It starts with a burning sensation in your throat or chest after a large meal. Whether you call it heartburn, acid indigestion or acid reflux, the discomfort occurs when stomach acid or undigested food come back up into your throat, causing irritation of the esophagus and the stomach lining.
Other symptoms may include:
- Upper abdominal pain
- Regurgitation of food or sour liquid
- Sensation of a lump in your throat
- Dry, persistent cough or laryngitis
- Disrupted sleep
- Symptoms that worsen at night or when lying down
The clinical term for occasional heartburn is gastroesophageal reflux, or GER. Symptoms typically occur after consuming fatty, fried or spicy foods, chocolate or peppermint.
While for many people these episodes of heartburn or acid indigestion are mild to moderate and infrequent, for others it can be a daily source of pain and discomfort. When episodes increase in frequency and severity, doctors call it gastroesophageal reflux disease, or GERD.
GERD affects about 20 percent of adults in the U.S. Untreated, GERD can cause ulcers, swallowing disorders, and even respiratory problems if stomach acid enters the lungs. Damage from stomach acid can cause precancerous changes to the tissue lining of the lower esophagus, a condition associated with increased risk of esophageal cancer.
You don’t have to live with acid reflux. Your doctor can evaluate your symptoms and suggest a treatment plan that will offer relief. In a few cases, your doctor may recommend surgery, but most cases of GER or GERD can be cleared up with lifestyle changes alone, or in combination with over-the-counter or prescription medications.
WHAT CAUSES ACID REFLUX?
The human digestive tract includes your esophagus, or throat canal, through which food passes into the stomach, where it is processed for the body to use for energy. Stomach acids digest the food in your stomach before passing it along to the lower esophageal sphincter and into the bowel. The problem begins when the esophageal sphincter becomes weak and can’t do the job of keeping your stomach acid where it belongs.
Smoking, being overweight, eating too much or too close to bedtime, and certain medications can all lead to a weakening of the esophageal sphincter. So can a hiatal hernia, in which the upper part of the stomach protrudes into the diaphragm.
A variety of medications can alleviate the symptoms of GERD, whether by neutralizing stomach acid (antacids), reducing acid production (H2 blockers) or blocking acid production while healing the esophagus (Proton pump inhibitors). All are available over the counter or by prescription.
- Antacids like Maalox, Mylanta, or Rolaids can offer fast relief of mild symptoms.
- H2 Blockers (Tagamet HB, Pepcid AC) decrease acid production in the stomach, providing rapid relief and helping heal a damaged esophagus. Antacids can usually be taken in tandem with H2 blockers.
- Proton Pump Inhibitors (PPIs) are usually recommended for long-term treatment for severe symptoms of GERD. Brands include Nexium, Prevacid and Prilosec.
Lifestyle changes, whether alone or in combination with medications designed for relief of heartburn symptoms, can go a long way toward reducing your discomfort.
- Avoid eating or drinking anything that may cause GER, such as spicy, fatty foods, alcohol and caffeinated beverages. Limit your food portions and avoid eating within 2-3 hours of going to bed.
- Losing weight often helps relieve symptoms, as excess weight can cause the stomach to press on the esophagus and worsen reflux.
- Wearing loose clothing and straightening your posture can help relieve pressure on the upper digestive tract.
- Raising the head of your bed by a few inches can usually relieve nighttime symptoms.
WHEN TO SEE YOUR DOCTOR
If your symptoms don’t improve with OTC medications, see your doctor. He or she may adjust your current treatment plan or refer you to a gastroenterologist for more in-depth treatment that may include surgery.
Seek immediate medical care if your heartburn is accompanied by chest pain, jaw or arm pain, or shortness of breath. These could be signs of a heart attack.
You should also seek medical attention right away if you experience any of the following:
- Rapid or unexplained weight loss
- Difficulty swallowing or choking while eating
- Vomiting blood or material that looks like coffee grounds
- Bloody or black stools
“Acid Reflux: GER and GERD in Adults.” The National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults
“GERD vs Acid Reflux.” The Mayo Clinic. May 22, 2020. https://www.mayoclinic.org/diseases-conditions/heartburn/expert-answers/heartburn-gerd/faq-20057894
“Gastroesophageal Reflux Disease (GERD).” The American Gastroenterological Association. https://gastro.org/practice-guidance/gi-patient-center/topic/gastroesophageal-reflux-disease-gerd/
“Gastroesophageal Reflux Disease (GERD).” The Mayo Clinic. May 22, 2020. https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940