What Else Should I Know
Early diagnosis and treatment can help reduce or even stop uncomfortable GERD symptoms. Untreated GERD can cause permanent damage to the esophagus.
You’ll probably find that one of the simplest ways to make living with GERD easier is to avoid the things that trigger your symptoms. Some people will have to limit certain foods others may have to give them up entirely. It all depends on your symptoms.
It can be hard to give up sodas or favorite foods at first. But after a while, lots of people discover that they feel so much better that they don’t miss the problem foods as much as they thought they would.
Symptoms Of Acid Reflux In Children
In older children, things are slightly different.
To make things clear, we report a table below. It shows GERD-related symptoms grouped by age.
As we can see, the differences are also due to the fact that children cannot express their feelings up to 3 years of age .
Another important symptom to remember is recurrent abdominal pain in children.
It refers to the frequency and duration of heartburn episodes in children.
In particular, the threshold to consider is the following: 3 months in the preceding period and, over this 3 months period of time, the occurrence of at least 3 serious episodes of pain that are severe enough to affect the daily activities of the affected patients.
Abdominal pain is closely related to acid reflux in children, and this has been proved because successful treatments for heartburn also fixed the abdominal pain.
Causes Of Heartburn And Acid Reflux
Lots of people get heartburn from time to time. There’s often no obvious reason why.
Sometimes it’s caused or made worse by:
- certain food and drink such as coffee, tomatoes, alcohol, chocolate and fatty or spicy foods
- being overweight
- some medicines, such as anti-inflammatory painkillers
- a hiatus hernia when part of your stomach moves up into your chest
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How To Tell If Its Heartburn Or Chest Pain From Coronavirus
Heartburn is nevertheless a very common symptom reported in a substantial portion of the general adult US population. It may be very easy to confuse heartburn with chest pain or pressure in the chest, which COVID-19 patients often experience. So here is a way to differentiate heartburn from chest pressure / pain from other causes:
- Heartburn feels like a burning pain in the chest that usually occurs after eating and may occur at night, the discomfort often worsens when lying down or bending over, and there may be a bitter or acidic taste in your mouth. Taking liquid antacids may quickly relieve this discomfort.
- Chest pain and pressure related to COVID-19 may feel like it is overall harder to breathe, does not worsen after you eat or while laying down, and does not respond to liquid antacids
What Can You Do If You Have Heartburn
If you experience occasional heartburn from acid reflux, try these:
- Donât lay down after eating for two to three hours
- Raise the head of your bed so gravity helps keep your stomach contents in your stomach
- Eat smaller, more frequent meals instead of two to three large meals
- Donât smoke
- Avoid tight clothing that can put pressure on your stomach
- Keep a food diary to pinpoint trigger foods to avoid
- Lose extra weight
- Use over the counter antacids if needed*
If youâre taking antacids more than two times per week, or your symptoms are getting worse, you may have GERD. Your doctor can talk to you about your history and symptoms, rule out other conditions, and determine if you have acid reflux or GERD.
Together you can come up with a plan to treat your symptoms and avoid the complications that can come from untreated GERD.
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Symptoms Location And Timing
Your symptoms, the site and character of your discomfort, and symptom timing are important factors your doctor will consider in differentiating acid reflux versus an ulcer. Burning pain behind the breastbone and possibly into the throat that occurs after meals points toward acid reflux. This discomfort often worsens when you lie down or bend over. Ulcer pain is commonly described as gnawing or boring discomfort located toward the bottom of the rib cage. Ulcer pain usually occurs on an empty stomach and is relieved by eating. Unintentional weight loss may point toward an ulcer, whereas difficulty swallowing or a chronic cough makes acid reflux more likely.
- Your symptoms, the site and character of your discomfort, and symptom timing are important factors your doctor will consider in differentiating acid reflux versus an ulcer.
- Ulcer pain is commonly described as gnawing or boring discomfort located toward the bottom of the rib cage.
Is Gerd Dangerous Or Life
GERD isnt life-threatening or dangerous in itself. But long-term GERD can lead to more serious health problems:
- Esophagitis: Esophagitis is the irritation and inflammation the stomach acid causes in the lining of the esophagus. Esophagitis can cause ulcers in your esophagus, heartburn, chest pain, bleeding and trouble swallowing.
- Barrett’s esophagus: Barrett’s esophagus is a condition that develops in some people who have long-term GERD. The damage acid reflux can cause over years can change the cells in the lining of the esophagus. Barretts esophagus is a risk factor for cancer of the esophagus.
- Esophageal cancer: Cancer that begins in the esophagus is divided into two major types. Adenocarcinoma usually develops in the lower part of the esophagus. This type can develop from Barretts esophagus. Squamous cell carcinoma begins in the cells that line the esophagus. This cancer usually affects the upper and middle part of the esophagus.
- Strictures: Sometimes the damaged lining of the esophagus becomes scarred, causing narrowing of the esophagus. These strictures can interfere with eating and drinking by preventing food and liquid from reaching the stomach.
