GER, also known as gastroesophageal reflux, is a medical condition characterized by your stomach contents moving upwards into your esophagus. When this stomach acid comes into contact with the lining of your esophagus, heartburn, also known as acid indigestion, can occur. At Batash Medical in Rego Park, NY, we believe nobody should suffer with the symptoms of GER or GERD. Today, we discuss why you should seek medical attention if you think you have GERD, as well as the most effective methods of GERD treatment, so you can get back to enjoying your life.
What Is GERD?
GERD is an acronym for gastroesophageal reflux disease. It is similar to GER in symptoms. However, the condition is long-lasting and far more serious. You may suffer from GERD if you have acid reflux symptoms at least three times weekly for at least four weeks in a row.
Over time, GERD can lead to a number of serious health problems. To mitigate the risk of developing serious complications, you should seek medical attention if you suspect you suffer from GERD.
What Causes This Condition?
GERD is an idiopathic disease. In other words, there is no single known cause that leads people to develop this condition. In fact, anyone can develop gastroesophageal reflux disease. However, there are some risk mitigation steps you can take. Here are some of the most common risk factors of developing GERD:
- High BMI
- Certain medications
- Smoking or inhaling secondhand smoke regularly
How Is GERD Diagnosed?
GERD is diagnosed via the review of your symptoms and medical history. If you have chronic heartburn or other symptoms of GER which do not improve with medication and lifestyle changes, you should come in for a diagnostic assessment. Your esophageal sphincter may be weak or it may relax when it shouldn’t.
Why Should I Seek GERD Treatment?
Anyone who suspects GERD should seek GERD treatment. This is due to the serious complications that can occur as a result of the ongoing condition. Let’s look at some of the most common complications of GERD.
Esophagitis is the medical term describing esophageal inflammation. Adults suffering from chronic esophagitis that affects them for several years increase their chance of developing precancerous changes in the esophagus.
An esophageal stricture describes the esophagus becoming too narrow. If your esophagus becomes too narrow, you may have difficulty with swallowing.
GERD often causes you to breathe stomach acid into your lungs. The acidity from your stomach, known as bile, is irritating to your lungs and throat. Respiratory problems which can develop include:
- Chest congestion
- Chronic dry cough
Occasionally, GERD can lead you to develop Barrett’s esophagus. If you are one of these unlucky few, you are at an increased risk of developing a rare, dangerous form of esophageal cancer known as esophageal adenocarcinoma.
Barrett’s esophagus is a potentially serious medical condition where the tissue lining of your esophagus is gradually replaced by tissue lining similar to what exists in your intestine.
Barrett’s esophagus is diagnosed by an upper gastrointestinal endoscopy and biopsy. Among the most effective treatment options for Barrett’s esophagus are repeated surveillance endoscopy, endoscopic mucosal resection, endoscopic ablative therapies and surgery.
What Are the Most Effective GERD Treatment Methods?
The most effective GERD treatment methods depend on the severity of your symptoms and the types of symptoms you are experiencing. Among the treatment options that may be right for you are lifestyle changes, medications and surgery.
There are several lifestyle changes that may improve your GER or GERD. If you are overweight or obese, you should start by losing weight. Moreover, you should only wear clothes that fit loosely around your abdomen. When you wear compression shirts and other tight garments, including girdles and corsets, your abdomen is squeezed and acid can be pushed up into your esophagus.
It is also important for people with GERD to remain upright for three hours after they eat. When you sleep, you should sleep at a slight incline. Use cinderblocks beneath the bedposts at the head of the bed to raise your bed six to eight inches. Alternatively, you can purchase a bed that allows you to adjust the incline.
Finally, you should stop smoking and do your best to avoid inhaling secondhand smoke.
Over-the-Counter and Prescription Medications
If you suffer from GER, you can take an over-the-counter medication that relieves your heartburn. However, if you have GERD, you really need to come in for a diagnosis and tailored treatment plan. OTC medications are not enough to treat all your symptoms safely and effectively.
Depending on the GERD symptoms you are experiencing, you may need to take antacids, H2 blockers, prokinetics, proton pump inhibitors (PPIs) or antibiotics.
Antacids are the first line of defense against GERD. This type of medication relieves heartburn and other mild symptoms of acid reflux. Among antacids which are effective for the treatment of mild GERD symptoms are:
If you have moderate-to-severe GERD symptoms, don’t take too many antacids. Instead, seek medical attention. Excessive consumption of antacids can cause diarrhea and constipation, among other side effects.
