The word on GERD

Dr. Michael Piper, Chief, Division of Gastroenterology, Providence Hospital

It’s an hour or so after dinner. You’re ready for bed. You lie down and that’s when it starts. The uncomfortable heat in your chest and throat. Maybe feeling like you’re regurgitating a bit of your supper. A bitter taste in your mouth. You may even experience hoarseness or wheezing. If this happens more than twice a week, it’s time to give your doctor a call. Because while over-the-counter antacids may help in the short term, they’re no match for GERD – Gastroesophageal Reflux Disease. This is an increasingly common condition in which acidic digestive juices travel back from the stomach into the esophagus.

The biggest culprits in causing GERD? Chocolate, coffee, alcohol, smoking and excess weight. GERD can lead to stricture, where stomach acids create scar tissue in the esophagus, making it hard to swallow.

Inflammation and irritation can cause gastrointestinal bleeding, leading to anemia and low blood count. And finally, left untreated, GERD can cause esophageal cancer.  For doctors, the mainstay for diagnosing GERD is an endoscopy, which enables us to look at the lining of the stomach and the esophagus. Once a patient is diagnosed with GERD, we most often recommend lifestyle modification. Avoid "the big three" – smoking, alcohol and coffee. Overweight patients should begin a weight loss program. Don’t eat right before bed, because when you lay flat, things just sit in the stomach, making it much easier for the acids to reflux into the esophagus. And avoid tight clothing that hinders emptying of the stomach.

GERD can also be treated with medication. The newest medicines, known as PPIs, or Proton Pump Inhibitors include Protonix, Prilosec, Nexium, Aciphex and Prevacid. Because GERD is chronic, the medications must often be taken indefinitely, but they are safe and can heal the esophagus in over 90% of the cases.