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Ihor Magun, MD, FACP OUR HEALTH Acid reflux happens to nearly everyone. Experienc- ing the primary symptoms (commonly referred to as heartburn) occasionally is totally normal, but if it occurs more than twice a week for over a period of several weeks, it may lead to the development of GERD — Gastro Esophageal Reflux Disease. GERD is defined as a condition in which the acid-con - taining contents in your stomach make their way into the esophagus (the tube that leads to your stomach). This occurs when the valve at the junction between the esophagus and stomach does not function prop - erly, and thus permits acid to backwash upwards. Symptoms vary and include chest pain (that is where the term “heartburn” was coined), indigestion, stom- ach discomfort, bloating, regurgitation, hoarseness in the morning, a sensation of food “stuck in the throat,” frequent throat clearing, new or worsening asthma, disrupted sleep, as well as a dry cough. The burning sensation is due to the acid originating in the stomach irritating the lining of the esophagus. Prolonged GERD is known to lead to inflammation of the esophagus, which is a major risk factor for the development of esophageal cancer. Persistent reflux can also lead to the development of scar tissue, which invariably leads to narrowing of the food pathway, leading to issues with swallowing. Stomach acid can also wear away tissue in the esophagus, producing a sore that is prone to bleeding and pain. Predisposing conditions that increase your risk of GERD include obesity, a history of a hiatal hernia (bulging of the stomach into the esophagus), smok - ing (including exposure to second-hand smoke), preg- nancy, and certain medications. It is not known why, but more than 75% of people diagnosed with asthma have GERD, and they are twice as likely to have GERD as people without asthma. Diagnosing GERD begins with a description of symp - toms and medical history. Some individuals need an examination with a special scope performed by a gas- troenterologist to examine the esophagus and stom- ach. Other studies may also be needed or required. Many over-the-counter medications, even available in prescription strength, relieve the symptoms of GERD. The use and duration of treatment are crucial for treatment response. Examples include: • Antacids (Mylanta, Tums) mechanism of action is to neutralize stomach acid • H2 blockers (Pepcid AC/Zantac) mechanism of action is reduction in acid secretion • Proton Pump Inhibitors (Nexium/Prevacid/Pri - losec) mechanism of action is a more potent form of reduction in acid secretion All the above-listed approaches of controlling acid work well but do not stop acid reflux. That said, we should also examine whether acid reflux can be managed in other ways. The answer is a definite Yes, and those “other ways” need to be part of the overall treatment protocol. A short list of “other ways” includes: Adjust your diet and eating habits. Maintain a healthy weight. Avoid trigger foods — spicy, fried, fatty, tomato-based. Limit alcohol, coffee, and carbonated beverages. Stop smoking. Avoid eating before bedtime — wait at least three hours prior to retiring to bed. Raise the head of your bed by eight inches using a “block” under the bedpost (extra pillows do not seem to work). Wear less tight-fitting clothes. Seek medical advice when symptoms do not seem to be improving; the issue may be something different and may need to be addressed professionally. Reflux symptoms can cause numerous nonspecific symptoms. Treatment should therefore be directed by addressing all the symptoms and issues experienced and should not be limited to reaching for relief with medication alone. Incorporating all the suggestions listed may also improve other medical issues, with the only “side effect” being overall improved health. GERD or Acid Reflux? НАШЕ ЖИТТЯ • Січень-Лютий 2022 33
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