H2 blockers decrease your stomach’s production of acid. This provides rapid short-term relief for all GERD symptoms. These medications may also be used to heal the esophagus from the damage of chronic acid reflux.
For mild GERD symptoms, you can purchase H2 blockers over-the-counter. For moderate-to-severe symptoms, you will need to take a prescription H2 blocker. Among the most common H2 blockers are:
- Ranitidine (Zantac 75)
- Cimetidine (Tagament HB)
- Famotidine (Pepcid AC)
- Nizatidine (Axid AR)
If heartburn is usually triggered by eating, you may want to take an antacid and H2 blocker. The H2 blocker prevents your stomach from producing acid while you eat. The antacid neutralizes the acid already in your stomach. By the time the antacid stops working, the H2 blocker has prevented any new stomach acid from being formed.
Prokinetics are recommended for severe cases of GERD. They help your stomach empty faster and are available by prescription. The two most common forms of this medication are bethanechol, sold under the brand name Urecholine, and metoclopramide, sold under the brand name Reglan.
However, you do not want to take these if you are taking certain other medications. During your initial consultation, bring in a complete list of all medications you are taking. This allows us to identify any potential contraindications.
Proton Pump Inhibitors (PPIs)
Like H2 blockers, PPIs are used to reduce the amount of stomach acid produced by your body. The primary difference is PPIs are much more effective than H2 blockers. They can also be used to heal the esophageal lining, just like H2 blockers can.
The secondary difference between PPIs and H2 blockers is that H2 blockers are fast-acting and designed to provide immediate relief. Proton pump inhibitors are designed to offer long-term GERD treatment.
The most important thing to remember when taking PPIs is that you need to take them on an empty stomach. Over-the-counter PPIs include low-dose omeprazole and lansoprazole. However, these doses may not be enough to treat your symptoms. High-dose PPIs which are available with a prescription include:
- Esomeprazole (Nexium)
- Lansoprazole (Prevacid)
- Rabeprazole (AcipHex)
- Pantoprazole (Protonix)
- Omeprazole (Zegerid, Prilosec)
Finally, you may be prescribed antibiotics, such as erythromycin, to help your stomach empty faster. Antibiotics tend to have fewer side effects than prokinetics. However, you may need to take them with an anti-diarrheal if you have a sensitive stomach.
If your GERD symptoms do not improve with lifestyle changes and medication, certain medical procedures may be necessary. These include fundoplication, endoscopic sewing and radiofrequency.
Fundoplication is the most common medical procedure used to treat GERD. It almost always results in long-term reflux control. This procedure involves the use of a laparoscope, which is a thin tube with a tiny video camera attached to the end.
During the procedure, the top of your stomach around your esophagus is sewn to increase pressure at the lower end of your esophagus. Recovery from this procedure typically takes only two to three weeks.
Endoscopic techniques are not uncommon for the treatment of GERD, either. Endoscopic sewing tightens your sphincter muscle using tiny stitches.
Alternatively, radiofrequency may be used to tighten your sphincter muscles by creating heat lesions. Both of these procedures are performed under general anesthesia on an outpatient basis.
Dietary Changes for GERD Symptom Relief
In almost all cases, GERD symptoms are triggered by certain types of food and beverages which irritate your stomach. To identify which types of food irritate your stomach, keep a food journal along with notes about the type, time of occurrence and severity of your symptoms. You may find that several of the following trigger your symptoms:
- Alcoholic beverages
- Citrus and tomato products
- High-fat foods
- Carbonated beverages
When keeping your food journal, it is particularly important to include what time you consumed the food and beverages. You may find that your symptoms are triggered when you eat certain foods three to four hours before bed. These same foods may not trigger symptoms earlier in the day.
This may be because your bed is not inclined while you sleep while you do not slouch after eating during the day. There is no single “GERD diet” to avoid all symptoms. However, we would like to mention a few things for you to keep in mind.
An orange pineapple smoothie may seem like the best breakfast or post-workout pick-me-up in the world to you. But citrus fruits may trigger your symptoms.
Try replacing citrus fruits with other sweet alternatives, such as pears, bananas, apples and your favorite melons. From fruit salad to smoothies, you are bound to find acceptable alternatives to your standard diet of highly acidic fruits.
