[6 MIN READ]
In this article:
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It isn’t normal to continually experience GERD symptoms like heartburn and acid reflux, so if you do talk to your provider to get help
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Certain foods are common triggers of GERD. Learn how and when to eat to minimize the discomfort of GERD symptoms.
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If you need treatment for GERD, talk to a provider about your options, which may include dietary and lifestyle changes, medication and surgical procedures.
The holiday season is unlike any other time of year. Calendars fill with parties and events, and it can seem like treats and indulgences meet us at every turn. This makes it challenging to eat healthy foods and means we might be more likely to experience heartburn and acid reflux.
For people with gastroesophageal reflux disease (GERD), navigating these social situations that revolve around food can be tricky—and potentially painful. GERD is a common digestive disorder that occurs when the reflux barrier at the junction between the esophagus and stomach weakens, allowing gastric acid and digestive enzymes to move from the stomach backward into the esophagus. And it can result in uncomfortable and sometimes downright painful symptoms such as acid reflux, heartburn and other symptoms.
You don't have to “just live with” acid reflux. If you start experiencing GERD symptoms, help is available at the Swedish Digestive Health Institute, even during the busy holiday season.
Is it GERD or something else?
Many people have acid reflux from time to time, and GERD has many possible symptoms. Most commonly, they include:
- Heartburn, which feels like a warming or burning sensation behind the breastbone or centered in the upper abdomen.
- Regurgitation, which is the effortless movement of food or sour-tasting fluid from the stomach toward the mouth (unlike vomiting, regurgitation happens without effort).
- Chest pain, which may feel like a spasm, or sharp and knife-like.
Other GERD symptoms may include:
- Frequent throat clearing
- A sore throat
- Asthma-like symptoms
- Shortness of breath
- The sensation of food sticking in the esophagus
- Hoarseness or voice changes
The challenge with identifying GERD symptoms is that they overlap with the symptoms of many other esophageal diseases. So it may take several visits — starting with your primary care provider and eventually with a specialist for testing — to determine if GERD is the cause of your symptoms.
Many people have acid reflux from time to time. But if you consistently have these problems more than twice a week for several weeks or find yourself avoiding certain foods or beverages to avoid this sensation, then you may have chronic GERD and should see a provider.
What causes GERD?
GERD typically results from deterioration of the reflux barrier in part from over eating leading to gastric distension (the enlargement of the stomach). It is often associated with a hiatal hernia, a condition where part of the stomach pushes into the chest cavity.
The types of food you eat, the sizes of your meals, and the times of day you eat can all exacerbate GERD symptoms. This is why you might be more likely to experience the discomfort of GERD during the holiday season — or any other time of year — when you eat a lot of heavy meals later in the day.
Some of the common GERD triggers include:
- Alcohol
- Caffeine
- Chocolate
- Citrus fruits
- Eating late at night, before lying down
- Tomatoes
Obesity, pregnancy and smoking are among the factors that increase the risk of developing GERD.
When to get help for GERD
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates that GERD affects about 20% of people in the United States. Anyone can develop GERD, and without treatment, it can lead to serious health complications such as:
- A change in the lining of the esophagus called Barrett’s esophagus, which could progress to esophageal cancer over time.
- Abnormal narrowing or scarring of the esophagus that causes problems with swallowing.
- Esophagitis (inflammation and erosions in the esophagus).
Many people don’t even consider talking to their primary care physician about the acid reflux symptoms they are experiencing, and they just consider it a normal part of life. But it is not normal to constantly think about how and what you eat so you don’t have painful acid reflux, and you shouldn’t continually take over-the-counter (OTC) reflux medication without consulting your provider.
So, how do you know when it’s time to seek care from a GERD specialist? While your primary care provider can help you begin to manage your GERD, you may eventually need care from a specialist, especially if the treatments your primary care provider recommends are not working, or if OTC medications are not controlling your symptoms.
Even if proton pump inhibitors (PPIs) control your symptoms, it may be helpful to see a specialist so you can discuss your risk of developing Barrett’s esophagus.
What to expect when you see a GERD provider
If you are experiencing ongoing GERD symptoms, your primary care provider may first refer you to a Swedish GERD specialist at Swedish Thoracic Surgery:
Your provider can also refer you to a GERD specialist at Swedish Gastroenterology:
Amarnath V. Ramakrishnan, M.D.
