When the holidays get closer, our attention turns to all the wonderful food that is served. Many of us tend to overindulge on rich foods that we might not otherwise eat during the year. Overindulgence is just one of the things that can bring on problems with what is referred to as gastroesophageal reflux disease (or GERD).
GERD is a common problem seen year around in the doctor’s office and can present itself in many ways. There is a valve like structure between the esophagus (food pipe) and the stomach that should close once the food is passed into the stomach. If this valve, referred to as the lower esophageal sphincter (LES), doesn’t close properly, acid from digestion will reflux back into the esophagus and may cause symptoms.
Symptoms that can be caused by GERD include heartburn, frequent burping, chest pain, sour taste in the mouth, cough, and worsening of asthma. Untreated reflux can lead to erosions in the teeth, a chronic sore throat, choking, and ulcers. If acid is chronically being refluxed into the esophagus, the esophagus can become scarred, and thus narrowed, causing food to get stuck and choking to occur.
Many of the symptoms of GERD can be controlled without medication by altering one’s diet and lifestyle. For instance, avoid overeating or eating within three hours of bedtime. Gravity plays a role in this condition. If you eat too much or just before bed, the full stomach pushes up against the esophageal sphincter and can cause reflux to occur. Caffeine (including that in chocolate), alcohol, tomato containing foods and sauces,citrus (such as oranges and orange juice), spicy foods and nicotine can all weaken the lower esophageal sphincter and make reflux more likely. Avoiding these items or limiting them can help. Some medications can also cause reflux. A few examples include cholesterol medications (statins), medications used for osteoporosis treatment (bisphosphonates), and some blood pressure, nausea and pain medications. If you are on one of these medications, do NOT stop it until you have discussed it with your doctor.
If your doctor diagnoses you with reflux, dietary changes and medication may be prescribed. If symptoms persist, a referral may be made to a gastroenterologist (GI specialist) for further evaluation utilizing an outpatient procedure called an EGD (esophagogastroduodenoscopy). This procedure involves use of a scope that allows direct visualization of the esophagus, stomach and upper intestestine. Biopsies of any abnormal tissue can also be accomplished through the scope to rule out any cancer or precancerous condition.
Enjoy your Thanksgiving holiday, but keep moderation in mind!