You love spicy pasta sauce. Hot chicken wings are your favourite late-game snack. Side order of onion rings? Even better. Wash it all down with a super-sized cola. Yum! But about 20 minutes later your stomach is sending you some serious S.O.S signals. Your belly aches, there's a burning sensation rising through your chest, and you are developing a really unpopular taste in your mouth. Even the dog won't kiss you goodnight.
Welome to GERD. Gastroesophageal Reflux Disease. Otherwise known as heartburn, reflux, gut-rot, or plain old "gas".
Real life GERD isn't like the T.V. commercials. This isn't just a little gas that goes away with a quick tablet or syrup from the corner store. GERD is a painful and usually chronic condition. In the beginning it shows up once in a while. Then it becomes more frequent. Soon it's getting you all the time. If you are having symptoms more than twice a week then you have GERD.
This can be really frustrating. You didn't have any problems when you were younger. All-night keg parties with midnight poutine or pizza deliveries were all part of the fun. But the aging body often doesn't tolerate this kind of behaviour for long. You don't have to be old to develop reflux - many people get it in their twenties and thirties. There are even some newborns and infants who get it.
GERD is caused by stomach acid backing up out of the stomach and travelling up the esophagus. The acidity burns the tissue lining the esophagus and causes inflammation and pain. Some people get this because the opening to their stomach is faulty (a relaxed valve at the opening or a hiatus hernia). Others get it because the stomach is overloaded by what's been consumed (too many cheezies) or because the stomach is being compressed (pregnancy or obesity).
There are a number of signs or symptoms of GERD. You may have heartburn or the sensation of regurgitating food or liquid into your throat. But many people with GERD don't sense any reflux at all. You might have a chronic dry cough, frequent sore throats, a hoarse voice, difficulty swallowing, or feel like there is a big lump in your throat. Some people have chronically bad breath or a sour taste in their mouth regardless of how often they brush their teeth. Others feel like they have chest pain.
These symptoms are your bodies way of telling you it's not happy. And its important to listen because uncontrolled GERD can lead to bleeding ulcers, breathing problems, Barrett's esophagus, and esophageal cancer. It's a good idea to visit your Nurse Practitioner or Doctor if you have symptoms of GERD and they can make sure you aren't developing any of these complications and prescribe medication if it is needed.
Making changes to your lifestyle is THE most important thing to learn for GERD. The more we can prevent symptoms with simple diet and activity changes the less medication you will need and the fewer complications you will have.
- Coffee: love it as I do, excess coffee exacerbates GERD. Doesn't matter if you've always had lots of coffee. One day the stomach just decides to rebel. The way your stomach handled this in your twenties isn't necessarily how it works in your forties. Removing coffee from the diet is a very successful way to reduce GERD. Reduce slowly to avoid caffeine rebound headaches.
- Pop & Carbonated beverages: also hard on the stomach but they have no nutrient value whatsoever (!!!) so get rid of them. Drink water instead.
- Alcohol: Sorry! It's true. You like a cold beer at the end of the day but your stomach probably doesn't agree with you. Especially if it's seven beers at the end of the day. All alcohol can cause problems - beer, wine, liquor. Enough said.
- Smoking: no surprise here. Ciggies decrease the effectiveness of your esophageal sphincter (valve at stomach opening). Plus they also cause esophageal cancer so Smoking + GERD = cancer cocktail.
- Late night meals: Eating late and then laying down is bad news. Your food hasn't been digested yet and the contents just zip right back up and cause immediate discomfort.
- Big meals: Large meals are hard to digest. Many people skip meals during the day (especially breakfast) and then have a super-sized meal in the evening. You may think this is "convenient" but your tummy hates it. Graze on 3 meals plus snacks and always always always eat breakfast.
- Obesity: big waistlines put pressure on the stomach and push acid up into your throat. And you don't have to be morbidly obese for this to happen. Anyone with a BMI over 25 can get it.
- Tight Clothes: hanging on to that party dress from 1982? Give it up. Clothes that are tight around your waist or diaphragm also apply pressure and push stomach acid upwards. But seriously? You needed to get rid of that dress anyway.
- Trigger Foods: there are certain foods that trigger GERD. These are different for every person but commonly include tomatoes, spicy food, fatty or fried food, chocolate, mint, wheat/gluten, onions and sometimes dairy products. Learn what sets you off and avoid avoid avoid.
- Bed Head: Most people sleep on a flat bed. If you have GERD this can exacerbate the back flow of stomach acid. Don't sleep in the LazyBoy or prop up on 10 pillows - this will lead to back and neck pain in no time. Elevate the head of your bed - you can put bricks or solid wood under the feet of your bed so the head is elevated.
References & Resources:
GERD (Mayo Clinic)
GERD in Adults for Health Care Providers (Guideline Advisory Committee)
Esophageal Cancer (Canadian Cancer Society)
Barrett's Esophagus (Up To Date)
Wheat Belly blog