Straight, No Chaser: Acid Reflux (Gastroesophageal Reflux Disease)

I’m at the point in life where I rarely eat after 8 pm. That has defined health benefits, but it’s also protective from today’s Straight, No Chaser topic: gastroesophageal reflux, aka GERD, aka acid reflux, aka reflux. You should be surprised and feel fortunate if reflux don’t bother you at some point. Let’s tackle this spicy topic via a question and answer format:

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What is reflux? Most simply put, acid reflux occurs whenever stomach contents back up into your food pipe (esophagus) and/or mouth.
Why does this occur? Your feeding tube (esophagus) has a connection to the stomach at its lower end. This connection is made via a circular ring of muscle called the lower esophageal sphincter (LES). The LES relaxes and contracts to allow food to enter and prevent it from forward back up into the esophagus. Unfortunately, there are a number of conditions that cause the sphincter to relax, such as episode overeating, lying flat and the presence of a hiatus hernia (more on that in the next blog).
Is this a disease? Some degree of acid reflux is actually normal, but it does rise to the level of a disease (gastroesophageal reflux disease, aka GERD) when symptoms create difficulties for the patient.

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What are the symptoms? You know them, and you hate them! The most common symptoms include heartburn, difficulty with swallowing (including pain or food getting stuck; this is called dysphagia), regurgitation and vomiting. In fact, heartburn occurs in 10 million adults in the US every day. In severe cases, the acid can cause hoarseness due to the effects on the vocal cords or go back down the air tube (trachea) and into the lungs (this is called aspiration). Here are some additional symptoms you may experience.

  • Asthma “only” at night
  • Chronic cough
  • Chronic sinus infections
  • Non-burning chest pain
  • Painful swallowing
  • Persistent sore throat
  • Persistent laryngitis/hoarseness
  • Recurrent lung infections
  • Sense of a lump in your throat
  • Stomach (upper abdominal pain)
  • Waking up with a choking sensation
  • Worsening dental disease

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Do foods cause heartburn or acid reflux? You already know they do! Here’s a quick list of common food that worsen or trigger symptoms:

  • Alcohol (think red wine)
  • Caffeinated drinks, including coffee, soda and tea
  • Chocolate
  • Citrus fruits and products, including oranges and orange juice
  • Peppermint
  • Spicy foods, such as black pepper, garlic, raw onions and tomatoes.

When should I seek help for reflux? Although you should feel free to contact your healthcare provider for any symptoms, you should be aware that the following signs and symptoms may indicate a more serious problem. The presence of any of these should prompt you to visit and emergency room or otherwise contact your physician immediately. Please do not assume because you’ve had these symptoms previously, that the symptoms represent the same thing they always have.

  • Chest pain
  • Choking
  • Difficulty or pain with swallowing, or a sensation that your food gets stuck
  • Unexplained weight loss
  • Vomiting blood or have Bleeding (vomiting blood or dark-colored stools)

In the next Straight, No Chaser, we’ll review some complications, how GERD is diagnosed and treatment options.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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