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What Is The Difference Between Heartburn And Acid Reflux
Heartburn is a symptom of acid reflux. Heartburn describes a feeling of burning, pain, or discomfort in the chest that can be quite uncomfortable. You also may a sour or bitter taste in the throat and mouth, and it usually occurs after you eat a big meal or when you lay down.
Not everyone with GERD will experience heartburn. Other symptoms of acid reflux include regurgitation of acid into the throat or mouth, a bitter taste in the mouth, upset stomach, belching, nausea after eating, feeling full, stomach and upper abdomen bloating, dry cough, wheezing, hoarseness, feeling of tightness in the throat, and in some people, vomiting.
Causes And Risk Factors
The food pipe becomes narrower just before it reaches the stomach. This narrow part is normally kept shut by the muscles in the food pipe and diaphragm. But this doesn’t work properly in GERD. It is often not clear why.
In some people it is caused by a hiatal hernia . The diaphragm is a sheet of muscle that separates the chest and abdominal cavities from each other. The food pipe passes through a small hole in the diaphragm and enters the stomach just below it. In people who have a hiatal hernia, the upper part of the stomach pushes up through the hole in the diaphragm and into the chest cavity. As a result, the diaphragm can no longer help to close the entrance to the stomach.
There is some debate about whether being overweight, smoking and drinking alcohol can affect the sphincter or the risk of reflux and heartburn. Many of those affected say that their symptoms are triggered or made worse by stress or by certain foods or drinks. The symptoms may also get worse after physical activities or through certain positions, such as bending forward or lying down.
Sometimes reflux symptoms and heartburn are caused by a problem with the food pipe. For instance, the food pipe might not move rising stomach juices back down into the stomach fast enough, or it might react very sensitively. The symptoms can also be made worse by medications such as birth control pills and certain drugs against high blood pressure.
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What Is The Least Acidic Beer
If some beers can worsen the symptoms of heartburn, GERD, and acid reflux, are there any that are better to drink if you have one of these conditions?
Barley malt lagers are the least acidic beer. Malted barley contains phosphates, which are acidic buffers. Making a mash of barley malt mixed with water will cause the phosphate buffers to achieve a natural pH of around 5.2-5.4. Barley malts include pale malt, Pilsner malt, Vienna malt, Munich malt, mild ale malt.
Compare this with 100% base malt grist mashed with distilled water whose pH is between 5.6 and 5.8.
First What Is Acid Reflux
To understand why stomach acid might move in the wrong direction, lets start with a quick anatomy refresher: The tube that stems from your mouth to your stomach is your esophagus, and at the very end of your esophagus is your lower esophageal sphincter , which is a bundle of muscle that acts as a valve above your stomach1.
This valve allows food to pass through into the stomach and, when operating properly, prevents powerful stomach acidswhich break down what you just atefrom splashing back up into the esophagus.
Thats the ideal operation. But when theres weakness or relaxation in your LES, then the valve doesnt close as tightly as it should. Thats when youre at higher risk of stomach acid and partially digested food coming up into the esophagus. This upward flow is called gastroesophageal reflux, according to the National Institue of Diabetes and Digestive and Kidney Diseases .
Many people who arent familiar with acid reflux may assume the issue is happening just near the stomach, but acid can come all the way up the esophagus, especially if youre lying down, Gokulakrishnan Balasubramanian, M.D., a gastroenterologist who focuses on esophageal, neurogastroenterology, and motility disorders at the Ohio State University Wexner Medical Center, tells SELF. For example, you may get acid damage in the vocal cords or trachea, and that acid may then go down into the lungs as well, so you could have coughing or other respiratory symptoms.
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Diagnosing Acid Reflux With Ph Monitoring
This test uses a pH monitor to record the acidity in your esophagus over a 24-hour period.
In one version of this test, a small tube with a pH sensor on the end is passed through your nose into your lower esophagus. The tube is left in place for 24 hours with the portion exiting your nose affixed to the side of your face. It will be connected to a small recording device that you can wear or carry.
During the course of this acid reflux test, you will record in a diary when you are eating or drinking. You will also push a specific button on the recording device to indicate when you are experiencing acid reflux symptoms. This detailed information will allow the doctor to analyze and interpret your test results.
A newer, wireless version of this test is now being used. In this version a small pH sensor is affixed to your lower esophagus using suction. The small capsule is able to communicate wirelessly with a recording device outside your body for 48 hours. The capsule ultimately falls off and passes through the remainder of the digestive tract.
Many patients have found the wireless pH monitoring exam to be far more pleasant than the traditional version. Both techniques yield similar information.
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Can Acid Reflux Disease Be Treated With Diet And Lifestyle Changes
One of the most effective ways to treat acid reflux disease is to avoid the foods and beverages that trigger symptoms. Here are other steps you can take:
- Eat smaller meals more frequently throughout the day and modify the types of foods you are eating..
