Gastroesophageal reflux disease should not be self-treated
AmNews Staff Reports | 10/10/2019, 1:21 p.m.
The symptoms of gastroesophageal reflux disease are often dismissed as “just heartburn.” This self-diagnosis often leads to self-management of the disease, which can be the same as mismanagement, warns the International Foundation for Functional Gastrointestinal Disorders, a nonprofit education and research organization.
Heartburn that occurs occasionally just after a meal and less than once a week is usually not a sign of serious disease. Heartburn that occurs more than once a week, becomes more severe, or occurs at night and wakes a person from sleep may be a sign of a more serious condition and warrants a visit to the doctor. Heartburn that occurs only occasionally, but has done so over a period of years, also may be a sign of disease.
GERD is a chronic disease that requires long-term treatment, even after symptoms have been brought under control. It does not resolve itself. It is essential for individuals who suffer persistent heartburn or other chronic and recurrent symptoms of GERD to seek an accurate diagnosis, to work with their physicians, and to receive the most effective treatment available.
Chronic heartburn is not the only symptom
The term gastroesophageal refers to the stomach and the esophagus, the tube leading from the throat to the stomach. The term reflux refers to the backflow of acidic stomach acid into the esophagus. The large diaphragm muscles and a band of muscles at the junction of the stomach and esophagus normally act together as a barrier to prevent reflux of stomach contents into the esophagus. Reflux occurs when that barrier is relaxed at inappropriate times.
Symptoms of GERD vary from person to person but can include:
chronic heartburn, the most common symptom
acid regurgitation (stomach contents refluxed into the mouth)
difficulty or pain when swallowing
sudden excess of saliva
the sensation of food sticking to the esophagus
chronic sore throat or irritation of the throat
hoarseness in the morning
inflammation of the gums
erosion of teeth enamel
a sore taste in the mouth
GERD may also be present with no apparent symptoms. Consult your physician to obtain an accurate diagnosis, which may include tests to confirm or exclude a diagnosis and to detect complications. Then work with your physician to develop a treatment plan that will work for you. Although there is no cure for GERD, long-term medical therapy is usually effective in bringing and keeping the symptoms under control, healing inflammation or injury to the esophagus and preventing or managing complications.
Treatment May Call for Changes in Diet and Daily Routines
Treatment methods range from lifestyle changes to medication or surgery. Lifestyle modification may include changes in diet and daily routines. While diet does not cause GERD, some foods and medications can aggravate GERD and the heartburn that often accompanies it. Certain foods are best avoided before sleep or exertion. These foods vary from person to person but often include onions, chocolate and fats. Beverages to avoid can include alcohol, coffee (both regular and decaffeinated), tea, cola, and tomato and citrus juices. Being overweight also can promote reflux.
How, when and where you eat can also affect whether you will experience reflux. Maintaining an upright posture until a meal is digested may prevent heartburn. Eating large meals and snacks right before bedtime can be troublesome. It is best to eat early in the evening so that the meal is digested before bedtime. Eating smaller meals in an upright and relaxed posture and in a stress-free surrounding should also help minimize reflux.
Drugs to treat GERD include proton pump inhibitors to limit acid secretion in the stomach. According to IFFGD, proton pump inhibitors “allow rapid resolution of symptoms and healing of the esophagus in 80% to 90% of patients.” Surgery is usually used only when long-term medical treatment is ineffective, undesirable or if certain complications are present. The surgery itself is associated with complications or side effects in about 5% to 20% of patients and should be thoroughly discussed with a gastroenterologist (a physician specializing in these disorders) before deciding whether to have it.