Living with GERD – Signs that Heartburn or Indigestion May Be Something More

The holidays are a season of joy, family, friends, and festive, rich foods. However, with holiday meals can come heartburn and indigestion. It’s essential to understand whether you’re experiencing harmless occasional heartburn or an underlying issue that needs attention.

Gastroesophageal reflux disease, or GERD, is one of the most common gastrointestinal diseases in the United States, but oftentimes it gets chalked up to simply heartburn or indigestion. According to the National Institute of Diabetes and Digestive and Kidney Disease, approximately 20 percent of people in the United States have GERD. Anyone can develop GERD, but some are more prone to it, such as those who are overweight, pregnant, take certain medications, or smoke.

GERD differs from occasional heartburn in specific ways. It is a condition where stomach acid flows back up into the esophagus, causing irritation and inflammation. GERD symptoms happen often and may get worse at night while lying down, after a large or fatty meal, after bending over, or after smoking or drinking alcohol.

Heartburn is occasional; it typically causes a burning sensation in the chest that is triggered by overeating rich or acidic foods or consuming alcohol. Heartburn usually resolves within a few hours or by taking an over-the-counter antacid.

I usually see 10-15 patients every week, and they often ask me how to know if their heartburn is something more serious. Below are some key symptoms I tell my patients to watch out for. If you experience any symptoms two or more times a week, schedule an appointment with your doctor.

• Frequent heartburn
• Regurgitation (sour or bitter-tasting acid backing up into the throat or mouth)
• Persistent cough or sore throat
• Hoarseness or voice changes
• Trouble swallowing (dysphagia)
• Unintentional weight loss
• Chest discomfort (especially after meals or lying down)

To manage GERD, you should understand not only what can trigger your symptoms and seek medical advice for managing your symptoms. Below is some everyday advice to help manage GERD and common triggers that may make your symptoms worse:

• Avoid fatty, spicy, acidic, or caffeinated drinks that can cause symptoms.
• Maintaining a healthy weight – excess weight, especially around the stomach area, can put pressure on the stomach and increase GERD symptoms.
• Avoid smoking or drinking alcohol.
• Eat smaller meals, which are easier for the stomach to digest.
• Walk around after your meals to help with digestion.
• Sit up straight after eating – ideally, wait a few hours before lying down or exercising.
• Elevate the head of your bed if you have nighttime symptoms
• Wear loose-fitting clothing around your abdomen
• Keep a food diary to identify possible triggers

Managing GERD requires a combination of lifestyle changes, medications, and sometimes endoscopic procedures or surgery. For persistent cases that don't respond to lifestyle changes or medication, treatment options can include:

• Fundoplication: a procedure where the upper part of the stomach is wrapped around the lower esophagus to strengthen the sphincter.
• LINX Device: a ring of magnetic beads is placed around the lower esophagus to prevent reflux.
• Endoscopic Procedures: Various newer, less invasive techniques that tighten the esophageal sphincter.

It’s important that GERD is managed. If left untreated, GERD can cause complications, such as esophagitis —an inflammation of the esophagus caused by stomach acid —that can result in pain, difficulty swallowing, bleeding, or ulcers. Untreated GERD can also cause an esophageal stricture, a narrowing of the esophagus due to scar tissue from acid damage, which can make swallowing difficult. Lastly, it can lead to Barrett's esophagus, damage to the esophagus from acid, which increases the risk of esophageal cancer.

Symptoms vary in severity and frequency among each person. If you’re experiencing symptoms of GERD, talk to your doctor, who can evaluate your condition and refer you to a gastroenterologist, if needed. If you don’t have a primary care physician, visit mypvhc.com to find care near you.

This holiday season, focus on quality time with your friends and family, not discomfort after every holiday meal. By recognizing the difference between occasional heartburn or indigestion and GERD symptoms, you can be better prepared to enjoy the holidays now and in the future.