Acid Reflux Should Be Treated to Prevent More Serious Trouble
SIOUX FALLS (Aug. 1, 2012) - What do heartburn, difficulty swallowing, constant throat-clearing and even chest pain have in common? They are all symptoms of a digestive disorder known as GERD.
GERD, also known as “acid reflux,” is a common ailment with a whole range of symptoms that may or may not include the classic pain and burning of heartburn.
GERD – gastroesophageal reflux disease – is the medical term for what happens when stomach acid comes up into the esophagus or even the throat, because one or both of the sphincters at either of end of the esophagus aren’t working properly, said Dr. Cristina Hill Jensen, gastroenterologist with Avera Medical Group Gastroenterology.
When the lower sphincter between the stomach and esophagus relaxes at the wrong time or too often, it usually causes the classic symptoms of frequent heartburn, nausea or indigestion. When the upper sphincter at the top of the esophagus is also not working properly, stomach acid backs up into the throat or “voice box.” This causes symptoms like constant throat clearing, frequent coughing, a feeling that there’s a lump in your throat, or excessive mucous when eating. Another less common symptom of GERD is non-cardiac chest pain, which may make the patient feel like he or she is having a heart attack.
If you have symptoms like this, you have plenty of company. “Fifty percent of people, at some point in their lifetime, experience symptoms of reflux, and 10 to 15 percent of the population have significant reflux disease,” said Dr. Christopher Hurley, gastroenterologist with Avera Medical Group Gastroenterology.
Fortunately, GERD is easily treated. The first thing your doctor may suggest is diet and lifestyle changes, Dr. Hill Jensen said. This includes eating smaller meals, not eating before bedtime, avoiding caffeine and other triggers of heartburn such as spicy foods, and not lying down immediately after eating.
Antacids like Mylanta, Tums or Rolaids might be helpful for occasional heartburn. But if the symptoms keep coming back, the next line of defense is often an over-the-counter acid reducer. These medications fall into two categories, including H2 blockers – like Pepcid AC, Tagamet, and Zantac, and proton pump inhibitors (PPIs) – like Prilosec, Nexium and Prevacid. “These medications can be safely used long term,” Dr. Hurley said. Some patients are concerned that PPIs may place them at higher risk for osteoporosis, but because the benefits of taking these medications outweigh the risks, Dr. Hurley said doctors usually recommend taking the medication, while supplementing with additional calcium and vitamin D.
“Most patients get better on these medications, with few side effects,” Dr. Hill Jensen added.
If GERD does not get better on medications, or if patients don’t want to take medications for the long term, surgery is an option. “Medications are not a cure for reflux – they simply reduce the acid. The actual problem is mechanical,” said Dr. Brad Thaemert, surgeon with Surgical Institute of South Dakota.
This mechanical problem is fixed through a procedure known as Nissen fundoplication. The surgery is done minimally-invasively, through laparoscopy or robotic surgery. “It can also be a “scarless” technique with all instruments inserted through a single incision in the navel,” Dr. Thaemert said.
It’s important that patients with GERD don’t ignore their symptoms. Left untreated, GERD can cause inflammation and scarring in the esophagus, leading to difficulty swallowing. What’s more, untreated GERD can cause cells in the esophagus to change. This condition is known as Barrett’s esophagus, and people who have it are at higher risk for developing esophageal cancer – a life-threatening disease.
If you have had symptoms of GERD for some time, your doctor may recommend an upper endoscopy to rule out Barrett’s or any other serious condition. Warning signs that require a doctor’s attention include weight loss, symptoms which are not responsive to medications, vomiting, severe chest pain, or a sensation of food getting stuck in the chest region.
To learn more, go to www.AveraDigestiveDisease.org