- If youre overweight or obese, take steps to lose weight with exercise and diet changes.
- Also, ask your doctor whether any medication could be triggering your heartburn or other symptoms of acid reflux disease.
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How To Treat Heartburn Caused By Acid Reflux
While GERD often requires a comprehensive, long-term treatment plan, occasional heartburn caused by acid reflux can often be managed with over-the-counter medications and especially lifestyle changes, says Dr. Balasubramanian.
In addition to adjusting your diet so youre eating smaller meals more frequentlyand avoiding trigger foods that seem to be problematic for youan antacid like Tums, Maalox, or Gaviscon can help neutralize stomach acid to ease the burning feeling. That tends to help about 70 to 80% of people who only get heartburn occasionally, says Dr. Balasubramanian. Over-the-counter Pepcid can also help this medication is classified as an H2 blocker that reduces the amount of acid thats released by the glands in the lining of your stomach.
However, if you are diagnosed with GERD and heartburn is a consistent problem for you, you should talk with your doctor about other options. In this case, the first line of defense includes prescription options like proton pump inhibitors , as they block the production of stomach acid.4 In certain cases, surgery may be an option to reinforce the lower esophageal sphincter so it is better at doing its jobthis is called a fundoplication procedure. Your doctor can help you assess the pros and cons of your treatment plan to ensure the benefit outweighs any possible risk of side effects based on your personal health history.
How Is Acid Reflux Disease Diagnosed
Its time to see your doctor if you have acid reflux symptoms two or more times a week or if medications dont bring lasting relief. Symptoms such as heartburn are the key to the diagnosis of acid reflux disease, especially if lifestyle changes, antacids, or acid-blocking medications help reduce these symptoms.
If these steps dont help or if you have frequent or severe symptoms, your doctor may order tests to confirm a diagnosis and check for other problems. You may need one or more tests such as these:
- Barium swallow can check for ulcers or a narrowing of the esophagus. You first swallow a solution to help structures show up on an X-ray.
- Esophageal manometry can check the function and movement of the esophagus and lower esophageal sphincter.
- pH monitoring can check for acid in your esophagus. The doctor inserts a device into your esophagus and leaves it in place for 1 to 2 days to measure the amount of acid in your esophagus.
- Endoscopycan check for problems in your esophagus or stomach. This test involves inserting a long, flexible, lighted tube with a camera down your throat. First, the doctor will spray the back of your throat with anesthetic and give you a sedative to make you more comfortable.
- A biopsymay be taken during endoscopy to check samples of tissue under a microscope for infection or abnormalities.
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Is It Gallbladder Disease Heartburn Or Acid Reflux
Patrick from Pasadena sent us this question:
Dr Darido,
The answers in your blog are so informative and in detail. I am a 28-year-old living in Pasadena, TX. For the last 1 year I used to experience excessive gas, bloating and flatulence every morning but never had any heart burn or acid reflux even after having a heavy spicy meal or binge drinking night. But Since March,2020 I started experiencing severe heart burn, with some episodes of unable to swallow food. The symptoms keep changing. Sometimes its the feeling as if the food is struck in my throat and chest, pain in my back and shoulders and sometimes its lot of belching. But one consistent symptom every single day I notice is constant throat clearing, burping, flatulence and bloating. I have been extremely strict with my diet . In this process I lost 35 lbs. in 10 weeks. I used to weigh 155 lbs. before . They have performed an endoscopy and ruled out hiatal hernia or ulcers. They found mild chronic gastritis in the reports.
Currently I am on 40mg Omeprazole in the mornings and 20 mg Famotidine in the evenings
Can you please advise if I should get my gallbladder out or should I wait till my GERD is cured? Also, can I use Urso to treat my gallstones meanwhile or while that aggravate the GERD symptoms too? I know stress can only elevate GERD, but this whole gallstone diagnosis is making me lose my sleep and making things worse. Would really appreciate your advice.
Thank you,
Dear Patrick,
Can Gerd Cause Asthma
We dont know the exact relationship between GERD and asthma. More than 75% of people with asthma have GERD. They are twice as likely to have GERD as people without asthma. GERD may make asthma symptoms worse, and asthma drugs may make GERD worse. But treating GERD often helps to relieve asthma symptoms.
The symptoms of GERD can injure the lining of the throat, airways and lungs, making breathing difficult and causing a persistent cough, which may suggest a link. Doctors mostly look at GERD as a cause of asthma if:
- Asthma begins in adulthood.
- Asthma symptoms get worse after a meal, exercise, at night and after lying down.
- Asthma doesnt get better with standard asthma treatments.
If you have asthma and GERD, your healthcare provider can help you find the best ways to handles both conditions the right medications and treatments that wont aggravate symptoms of either disease.
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Cant I Just Take Over
The amount of medicine in the over-the-counter drugs for heartburn is lower than the amount in the prescription form of these medicines. And before you try an over-the-counter medicine, its important to see your doctor. Your doctor will help you get a medicine that works well for you.
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