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What are Acid Reflux and GERD and How Can You Relieve Symptoms

The conditions can be unpleasant — but there are diet strategies and drugs that help

Jim Craigmyle / Getty Images Anyone who’s ever reached for an antacid tablet after a really good Thai meal or been abruptly awakened from a restful slumber, gasping for air, can tell you this: . Even less fun? When it becomes a chronic condition, known as GERD.
The discomfort is caused by stomach contents flowing upward into the esophagus, where they lead to symptoms like heartburn. Some people also experience regurgitation, an acidic or bitter taste in their mouths, or chest pain. “Have you ever done shots in a bar?” says Gulchin Ergun, M.D ., a gastroenterology specialist in Houston and professor of medicine in digestive disorders at Houston Methodist Hospital. “That’s what it feels like — an uncomfortable burning sensation.” During an episode of nighttime acid reflux, you may find yourself choking or coughing uncontrollably when that acid finds its way up. Difficulty swallowing or the sensation of a lump in your throat are also common symptoms. Get instant access to members-only products and hundreds of discounts, a free second membership, and a subscription to AARP the Magazine.

Why is this happening

Everybody needs acid in their stomach — it helps break down food for digestion and kills bacteria. “It’s a defense mechanism and it’s pretty strong,” Ergun says. “Normally, you don’t buy things to clean your house that are as strong as stomach acid. But the stuff in your stomach doesn’t usually come up into your chest. There are mechanisms that the body has created for that.” At the bottom of the esophagus is a circular band of muscle, called the lower esophageal sphincter, which separates it from the stomach. It generally remains closed, but when we eat and swallow , this valve relaxes to let food and liquid pass through to the stomach, then closes again. Acid reflux occurs when the valve opens when it’s not supposed to, so the stomach contents — be they food, acid or digestive juices — flow backward. It’s normal for that valve to open from time to time, allowing us to let out a discreet (or hearty) burp. But problematic reflux can cause heartburn, especially after a meal or when you lie down to doze. Gastroesophageal reflux disease (GERD) is chronic acid reflux that becomes problematic. According to the American College of Gastroenterology, it’s believed that as many as 20 percent of U.S. adults suffer from it. Age can be a factor. Just as our skin gets looser as we get older, the bundle of muscle that makes up the lower esophageal sphincter , as well as the supporting structures of the stomach, may not be as taut, ultimately creating more leeway for digested food to gravitate upward. Producing less saliva — which helps neutralize acid in your esophagus as it goes down — after a certain age can also play a role, Ergun says. AARP Membership — $12 for your first year when you sign up for Automatic Renewal Get instant access to members-only products and hundreds of discounts, a free second membership, and a subscription to AARP the Magazine. Entertainment $3 off popcorn and soft drink combos See more Entertainment offers > Another concern: Acid reflux and cardiac problems can sometimes mimic each other. “People will say, ‘Oh, I have indigestion’ and assume it’s the esophagus, , or vice-versa,” Ergun says. If you’re experiencing chest pain, address it with your doctor to make sure it isn’t something other than acid reflux. You may also want to pay your physician a visit if you’re experiencing severe GERD symptoms or find yourself popping antacid medication more than twice a week. “If symptoms are becoming more troublesome or not being controlled by lifestyle changes or medications, or you have alarm symptoms, such as difficulty swallowing, we want to investigate further to make sure there’s no other changes in the esophagus that could cause problems down the line,” says Neena Mohan, M.D., assistant professor of clinical medicine in gastroenterology at the Lewis Katz School of Medicine at Temple University. Patients may require further evaluation with an endoscopy — during which a thin tube equipped with a camera is slid down the throat to examine the esophagus to look for changes.

How to banish the burn

“Lifestyle changes can be very effective for those with mild to moderate acid reflux,” says Pichetshote. Start with these tweaks and see if they help. Avoid certain foods. To find what triggers your acid reflux, Mohan recommends keeping a food journal that includes . You may notice fried and fatty foods in particular cause trouble. “There are chemical components in these foods that can affect receptors in the lower sphincter muscle, causing it to relax,” Mohan says. What’s more, she says, because foods with greater fat content can take longer to digest, they may sit in your stomach longer. And the longer that food stays there, the more likely it is to be refluxed back into your esophagus. Another potential trigger? Carbonated beverages, which can cause acid reflux by expanding our stomach, Pichetshote says: “When we distend our stomach, it can cause a relaxation or lowering of the lower esophageal pressure.” Other foods are direct irritants, such as citrus fruits. Alcohol has a low pH and irritate s the esophagus and stimulate s acid production. Coffee can be on the acidic side, depending on how potently it’s brewed. “If you drink something and it burns going down, it’s a good hint that it will bother you if you have too much,” Ergun says. It’s also been shown that people take longer to consume acidic foods. “They take smaller bites, so the acid is in the esophagus much longer than something that is more neutral, like a piece of bread,” says Pichetshote.
AARP Membership — $12 for your first year when you sign up for Automatic Renewal Get instant access to members-only products and hundreds of discounts, a free second membership, and a subscription to AARP the Magazine. can cause a significant reduction in symptoms, notes Pichetshote. Hit the gym. can help with reflux as well. “The muscles around the lower esophagus can actually get stronger when you exercise, making the area tighter,” Pichetshote says. “When you have acid in your stomach, there’s more of a barrier so it doesn’t go up into your esophagus.” Don’t down meds without water. Certain medications — among them, aspirin and ibuprofen, bisphosphonates to prevent bone loss, and some antibiotics — can worsen reflux-related heartburn. What’s more, if they break down before they reach the stomach, they can irritate the lining of the esophagus.

Reflux Rx s and when to consider surgery

If lifestyle tweaks aren’t doing the trick, you might consider medication. Over-the-counter antacids neutralize stomach acid and offer fast relief. At the next level of treatment, for moderate to severe acid reflux, are H2-receptor blockers (Tagamet and Pepcid), which reduce the production of acid in your stomach. “H2 blockers don’t completely block acid production but affect it enough that people feel improved, and they work pretty fast,” Ergun says. The next choice: proton pump inhibitors (Prevacid and Prilosec). Stronger than H2 -receptor blockers, they block stomach acid secretion and giv e damaged esophageal tissue time to heal. These drugs are helpful when you have esophagitis or Barrett’s esophagus. And, unlike H2 blockers, you don’t have to take them two or three times a day. Many are found over the counter, but a doctor can prescribe them in higher doses. The good news: GERD can usually be tamed with medication. But if the problem is persistent, your doctor may suggest using a medical procedure or surgery to get things under control. Laparoscopic fundoplication is one such treatment. During this minimally invasive procedure, a surgeon wraps the top of your stomach around the lower esophageal sphincter to tighten the muscle and prevent reflux. “The two major components of gastro reflux are heartburn and regurgitation,” Ergun says. “When you have heartburn, if you block the acid, the heartburn gets better. You’re preventing what comes up from being as noxious as it normally is. But although pills may take care of the acid, they won’t do anything for the reflux barrier, which is why people will say, ‘The heartburn is gone, but I still have regurgitation.’ That’s evidence there’s a mechanical problem, such as hiatal hernia, and that’s when surgery makes the biggest difference.” Watch: Foods That Help Get Rid of Acid Reflux Barbara Stepko is a longtime health and lifestyle writer, and former editor at Women’s Health and InStyle. Her work has appeared in The Wall Street Journal, Parade and other national magazines.
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