Heartburn. Burping. Bitter taste. Abdominal pain.
These are the symptoms we associate with GERD – gastroesophageal reflux disease. But GERD is responsible for some less common symptoms as well. It can cause chronic cough, wheezing, hoarseness, and even a runny nose. Some folks experience chest pain from the disease, and it can be responsible for bad breath, too. All of these symptoms result from the acid in the stomach flowing backward up into the esophagus.
The diagnosis of GERD is made by noting these annoying symptoms. There isn’t a test like an x-ray or lab labwork that can diagnose the disorder. When you hear of diagnostic tests associated with GERD, they are typically tests that rule out something more serious in the presence of concerning GERD PLUS symptoms that set off alarm bells for cancer. These include the usual reflux symptoms listed above PLUS anemia, weight loss, or dysphagia (difficulty swallowing).
The test used when these GERD PLUS symptoms are present is usually an esophagogastroduodenoscopy, or EGD for short. Some people call it an upper endoscopy. However you say it, the test involves threading a tiny camera through the esophagus, stomach, and upper part of the small intestine to look for abnormalities. But if you don’t have these more concerning PLUS symptoms, your physician may determine that the EGD is not necessary. Instead, she may offer treatment based on your symptoms and follow up with you over time to see how you respond.
The most common treatment is medication. You’ve probably heard of a number of reflux medications such as Prevacid and Nexium which are available over-the-counter. They are classified as proton-pump-inhibitors, or PPIs. They work by decreasing the acid levels in the stomach. And they work pretty well – most people find that their symptoms get much better with these medications.
However, research is emerging that suggests long term use of PPIs has some potential downsides. Long-term PPI use has been associated with:
- poor absorption of important nutrients like calcium,
- overgrowth of unwelcome bacteria in the gut,
- kidney disease,
- and even dementia.
To be clear, PPIs are simply associated with these disorders, and more research is needed to determine if PPIs actually cause these problems. But there are enough red flags that the FDA recommends using lowest dose for the shortest necessary amount of time.
This means PPIs should be used to help ease symptoms while you make lifestyle changes for long time relief from GERD. Several steps you can take to reduce your symptoms include:
- Keeping a food and symptom diary to discover which foods trigger your symptoms. Then avoid those foods as much as possible.
- Elevating the head of your bed to prevent stomach acid from flowing upward.
- Losing weight. As body mass index increases, so does the prevalence of GERD. This means you may not develop GERD if you are overweight, but if you have GERD, it can be beneficial to lose weight.
Reflux is a common problem many Americans deal with every day. Your physician can rule out more serious health concerns and help you strike the right balance of medication and lifestyle changes to address your symptoms. If you are experiencing GERD symptoms, why not make an appointment today to let us help you?