Posts Tagged ‘GERD’

You may not know it but November 20-26 is National GERD Awareness Week.

This national awareness week began in 1999 and during this time the International Foundation for Gastrointestinal Disorders (IFFGD) places an emphasis on encouraging people with symptoms of GERD to seek treatment.

GERD stands for Gastroesophageal Reflux Disease, and it affects about 20% of the population. If you have never heard of GERD, you may be suffering from it without knowing. Without treatment it is possible for GERD to lead to serious health conditions over time, so it is important to educate yourself on the condition so you can recognize symptoms in yourself and loved ones.

What is the difference between acid reflux and GERD?

Acid reflux, heartburn, and GERD are often used interchangeably, but it is important to understand the differences between them.

Acid reflux is when stomach acid backflows into the esophagus.

Heartburn is the feeling associated with acid reflux and it presents as a mild burning sensation in the mid-chest. Heartburn often occurs after meals or when lying down.

Nearly everyone will experience acid reflux at some point in life. When acid reflux causes bothersome symptoms or causes damage to the body, it is classified as GERD, or chronic acid reflux. If you experience acid reflux more than twice a week for several weeks and are experiencing symptoms despite taking medication, you may have developed GERD.

What are the symptoms of GERD?

• Heartburn- burning sensation in the chest
• Regurgitation- acid and undigested food backflow into the throat or mouth
• Feeling of food stuck in the throat
• Chest pain
• Trouble swallowing
• Raspy voice
• Sore throat
• Unexplained cough
• Nausea or vomiting

How do I know I’m experiencing heartburn and not having a heart attack?

Heartburn is an uncomfortable burning feeling or pain in the chest that can move up to the neck and throat area. A heart attack can cause pain in the arms, neck, and jaw.

Symptoms of a heart attack also include:

• shortness of breath
• sweating, nausea
• dizziness
• extreme fatigue
• anxiety

If you are experiencing chest pain that is accompanied by any of these symptoms, call for medical attention immediately.

 How is GERD treated?

The most common over-the-counter (OTC) medications used to relieve symptoms of GERD are:

Antacids: provide quick relief of symptoms by neutralizing stomach acid. Examples: Maalox, Tums, Mylanta

H-2 receptor blockers: prevent symptoms by decreasing acid production. Examples: Pepcid, Tagamet (Zantac was removed from the market in 2020 due to cancer risk. If you still have this medication at home please stop taking it and throw any left-over medication away.)

Proton pump inhibitors: stronger class of medication that prevents symptoms by reducing stomach acid production. Examples: Prilosec, Nexium, Prevacid

If you are having any of the symptoms of GERD and they are interfering with your daily life, reach out to your provider to discuss treatment options. If your symptoms are not controlled with OTC medications your doctor may prescribe you a medication or recommend surgery.

References:

1. GERD Awareness Week – November 23-29. National Today. https://nationaltoday.com/gerd-awareness-week/. Published March 26, 2021. Accessed November 7, 2022.

2. Heartburn, Acid Reflux, or GERD: What’s the Difference? Pfizer. https://www.pfizer.com/news/articles/heartburn_acid_reflux_or_gerd_what_s_the_difference. Accessed November 7, 2022.

3. Patient education: Acid reflux and gastroesophageal reflux disease in adults (The Basics). UpToDate. https://www.uptodate.com/contents/acid-reflux-and-gastroesophageal-reflux-disease-in-adults-the-basics. Published January 21, 2021. Accessed November 7, 2022.

The upcoming week, November 21 to 27, is GERD Awareness Week, so I want to give you some information about GERD.

GERD (gastroesophageal reflux disease, or chronic reflux disease) is a condition where acid in your stomach leaks back to the esophagus (the tube in your throat) causing a burning sensation (heart burn). If this happens for a long period of time, the esophagus will be damaged.

GERD is usually caused by the damaged esophageal sphincter, which can not close as it is supposed to, creating a back flow of stomach acid.

Keep in mind that having heart burn or acid reflux does not mean that you have GERD, since everybody will experience heart burn now and then. However, if you experience heart burn more than twice weekly, discuss with your doctor since that may be a sign for GERD.

GERD is very common. About 20% of the US population has GERD.

Some risk factors of getting GERD are:

• Age: >40 years
• Obese or overweight
• Pregnant
• Smoking (including secondhand smoke)
• Medications that cause GERD:
  • Iron supplements
  • Potassium
  • Antibiotics: especially tetracyclines and clindamycin
  • Bisphosphonates (osteoporosis medications) which include:
    • alendronate (Fosamax)
    • ibandronate (Boniva)
    • risedronate (Actonel, Atelvia)

Symptoms of GERD include:

• Heart burn
• Regurgitation (food comes back into your mouth from the esophagus)
• The feeling of food caught in your throat
• Coughing
• Chest pain
• Problems swallowing
• Vomiting
• Sore throat and hoarseness

***Keep in mind that people often confuse the chest pain from a heart attack with that from heart burn. The image above from the University of Washington Medicine does a very good job of comparing the symptoms of heart burn and heart attack.

Treatment options:

• Lifestyle modification:
  • Lose weight if you’re overweight or obese.
  • Elevate your head during sleep by placing a foam wedge or extra pillows under your head and upper back to incline your body and raise your head off your bed 6 to 8 inches.
  • Have the last meal of the day about two hours before bedtime.
  • Quit smoking, if you smoke.
  • Reduce consumption of foods that can cause GERD including:
    • acidic foods, such as citrus fruits and tomatoes
    • alcoholic drinks
    • chocolate
    • coffee and other sources of caffeine
    • high-fat foods
    • mint
    • spicy foods
  • Take medications that help with heart burn and reduce acid:
    • Antacids: mild heart burn can be relieved by taking antacids; however, antacids should not be used on a regular basis without the advice of doctors. Antacids could decrease the absorption of some medications such as levothyroxine, ciprofloxacin, etc…, so they should be taken about two hours apart from these medications.
    • H2 blockers: famotidine (Pepcid) is preferred over cimetidine (Tagamet) because it has fewer drug interactions. These medications could help lower the amount of acid in your stomach.
    • Proton Pump Inhibitors (PPI) including pantoprazole (Protonix), omeprazole (Prilosec), lansoprazole (Prevacid): These medications could lower the acid in your stomach much better than H2 blockers; however, they need about 2-3 days until you feel the difference. PPIs should not be taken for more than 14 days unless instructed otherwise by your doctor. Studies have shown that taking PPIs for a long period of time could increase the risk of fracture and clostridium difficile (C. diff ) infections.

If you have any questions, do not hesitate to call any of our friendly pharmacists. We are more than happy to answer any questions.

References:

• Badillo R, Francis D. Diagnosis and treatment of gastroesophageal reflux disease. World Journal of Gastrointestinal Pharmacology and Therapeutics. 2014;5(3):105–112. doi: 10.4292/wjgpt.v5.i3.105
• GERD (Chronic Acid Reflux): Symptoms, Treatment, & Causes. (n.d.). Retrieved from https://my.clevelandclinic.org/health/diseases/17019-gerd-or-acid-reflux-or-heartburn-overview
• (n.d.). Retrieved from https://healthlibrary.uwmedicine.org/Library/Wellness/Prevention/85,P00381
• Treatment for GER & GERD. (n.d.). Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/treatment