You’ve just had a satisfying meal and are now settled in for an evening of relaxation – but, uh-oh, here comes the heartburn – again.
Heartburn affects millions of Americans, and while it is common especially after eating a large or spicy meal, it is usually not serious. However, if you feel regularly uncomfortable after meals with heartburn or indigestion, it may be acid reflux, which can develop into a more severe form called gastroesophageal reflux disease or GERD.
What Is Acid Reflux & GERD?
Acid reflux occurs when stomach acid backs up into the esophagus due to a faulty valve.
At the point where the esophagus connects with the stomach, a ring of muscles function like a valve, closing the esophagus after food passes through it. If that valve doesn’t close completely or if it opens too often, stomach acid can seep backwards into the esophagus where it does not belong. The sensitive lining of the esophagus gets inflamed by the acid, causing the discomfort or pain we recognize as heartburn or indigestion.
Other symptoms can include nausea, bloating, regurgitation or a sour taste of stomach acid in the throat or mouth, and dry cough.
“Although annoying, getting acid reflux once in a while is usually not harmful, but if it increases in frequency, it can lead to more serious issues,” said Samantha Shah, MD, of Samaritan Internal Medicine – Corvallis.
“Frequent acid reflux – two or three times a week -- can progress into GERD, a condition that will damage the esophageal lining,” she said.
When damaged, scar tissue can narrow the walls of the esophagus and effect the ability to swallow. Over time, esophageal cells can become altered and develop into a condition called Barrett’s esophagus or even cancer.
“Most of the time, acid reflux can be controlled or prevented by lifestyle changes and over-the-counter antacids or acid reducers,” Dr. Shah explained. “If those changes don’t work, we may need to explore a surgical option to repair the valve.”
Lifestyle Changes Can Help
Exploring dietary changes as well as altering the timing and size of meals, can help minimize acid reflux.
Eat Smaller Meals
Large meals expand the stomach upward causing stress on the esophageal connection, prompting stomach acid to travel backwards. Smaller meals put less of a burden on the stomach and can help with acid reflux.
“Aim to get the same number of calories you typically would get from three good-sized meals by eating much smaller amounts more frequently. You may find this method helps you feel better,” Dr. Shah said.
Let Food Digest Before Sleep
Eating right before bed will worsen symptoms of acid reflux. Try to eat your last bit of food 2 to 3 hours before bedtime.
“When lying down, your esophagus and stomach are at the same level and acid can more easily flow back into your throat,” explained Dr. Shah. “After a couple hours, your meal will have partially emptied out of the stomach and the digestive acids will be reduced by then.”
Be Aware of Food Triggers
Many types of food can trigger acid reflux, including:
- Spicy, fried or fatty foods
- Tomato products
- Garlic and onions
- Carbonated beverages
“Pay attention to the foods that seem to bother you and avoid them, if possible, or minimize the quantity or frequency of consuming them,” said Dr. Shah.
Lose Excess Weight
Carrying extra weight, especially in the abdomen, puts added pressure on the esophagus.
“People who are overweight or pregnant have increased risk of heartburn and acid reflux because of the pressure that the extra belly fat puts on the esophageal sphincter or valve,” noted Dr. Shah. “If you can lose weight, even if it’s a small amount, you may notice a relief of symptoms.”
Try Over-the-counter Medications
Along with changing your dietary habits, using an over-the-counter antacid or acid reducer can also relieve symptoms.
Antacids, such as Tums and Rolaids, provide immediate relief from symptoms by neutralizing stomach acid. Take as directed on the packaging for those times you’ve eaten a trigger food or overeaten.
Acid reducers, such as Pepcid and Prilosec, act more gradually to decrease the amount of stomach acid the body produces. They are usually taken for a two-week period.
When to Call Your Doctor
First, it’s important to note that the burning, uncomfortable feeling of heartburn can be confused with symptoms of a heart attack. Get immediate medical attention if you have other heart attack symptoms such as sweating, dizziness, intense pressure or pain in the chest, upper back, arm or jaw or, even if you are unsure.
“Other concerning symptoms you’d want to talk with your doctor about include blood in your vomit, any unexpected weight loss, chronic sore throat, prolonged nausea and anything else that is worrying you,” said Dr. Shah.
“Primarily, if your symptoms last longer than two weeks or become more severe, see your primary care provider. We may need to do some tests to rule out anything more serious or to discuss other options that might work better for you,” Dr. Shah said.
Samantha Shah, MD, is an internal medicine physician who sees adult patients at Samaritan Internal Medicine Clinic – Corvallis. She can be reached at 541-768-5140.