What Is Gastroesophageal Reflux Disease (GERD)?
You enjoyed the meal... but now you're paying for it, big time. You've got heartburn - an uncomfortable burning sensation radiating up the middle of your chest. Heartburn, the most common gastrointestinal malady, can hit after you eat spicy foods, when you lie down to take a nap, or perhaps at bedtime.
Many women experience this sensation during pregnancy.
Sometimes the pain is so intense that you may think you are having a heart attack. Heartburn can mimic a heart attack but luckily is not life-threatening.
One survey revealed that 65% of people with heartburn may have symptoms both during the day and at night, with 75% of the nighttime heartburn patients saying that the problem keeps them from sleeping, and 40% reporting that nighttime heartburn affects their job performance the following day.
This epidemic leads people to spend nearly $2 billion a year on over-the-counter antacids alone. Clearly, it's a major problem.
The burning sensation is usually felt in the chest just behind the breastbone and often extends from the root of the neck to the lower end of the rib cage. It can last for hours and may be accompanied by the very unpleasant, stinging sensation of highly acidic fluid rushing into the back of the throat. There may also be a sour taste in the mouth.
Who is at risk?
GERD is a digestive disorder affecting the lower or reflux esophageal sphincter (LES), the muscle connecting the esophagus and stomach. The LES is a high-pressure zone that acts as a barrier to protect the esophagus against the backflow of gastric acid from the stomach.
Normally, the LES works something like a dam, opening to allow food to pass into the stomach and closing to keep food and acidic stomach juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the LES relaxes when it shouldn't or becomes weak, allowing contents of the stomach to flow up into the esophagus. Scientists aren't sure exactly why this happens.
Episodes of reflux often go unnoticed, but when reflux is excessive, the gastric acid irritates the gullet and may produce pain, experienced as heartburn. Most symptoms of GERD are transient and only occur, for example, after a big meal or when a person bends over or lies down.
Overweight people and pregnant women may suffer more heartburn episodes because increased abdominal pressure contributes to reflux. Pregnant women are also more prone to heartburn because the LES relaxes in response to the high levels of the hormone progesterone that occur with pregnancy. Generally, though, GERD is uncommon in people under age 40.
What causes GERD?
Foods That Cause Reflux. Diet can contribute to LES dysfunction. For example, alcohol can irritate the esophageal lining and loosen the LES, as can coffee and other caffeine-containing products. Coffee, tea, cocoa, and cola drinks are all powerful stimulants of gastric acid production.
Mints and chocolate, often served to cap off a meal to aid in digestion, can actually make things worse. Both relax the LES and can induce heartburn, as can fried and fatty foods. Some people say that onions and garlic give them heartburn. Others have trouble with citrus fruits or tomato products. If you notice that a particular food leads to episodes of heartburn, by all means stay away from it.
Lifestyle Causes. How you eat can also be as important as what you eat. Skipping breakfast or lunch and then consuming a huge meal at day's end can increase gastric pressure and the possibility of reflux. Lying down right after eating will only make the problem worse. It is best to wait three hours after eating before going to bed. And stay away from late-night snacks, too. Even a modest weight gain may induce heartburn, so a low-fat diet is a good idea for more than just one reason.
Smoking. Smoking can irritate the entire GI tract. Frequent sucking on a cigarette causes air to be swallowed, increasing stomach pressure and encouraging reflux. Smoking sometimes also relaxes the LES muscle.
Medications That Cause Heartburn. Some prescription drugs can exacerbate heartburn. Oral contraceptives or postmenopausal hormone preparations containing progesterone are known culprits. Aspirin and other anti-inflammatory drugs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) may also pose problems.
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