Is it heartburn or something more serious?

Everyone suffers from an occasional case of heartburn. But for some people, the symptoms become chronic, and may be the result of a condition called gastroesophageal reflux disease (GERD).

GERD is more than just the body reacting to a spicy meal or overeating. It is a digestive disorder of the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. This condition can eventually result in serious problems.

According to the American College of Gastroenterology, 20 to 30 percent of the adult population has weekly symptoms of GERD. Even young children can experience GERD.

What causes GERD?

In normal digestion, the LES opens to allow food to pass into the stomach and then closes to prevent food and acidic stomach fluids from flowing back up. Reflux occurs when the LES is weak, allowing the stomach’s contents to flow back up into the esophagus.

Is GERD dangerous?

Over time, untreated GERD can result in serious complications.

Esophagitis – inflammation or irritation of the tissue lining the esophagus – can occur, and may lead to esophageal bleeding or ulcers.

Additionally, acid can eventually scar the tissue and cause narrowing or restriction of the esophagus. Some people develop a condition known as Barrett’s esophagus – the cellular makeup of the esophagus tissue lining changes – which can increase the risk of esophageal cancer.

How to control GERD

Diet and lifestyle modifications

▪ Avoid foods and beverages that can weaken the LES: chocolate, peppermint, fatty foods, coffee and alcoholic beverages.

▪ Avoid esophageal lining irritants: citrus fruits and juices, tomato products and pepper.

▪ Eat smaller portions.

▪ Eat meals at least two hours before bedtime. This allows the stomach acids to decrease and the stomach to empty partially before laying down.

▪ Maintain a healthy weight. Being overweight makes symptoms worse.

▪ Don’t smoke. Cigarette smoking weakens the LES.

▪ Elevate head and chest while sleeping. This allows gravity to minimize reflux of stomach contents.

Antacids

▪ Antacids help neutralize acid in the esophagus and stomach.

Caution: Long-term use of antacids can result in side effects, including diarrhea, calcium metabolism changes, and buildup of magnesium in the body, which can damage the kidneys.

When to see a doctor

If you need antacids for more than two weeks, consult your doctor.

Diagnosing GERD

Tests may include:

▪  Upper GI series. X-rays that show the esophagus, stomach and small intestine (duodenum).

▪ Endoscopy. A small lighted tube with a tiny video camera on the end (endoscope) is inserted through the mouth allows the doctor to examine the esophagitis.

▪ Esophageal manometric and impedance studies: Pressure measurements of the esophagus help identify low pressure in the LES or abnormalities in esophageal muscle contraction.

▪ pH testing: Measures the acid levels in the esophagus as well as symptoms during meals, activity and sleep.

If a patient is diagnosed with GERD, additional treatment options may be needed:

Prescription medications

▪ Oral medication to reduce acid in the stomach.

▪ Medications to increase the strength of the LES and accelerate emptying of stomach contents.

Surgery

A small number of people with GERD may need surgery because of the severity of reflux and/or because they have a poor response to medical treatment. The surgical procedure most frequently used strengthens the LES.

Most people with GERD can enjoy normal, pain-free lives by making a few changes. If you suspect you or a loved one have GERD, see your primary care physician.

This story was originally published March 17, 2015 at 7:16 AM with the headline "Is it heartburn or something more serious?."