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Gastroesophageal reflux disease (GERD) affects 20% of the American population, according to the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK). Other terms for GERD familiar to many include acid reflux, acid indigestion, acid regurgitation and heartburn. The Harvard Medical School reports that over eight million emergency department visits result from chest pain annually but GERD, not heart attack, is diagnosed in 50% of them.

Gastroesophageal reflux (GER) occurs when certain contents of the stomach return to the esophagus. This is not unusual for most people when it happens occasionally. An article published by the American Heart Association (AHA) states that when it occurs, acids that the stomach can tolerate can irritate the esophagus. This causes the discomfort associated with acid reflux. When acid reflux, heartburn or regurgitation created by stomach acid strikes frequently, is noticeably more severe and tends to last for a longer period, GERD is diagnosed.

Symptoms and risk factors

Heartburn, the term that refers to a burning sensation in the chest, is a common symptom of GER, especially after consuming food or drink. In some, this symptom can occur more often at night. Mayo Clinic states that other symptoms noticed more often with nighttime acid reflux include disturbed sleep, chronic coughing, laryngitis or asthma.

Chest pain is another symptom. When this occurs just behind the breastbone, it is sometimes mistaken for a cardiac event, including heart attack. Other symptoms include the sensation of a lump in the throat, problems with swallowing and regurgitation of solids or sour liquids into the throat. Hoarseness, unexplained weight loss, persistent vomiting and irritation in the digestive tract that may include bleeding can also signal GER.

Risk factors for GER include obesity or being overweight, pregnancy and inhaling second-hand cigarette smoke. A hiatal hernia also increases the possibility of GER, as does the use of certain medications. Among the medications associated with GER are some sedatives, calcium channel blockers used to control hypertension and some asthma medicines. Non-steroidal anti-inflammatory drugs (NSAIDS) and tricyclic antidepressants can also contribute.

Among controllable causes of GER are smoking, large meals, late night meals and certain foods. Fried and high fat foods can also contribute. Alcohol and caffeine consumption may also increase GER possibility.

Complications possible if untreated

GERD may cause inflammation in the esophagus. Persistent inflammation, called esophagitis, can lead to complications including esophageal stricture, a condition causing a narrowing that creates swallowing problems. An esophageal ulcer, an open sore in the esophagus, may also develop, resulting in bleeding, difficulty swallowing and pain. Barrett’s esophagus, a precancerous condition, causes the lining of the esophagus to be altered.

Beyond the esophagus itself, GERD may also exacerbate other conditions such as tooth enamel decline, irritation of the larynx and chronic coughing. Asthma is also associated with GERD. According to Mayo Clinic, each may cause the other to get worse. The connection between the two has been noticed in adults and in children. The clinic reports that about fifty percent of children with asthma also have GERD.

Several clinical trials are under regarding the relationship between GERD and esophageal cancer and drugs that target esophagitis, heartburn and other symptoms.

Preventative measures

Among ways to prevent GERD symptoms is avoiding the substances known to contribute, such as cigarettes and alcohol. In addition to fatty foods, an overabundance of citrus fruit consumption can also add its probability. It is possible for citrus acids to relax a valve that allows easier flow of stomach acids to flow back into the esophagus.

Other ways to reduce the possibility of acid reflux and GERD are maintaining a healthy diet and eliminating late night meals. Lying down after any meal can aggravate acid reflux. Waiting three hours after meals to recline is recommended. If symptoms such as heartburn arise consistently during sleeping hours, raising the height of the bed may reduce them. Elevating the head end of the bed six to nine inches will help alleviate heartburn or acid reflux.

Certain over the counter and prescription medications can also reduce or eliminate symptoms. The use of any medication should begin only after consultation with a physician. If unexpected severe chest pain is experienced, 911 should be called immediately.

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Do you have questions about your heart health? ask dr Haqqani. If you have questions about your cardiovascular health, including heart, blood pressure, stroke lifestyle and other issues, we want to answer them. Please submit your questions to Dr. Haqqani by email at

Omar P. Haqqani is the Chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.

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