, bloating and nausea that often accompanies this condition. Acid reflux or heartburn occurs when the lower esophageal sphincter(a tight ring of muscle at the top of your stomach) relaxes and allows stomach contents to flow backwards into your esophagus. Sometimes the acidic contents of your stomach can flow backwards into your lungs causing coughing, wheezing or choking. Almost a third of us suffer from this condition on a daily basis. Common causes of acid reflux disease include obesity, smoking, alcohol use, pregnancy and other hormonal changes and eating too-large portions. 

Diagnosis and Treatment


Left untreated, GERD can develop into severe health problems. Some conditions associated with severe long-term acid reflux disease include asthma type symptoms as described above, insomnia, and pre-cancerous changes to the esophagus as well as cancer of the esophagus in very rare cases. There are several home remedies you can try to treat occasional heartburn. Effective remedies include weight loss and avoidance of trigger foods such as fast food, carbonated drinks, chocolate, caffeine and citrus foods. Along with preventing many other problems such as heart disease, cancer and lung disease, many people find that reflux symptoms improve as consumption of alcohol and tobacco products decrease. If your symptoms flare at bedtime, elevating the head of your bed slightly can decrease acid reflux. If your symptoms persist for more than a few days or are accompanied by weight loss, recurrent vomiting or blood in the stool an urgent visit to your provider is warranted. Simply discussing your symptoms with your provider can help you and your physician develop a plan to manage your symptoms but sometimes further testing is warranted to rule out more serious conditions. 

Treatment


As with many conditions, the primary therapy for GERD includes lifestyle modification. A 10 lb. weight loss is often enough to noticeably improve acid reflux symptoms. Switch to smaller meals every 3-4 hours and follow a low fat diet high in fruits, vegetables and lean protein. Herbal remedies for GERD include the use of cardamom or licorice to improve digestion and decrease bloating. Ginger is a well-known remedy for nausea and may decrease reflux by acting as an antispasmodic as well as by tightening the esophageal sphincter. Avoid trigger foods and add spices such as mint, ginger, cardamom and fennel to your diet if these remedies improve your symptoms. Decrease alcohol consumption, especially close to bedtime, and stop smoking. Tight clothing can worsen symptoms as well. There are many pharmaceutical treatments for heartburn that are safe for short-term use but have long term side effects including B12 deficiency, osteoporosis with hip fracture, gastric polyps and C. diff coliti s. It is typically recommended that prescription heartburn medications be used for no longer than 6-8 weeks without a physician’s recommendation. There’s no need to suffer in silence. Acid reflux disease is an unpleasant and often painful condition that can be improved with a few lifestyle changes. Speak with your provider today to develop a treatment plan. 

Citation: David C. Metz, MD. Gastrol Hepatol (NY). 2008 May; 4(5): 322-325. Long-term Use of Proton-Pump Inhibitor Therapy.