Physicians in these clinics have additional education and training in GERD and the options for treatment. At the Swedish Digestive Health Institute, our team will listen as they ask you about:
- The medications you have been taking
- The severity of your symptoms
- Your lifestyle and diet
Depending on your condition, the GERD specialist may recommend:
- Additional diet and lifestyle changes
- Medication changes
- Stopping medication to monitor symptoms
- Testing to confirm GERD (e.g., endoscopy with biopsy, X-ray, ambulatory acid (pH) probe testing)
Surgery to treat your GERD may also be recommended by the GERD specialists, you can make an appointment with a surgeon at the Swedish Digestive Health Institute who will talk you through your surgical options and help you determine which will work best for you.
Treatments for GERD
While over-the-counter medications might seem like the first thing to try when you first notice symptoms of GERD, the best way to avoid this painful disease and stop it from becoming more serious is to consider a more holistic approach. Our GERD specialists can help you identify what’s causing your symptoms and guide you to the right treatment, which may include a combination of lifestyle modifications and medical care.
GERD diet and lifestyle changes
The starting point for most patients with GERD is to make diet and lifestyle modifications. This includes losing weight if you have an elevated body mass index (BMI). Additional steps you can take include:
- Avoid “trigger foods” (e.g., caffeine, chocolate, tomatoes, alcohol)
- Stop eating at least three hours before bedtime
- Eat four or five smaller meals throughout the day instead of one or two big meals
- Eat smaller, less fatty and rich meals
- Elevate the head of your bed while sleeping
- Meeting with a Swedish weight loss professional if you are overweight and want to reach a healthier weight
- Incorporate more exercise and movement into your daily routine
GERD medications
The most common treatments for chronic acid reflux are medications that either neutralize or suppress stomach acid. These can be purchased over the counter and include:
- Antacids like Tums that neutralize the stomach acid and provide short-term relief from heartburn
- Histamine blockers such as Pepcid
- PPIs, which are the most powerful acid suppression medications
You can find PPIs at your local drug store, but before taking them, talk about the risks and benefits with your provider. It’s crucial that you discuss your treatment options and confirm that your symptoms are actually from GERD and not another condition. Your provider can also refer you to an expert in GERD — such as an esophageal surgeon or gastroenterology specialist — for a consultation.
GERD surgery
When lifestyle changes and medicine no longer work to control your GERD or you wish to have alternative to mediciation, there are four different surgical options available. Each has its pros and cons:
- Nissen fundoplication, which creates a new valve by wrapping part of the stomach around the lower esophagus, stopping reflux of gastric juice into the esophagus
- Partial fundoplication otherwise known as the Toupet, Dor, or Hill gastropexy procedures, where the surgeon only folds the stomach part of the way around the lower esophagus
- Magnetic sphincter augmentation (LINX), where the surgeon implants a small bracelet of magnetic beads, called LINX, around the lower esophagus to reinforce the leaking valve and prevent reflux of gastric juice into the esophagus
- Transoral incisionless fundoplication (TIF), an advanced endoscopy procedure that allows the provider to augment the defective valve by bringing stomach tissue partially around the esophagus
The American College of Gastroenterology GERD Guidelines recommend that patients find an experienced surgeon to discuss each option. At the Swedish Digestive Institute, our GERD surgeons are nationally known for their work in surgery for GERD and will help you to find the procedure that will work best for you.
Get expert GERD care at Swedish
The Swedish Digestive Health Institute is part of Providence Health and home to a group of leading reflux experts — gastroenterologists and esophageal surgeons — working with patients across the seven states we serve. Some of the most well-known GERD experts in the world work at the Providence hospitals and with the Digestive Health Institute to drive research across the country. Their work has influenced GERD management and led to the adoption of new surgical techniques.
At Swedish, our providers take a patient-centered approach. They recommend treatments based on your individual circumstances and goals. They are experienced in all the different types of medical and surgical therapies and can help you get the treatment that addresses your unique circumstances in a location that is as close to home as possible.
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Learn more and find a provider
If you have questions about GERD symptoms and treatments, contact the Swedish Digestive Institute. We can accommodate both in-person and virtual appointments.
With Swedish Virtual Care, you can connect face-to-face with a nurse practitioner who can review your family and health history. To find a provider, try searching our provider directory.
Join our Patient and Family Advisory Council.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
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