Dealing with ‘GERD’? Know when to call a doctor

Published Dec 25, 2016 at 9:00am

That burning sensation in your chest under your breastbone is coming more frequently lately.

Should I talk with my physician or wait for it to go away? It affects 44 percent of Americans, but if you are one who has it frequently you should make your physician aware and try to change your eating habits. Diet and lifestyle can help fight heartburn and “GERD” (gastro-esophageal reflux disease).  

“Heartburn and GERD are caused by stomach acid refluxing up into the esophagus, thereby causing damage to the surface lining of the esophagus,” explained Dr. Robert M. Russell, professor emeritus at Tufts’ Friedman School. Because of the downsides of heartburn medications, he said, you should try dietary and lifestyle changes first, or in combination with occasional medication use.

Is it GERD?: Your diet doesn’t cause GERD, but certain foods can trigger its painful symptoms such as heartburn. Occasional heartburn may be uncomfortable, but its nothing to worry about. According to the National Institute of Diabetes and Digestive and Kidney Diseases, if you get heartburn more than two days a week, however, you should tell your doctor. 

• Heartburn – which has nothing to do with your heart — is also known as gastro-esophageal reflux (GERD), acid indigestion, acid reflux, acid regurgitation and heartburn reflux. By whatever name, its cause by a weak lower esophageal sphincter or one that relaxes when it shouldn’t. This sphincter, a ring of muscle, ordinarily acts as a valve between the esophagus and the stomach, opening to let through the food and liquids you swallow. With heartburn, that one-way passage becomes bidirectional. 

• Frequent heartburn could be a sign of GERD, in which stomach acids flow up into the esophagus so often that they can cause damage. Some GERD sufferers also experience hoarseness in the morning, or a feeling like something stuck in the throat. Some other symptoms include: regurgitation of gastric acid, difficult or painful swallowing, chest pain, chronic cough, bad breath, and nausea or vomiting. Some people with GERD still may experience these symptoms without the chronic heartburn. 

• Reducing the level of stomach acids by medication seems like a natural way to counter heartburn and the risks of GERD, but studies have raised red flags about the consequences of long term use of such drugs. By blocking stomach acids, these medications can also interfere with the absorption of key nutrients.

Calcium is one such worry. A study published in JAMA reported that people over the age of 50 who took the most popular type of acid suppressor drugs for a year or more had a significant (44 percent) increase in their risk for breaking a hip. Avoid the long-term use of acid blocking drugs like PPIs or proton pump inhibitors like Nexium, Prevacid and Prilosec.

The study also found a similar increase risk of hip fracture among users of other acid-suppressing medications known as histamine 2 receptor agonists (H2RA), such as Tagamet and Pepcid. Patients using H2RA drugs for longer than 1 year had a 23 percent higher risk of hip fracture. If your doctor recommends these PPI medications, make sure you’re getting enough calcium in your diet and from supplements if necessary. 

Another nutrient of concern is vitamin B12. Adults over age 50 have a condition called atrophic gastritis, decreases the secretion of hydrochloric acid in the stomach. Taking medications to reduce stomach acid levels has a similar effect. Without enough stomach acids, the body can’t extract adequate vitamin B12 from foods.

Your body needs B12 for proper blood cell formation, neurological function, DNA synthesis and other tasks. B12 is naturally present in foods like meat, fish, poultry, eggs and dairy products. Make sure to choose foods rich in the nutrients you may be lacking, including dairy products, green leafy vegetables, whole grains and fortified breakfast cereals. If you’re taking PPIs or H2RAs for heartburn or GERD, be aware of your body’s B12 demands. 

More steps you can take to help control your symptoms include: 

• Eat more frequent lighter meals and snacks. Large quantities of food are more challenging and take more time to digest. 

• Work to lose weight. Cutting calories from unhealthy sources such as starches and added sugars can reduce your risk for heartburn and GERD. 

• Try chewing gum after meals to stimulate saliva production. Saliva contains compounds that help neutralize stomach acids and increase peristalsis. 

• Follow your meals with a small glass of water. This could help dilute and wash down any refluxing stomach acids. 

• Skip carbonated beverages, especially with meals. 

• Try eating more fiber. 

• Don’t lie down within three hours of eating. 

• When you do lie down, try keeping stomach acids in their place by raising your bed six to eight inches. 

• If you smoke, here is another reason to quit. 

• Check with your physician about other medications that may be promoting heartburn. 

Try this recipe for a warm meal with plenty of nutrients to benefit you. 

Vegetable Beef Stew: 

Cooking spray 

3/4 lb. lean beefsteak, cubed 

1 Tbsp. canola oil 

1 small onion, chopped 

1 garlic clove, finely chopped 

1 medium green bell pepper, seeded and chopped 

1 can (15 oz.) diced tomatoes 

2 cups cauliflower florets cut in 3/4 inch pieces 

1 cup corn kernels, frozen or canned 

2 cups cooked brown rice

Salt and freshly ground black pepper, to taste

1/4 cup firmly packed cilantro leaves. Chopped 

Coat large, nonstick skillet with cooking spray and set over medium-high heat. Cook meat until browned on all sides. 

Transfer to bowl and set aside. Wipe out pan and heat oil over medium-high heat. 

Sauté onion, garlic and pepper until onion is translucent, 4 minutes. Add tomatoes and cauliflower. Cook another 4 minutes, until cauliflower is tender. Add corn and rice. Return meat to pan. Season to taste with salt and pepper. Cook, stirring occasionally, until mixture is heated through. Mix in cilantro and serve. 

Enjoy and have a Happy New Year!