It is common to experience occasional bouts of acid reflux. This can sometimes happen after a big meal of fried or spicy foods or from eating too close to bedtime. However, if you notice you are frequently experiencing heartburn or other symptoms, this can be a sign of a more serious condition called gastroesophageal reflux disease (GERD). The good news is that treatments such as proton pump inhibitors can often help.
What Causes GERD and How Do You Know if You Have It?
Acid reflux occurs when contents from your stomach flow back up into your esophagus. Although your body is designed to prevent this from happening, thanks to a small valve between your stomach and esophagus, sometimes gastric acid and bile get through. The valve, called the lower esophageal sphincter, can sometimes become weak or not work properly. When this happens regularly, it can lead to GERD.
The most common symptoms of GERD include:
- Heartburn: Pain or burning in the upper abdomen or middle of your chest, behind your breastbone
- Regurgitation: The contents of your stomach coming back up, flowing through the esophagus and into your throat or mouth
Other symptoms of GERD can include:
- Chest pain
- Difficulty swallowing
- Nausea
Over time, GERD can cause complications in the mouth, throat and lungs. Some people experience chronic coughing or hoarseness. More serious complications are also possible, such as:
- Asthma – a chronic respiratory condition that affects the bronchial tubes, the airways that carry air in and out of your lungs
- Barrett’s esophagus – a condition that causes tissue similar to the lining of the intestines to replace the esophageal lining, which can lead to cancer
- Esophagitis – inflammation in the esophagus that can lead to ulcers and bleeding
- Esophageal stricture – narrowing of the esophagus that can cause difficulty swallowing
- Laryngitis – inflammation of the voice box that leads to a temporary loss of the voice
- Wearing away tooth enamel
Risk Factors for GERD
Taking some medicines can put you at risk of developing GERD. These include:
- Benzodiazepines (sedatives used to ease anxiety or help you sleep)
- Calcium channel blockers prescribed for high blood pressure
- Certain asthma medications
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Tricyclic antidepressants
Having a hiatal hernia can increase your chances of developing GERD. This condition causes the upper part of the stomach to move up into the chest through the opening in the diaphragm. However, this can be repaired surgically if necessary.
Some lifestyle factors can also raise your risk of developing acid reflux and GERD. These include:
- Being overweight or obese
- Being pregnant
- Smoking
Treating GERD with Proton Pump Inhibitors (PPIs)
Several medications can help reduce stomach acid and ease symptoms of acid reflux. If you have been diagnosed with GERD, PPIs can effectively treat the condition and help prevent complications.
PPIs work by reducing acid secretion from the stomach glands. They frequently successfully heal symptoms, and they can also help repair damage to the esophageal lining.
Generally, PPIs are considered quite safe, and side effects are rare. Short-term PPI use can cause minor symptoms including:
- Constipation
- Diarrhea
- Headache
- Itching
- Nausea
Long-term PPI use might raise the risk of Clostridium difficile infections, which can happen in the large intestine. Other potential adverse effects include malabsorption of minerals and vitamins including magnesium and calcium, which can increase fracture risk and kidney disease. However, more studies are needed to determine the full correlation between these complications and chronic PPI use. Talk with your health care provider about the risks and benefits before taking these medicines.
How to Take PPIs
Some PPIs are available over the counter, including:
Available in tablet or capsule form, PPIs are taken by mouth. Often, these pills should be taken 30 minutes before meals. Follow the instructions on the package or take it as directed by your provider.
If you are pregnant or breastfeeding, talk to your provider before taking PPIs. If you’re taking other medications, you should also check with your provider, as PPIs can change how some medicines work. These include certain blood thinners and anti-seizure medications.
However, if you notice that you need to take this medicine almost every day, it’s a good idea to talk to your provider. They might prescribe a high-dose PPI or increase the frequency from once daily to twice daily. However, the lowest possible effective dosage is generally recommended for long-term use.
If your symptoms don’t get better after taking medicine for a few weeks, or if you have more serious problems like trouble swallowing, blood in your stool, low iron from blood loss or unexplained weight loss, talk to a gastroenterologist. They can check if you have GERD or something more serious. Doctors use tests like an upper endoscopy (where a small camera looks inside your throat) and pH testing to find out what’s wrong. If you have Barrett’s esophagus, you will also need regular checkups with an upper endoscopy.
Treating GERD with Lifestyle Changes in Addition to PPIs
For some people, along with the help of PPIs, making changes to your diet and losing weight can help control GERD. Try these tips:
- Avoid foods that are known to trigger symptoms: mint, fatty foods, spicy foods, tomatoes, garlic, coffee, tea, onions, chocolate and alcohol. You can try removing these foods and drinks from your diet and then adding them back in one at a time to see what your triggers are.
- Skip carbonated beverages, which can send acid into your esophagus.
- Don’t go to sleep right after eating. Lying down can cause acid to come up from your stomach. Make sure you finish eating at least three hours before you go to bed.
- Lose weight if you are overweight. Excess weight can cause the muscular structure supporting the lower esophageal sphincter to relax when it shouldn’t, leading to acid reflux.
- If you smoke, quit.
- Don’t engage in vigorous exercise for a couple of hours after eating.
More to Read
- How Serious Is a Hernia?
- IBD vs. IBS: What’s the Difference?
- IBS Treatment: Find Relief from Digestive Distress
- Digestive Health Facts for You to Digest
- What Is the Difference Between Prebiotic and Probiotic Foods?
- 5 Ways to Improve Gut Health
Medically reviewed by Guofeng Xie, MBBS, PhD.