While botanically classified as a fruit, most people consider tomatoes to be a vegetable. Regardless of what you call this produce, avoid it and its byproducts, including marinara sauce, tomato sauce, spaghetti sauce and ketchup.
The acidity in tomatoes can easily trigger your acid reflux. You should also minimize your consumption of raw onions, including yellow onions and Vidalia onions. Green onions are not very acidic and will probably not trigger your symptoms like white or yellow onions will.
Eggs are an excellent source of bioavailable protein and good cholesterol. However, if eggs trigger your GERD symptoms, leave out the high-fat yolks and stick to only the lean egg whites. You can either separate the yolks out when you cook or bake or you can buy egg whites at any grocery store.
Suffering from GERD doesn’t mean you have to give up meat entirely. Instead of high-fat meat sauteed in butter or deep-fried in oil, stick to grilled, baked, broiled or poached meats.
If you can stomach it, try to eat leaner cuts of meat, as well. High-fat foods make your stomach take longer to empty and decrease LES (lower esophageal sphincter) pressure.
People with GERD should aim to add more complex carbohydrates to their diet. This can be found from sources such as couscous, brown rice, whole grain bread and oatmeal. These complex carbohydrates are an excellent source of healthy fiber, proteins and other essential nutrients.
You can also find healthy carbs and soluble fiber from sources such as potatoes and other root vegetables. Just be sure to avoid garlic and onion while preparing these foods as they may trigger your GERD symptoms.
Fat is a macronutrient, just like protein and carbohydrates. It is a necessary part of your diet. It’s just especially important for people with GERD to eat the right kinds of fats.
Do not consume trans fat, a key ingredient found in shortenings, margarine and processed foods. Instead, get your recommended daily allowance of fat from polyunsaturated and monounsaturated sources.
Monounsaturated fats are commonly found in some oils. This includes olive oil, sesame oil, avocado oil, peanut oil, canola oil and sunflower oil. They can also be found in avocados, peanuts, peanut butter, almonds, pecans, sesame seeds and sunflower seeds, among other sources.
You can incorporate polyunsaturated fats into your diet via safflower oil, corn oil, walnut oil, flaxseed oil or soybean oil. You can also find plenty of polyunsaturated fats in tofu, soybeans and in fatty fish like trout, salmon and fatty cuts of tuna.
Other Lifestyle Tips for Treating GERD
Good posture is always important for everyone. But it is particularly important for people suffering from GERD during and after a meal. Sit up straight while eating. Keep your chin level and your shoulder blades back.
You should refrain from lying down for at least two hours after finishing a meal. Depending on how slowly your stomach empties, you may need to wait three or four hours after eating before you can lie down or recline. To encourage the proper flow of gastric juices, stand up and walk around after you eat, even if you’ve only eaten a snack.
Do Not Imbibe
Alcohol is terrible for people who live with GERD. It irritates the stomach and triggers acid reflux by weakening the LES. If you must imbibe, drink at least eight ounces of water before your first alcoholic beverage. Drink eight ounces of water between alcoholic beverages and wait at least an hour between drinks.
If you chew peppermint, wintermint or spearmint gum, you may associate chewing gum with increased GERD symptoms. However, this is only due to the mint in the gum.
Research has shown that chewing bubble gum increases saliva production, which reduces the amount of acid in your esophagus. Sucking on lollipops has the same effect of increasing saliva production.
Don’t Eat Right Before Bed
Many people with GERD must remain upright for three to four hours to avoid triggering acid reflux symptoms. Thus, you should not eat a full meal within two hours of bed.
Don’t eat a plate of lasagna with high-fat cheese, onion powder, marinara sauce and garlic and then lie down for a nap. This is a recipe for disaster. If you have to eat right before bed, choose a GERD-friendly option, such as a bowl of oatmeal and skim milk or grilled salmon on a bed of spinach and arugula salad.
Take Back Control of Your Life Today
Approximately 20% of Americans suffer from GERD. But not enough of them seek medical attention for their condition. They are putting themselves at undue risk for serious complications later on. To learn more about the most effective GERD treatment to resolve your acid reflux, contact Batash Medical in Rego Park, NY today to schedule your initial consultation. Our mission is to provide you with the best possible care at a price you can afford. We can’t wait to meet you and help you take back control of your life.