What is GERD? Nearly everyone experiences heartburn at some point. Heartburn (gastroesophageal reflux) is a burning sensation in your chest and throat caused by acid backing up into your food pipe (esophagus).

Occasional heartburn is normal. Forty-four percent of Americans experience heartburn at least once a month. However, when heartburn is frequent, it can be a symptom of acid-reflux disease (GERD). When more frequent than twice a week for a prolonged period, the existence of GERD becomes more likely.

What are the symptoms of GERD?

The most common symptoms of GERD are heartburn and acid regurgitation, a sour acid taste in the back of your throat. Other signs and symptoms may include:

• Indigestion
• Difficulty swallowing
• Chest pain
• Coughing
• Choking while lying down

When heartburn and acid regurgitation become chronic, the acid can irritate or inflame your esophagus (esophagitis) and even cause an ulcer on your esophagus. Stomach acid can also erode dental enamel. If you have GERD, you're at greater risk of Barrett's esophagus, a chronic inflammation of the lining of the esophagus that may sometimes lead to cancer.

Anyone can develop GERD. But you're at greater risk of GERD if you're age 40 or older. More than half the people with GERD are between ages 45 and 64. In addition, symptoms worsen with age.

What causes GERD?

The most common cause of GERD is the weakening of the valve at the lower end of the esophagus (lower esophageal sphincter). This valve normally opens to allow food to enter your stomach and closes to prevent food from backing up your esophagus. If you have a weakened valve, it may not close completely once food enters your stomach, allowing stomach acid to back up your esophagus.
 

You experience chronic heartburn (burning, churning feeling in your chest) and acid regurgitation (a sour taste
in the back of your throat). Your doctor tells you that you have gastroesophageal reflux disease (GERD).

Your treatment plan may include lifestyle changes and medication. But you should discuss with your doctor the over-the-counter (OTC) and prescription drugs to avoid — because they can aggravate your GERD symptoms.
 

When does GERD happen?

GERD typically occurs when the valve at the lower end of your esophagus (food pipe) weakens. When you eat, food moves down your esophagus to your stomach. A ring of tissue called the lower esophageal sphincter (LES) at the base of your esophagus serves as a valve. This valve opens to allow the food into the stomach and
closes to prevent the food and stomach acid from backing up into your esophagus. If
you have a weakened valve, it may not close completely once food goes into your stomach — allowing acid and other digestive juices to back up into your esophagus.

Eventually, the acid can cause irritation, inflammation and even erosions of the esophagus (esophagitis). In some cases, chronic exposure to acid scars esophageal tissue, causing a narrowed esophagus (esophageal stricture). This can make swallowing difficult.  

Drugs that can hinder your Lower Esophageal Sphincter (LES) function

Because these drugs are intestinal muscle relaxants and the LES is a muscle, they can reduce your sphincter's ability to completely contract and close. These include:

• Anticholinergics for treating digestive disorders
• Sedatives or tranquilizers, such as benzodiazepines
• Theophylline for treating asthma
• Calcium channel blockers for treating high blood pressure
• Progesterone for hormone replacement
• Opioids for relieving pain

Drugs that can damage your esophagus

These prescription and OTC medications can further inflame an already damaged esophagus. This is especially true if you use any of these drugs regularly. Frequent contact of the medication with the inner lining of your esophagus probably causes the damage. Dosage of the drug is NOT a factor.

These drugs include:

• Potassium supplements
• Iron supplements
• Antibiotics, such as tetracycline
• Nonsteroidal anti-inflammatory drugs (NSAIDS), such as aspirin and ibuprofen
• Alendronate (for treating osteoporosis)
• Quinidine (for treating heart rhythm disturbances)

If you have GERD and you're taking any of these drugs to treat other conditions, talk to your doctor. Together you can find a solution that addresses both your GERD symptoms and any other condition that requires drug therapy.
 

It has become an all-too-familiar routine. You gobble a handful of heartburn pills after a meal to alleviate the burning sensation in your chest. You must use antacids (such as Rolaids and Maalox) and over-the-counter H-2-receptor blockers (such as Pepcid and Zantac) repeatedly to get relief from frequent bouts of heartburn  You may reduce the frequency and intensity of heartburn by making a few simple modifications to your diet and lifestyle.

8 Ways to Reduce Heartburn

Heartburn occurs when the valve between your stomach and food pipe (esophagus) either relaxes inappropriately or lacks the strength to tighten enough to block stomach acid flowing back up the esophagus. Heartburn triggers vary from person to person.
Here are eight tips that may help you reduce your heartburn symptoms:

• Quit smoking. Smoking dries up saliva, which normally protects your esophagus from stomach acid.
   
• Avoid problem foods. Chocolate, garlic, onions, peppermint, spearmint, cinnamon, carbonated beverages, alcohol and just about any high-fat food can make your esophageal valve relax inappropriately. In addition, citrus fruits and juices, coffee (regular and decaffeinated) and anything containing tomatoes can irritate your esophagus.
   
• Eat small meals. Any large meal can expand your stomach and force open the valve between your stomach and esophagus, allowing stomach acid to escape.
   
• Don't lie down right after you eat. When you lie down, gravity stops working in your favor. Wait at least 3 hours after a meal before lying down so that your food can digest.
   
• Avoid exercising immediately after eating. Strenuous exercise may force stomach acid back into your esophagus. Wait at least 1 hour after eating before engaging in a strenuous physical activity.
   
• Lose any excess weight. Heartburn is more likely to occur when there is added pressure on your stomach from extra weight.
   
•  Make gravity work for you when you sleep. Stuffing a big pillow under your  head isn't enough. You have to raise the upper part of your torso as well. There are pillows designed to give the proper amount of head and torso elevation. You can also buy an under-the-mattress foam wedge or stick a board under the legs at the upper end of your bed. The head of your bed needs to be raised 6 to 9 inches. Illustration from website.
   
• Don't wear tight-fitting clothes. Squeezing into a tight pair of pants can put pressure on your stomach, forcing stomach acid upward.
   

Don't ignore symptoms

Talk to your doctor about which of these tips may be appropriate for you. If you suffer from persistent heartburn that has occurred for at least 3 months on 2 or more days a week, you may have gastroesophageal reflux disease (GERD.)

If you have GERD, diet and lifestyle changes may help but your doctor probably will also prescribe medication. Left untreated, GERD can cause serious health problems so don't ignore your symptoms.