Feeling the Burn?

5273 users shared this document! click

vim & vigor 46 winter 2007 By Jane F arr ell ILLUSTRATION BY TERRY ALLEN Feeling the Burn? Answers to the 6 most FdVVWI0700_46-48_GERD.indd 46 FdVVWI0700_46-48_GERD.indd 46 7/30/07 5:33:03 PM 7/30/07 5:33:03 PM vim & vigor 47 winter 2007 For years, nutritionist Jen Rackley suffered from persistent
upper respiratory infections, coughs
and horrible stomachaches. I ate Tums like candy, Rackley says. Because of her indigestion,
doctors prescribed medicine for a
spastic colon, but that didnt help.
Eventually, her physician deciphered
her symptoms as GERD, or gastro-
esophageal reflux disordera con-
dition that afflicts 21 million adults
in the United States and can lead to
major health problems. But through medical treat- ment and lifestyle changes, it can
be controlled and even eliminated.
Here are important things to know
about GERD. 1. What Causes It? GERD occurs because of a mal-
function in the digestive system.
Normally, food travels from the
esophagus to the stomach via
a muscle, the lower esophageal
sphincter, which acts as a valve,
opening to let food into the stom-
ach and closing to prevent acidic
contents from backing up into
the esophagus. When the lower esophageal sphincter is weak and doesnt func-
tion as it should, acidic stomach
contents leak back (reflux) into
the esophagus. This causes a bit-
ter taste in the back of the mouth
or a burning sensation, known as
heartburn, in the throat or chest. GERD also can be caused by a hiatal hernia, a condition in
which part of the stomach distorts
another valve-like muscle known
as the esophageal hiatus, disrupting
normal digestion. 2. What Are the Symptoms? The most widely known signs are
persistent heartburn or acid regur-
gitation. But you can have GERD
even if you dont have heartburn,
according to the National Institute
of Diabetes and Digestive and
Kidney Diseases. Signs can include morning hoarseness, food sticking in the
throat, trouble swallowing, bad
breath, coughs or chest pain. (Of
course, if you do experience severe
chest pain, get medical attention
right away. Chest pain can be a sign
of a heart attack.) 3. When Is It Time to See the Doctor? Jack DiPalma, M.D., former presi-
dent of the American College of Gastroenterology, recommends
going to a physician if you are using
antacids more than twice a week
or if symptoms affect your daily
life. For example, Rackleys cough
was so severe that she had to quit
competitive swimming. DiPalma also stresses the importance of giving your doctor
a complete picture of your health-
care. I like it when a patient brings
all their medications so I can see
if theres an injurious drug involved,
he says. They should bring pre-
scription, over-the-counter, and
any alternative or complementary
products, even if they dont think
[the medicines] are relevant. important questions about acid reflux FdVVWI0700_46-48_GERD.indd 47 FdVVWI0700_46-48_GERD.indd 47 7/30/07 5:33:22 PM 7/30/07 5:33:22 PM vim & vigor 48 winter 2007 Stop the Burn If you suspect that you or your child is
experiencing gastroesophageal reflux
disease, talk to your doctor. You also can
find more information at reflux.org. Kids Get It, Too Contrary to popular perception, GERD is not exclusively an illness
of older people. An estimated 3 million to 7 million children and
adolescents suffer from the condition. It seems to be on the rise, says Jan Gambino-Burns, associate director of the Pediatric/Adolescent Gastroesophageal Reflux
Association. But its not certain whether thats because its being
more easily identified now, or because of other factors. Other pos-
sible explanations she cites include the increasing obesity rates
among children, a lack of exercise and an increase in asthma. Gambino-Burns says symptoms may not be obvious. Kids who seem fussy may be just bypassing food that gives them indigestion.
Sometimes certain foods dont taste good, she explains, so a
child will avoid them. Hes not being a picky eater; hes being a
careful eater. Other signs, which can be mild or severe, include
breathing problems, sour breath and disrupted sleep. The easiest way to find out if a child may be experiencing acid reflux, Gambino-Burns says, is simply to ask, Do you have a yucky
taste in your mouth after you eat? If the answer is yes, parents
should take their child to the pediatrician rather than going to the
drugstore on their own. Its tempting to go to the pharmacy and
buy something over the counter, she says, but a doctor will know
which kind of treatment is best. 4. How Is It Treated? Antacids (Rolaids, Maalox, Mylanta)
are usually recommended first. If
they dont work, stronger medicines
like H2 blockers (Tagamet, Zantac)
can lessen acid production, as can
a class of medications called PPIs
(proton pump inhibitors), which
includes Prilosec and Prevacid. If you dont respond to these, a doctor can perform diagnostic
tests. These include X-rays of the
esophagus and stomach; an in-
office endoscopy, (an exploration
of the esophagus using a flexible
tube, or endoscope, which has a
tiny camera); and a pH monitor-
ing examination, in which a tube
is placed in the esophagus to track
acidity levels for 24 hours. These tests also can detect a severely inflamed esophagus, which
may lead to a condition known as
Barretts esophagus. The exact
causes of Barretts esophagus are
not known. The American Cancer
Society cites Barretts esophagus as
a risk factor for esophageal cancer. 5. What Lifestyle Changes Should You Make? The most crucial changes, DiPalma
says, are to stop smoking and to avoid
nonsteroidal anti-inflammatory
drugs, such as aspirin, which have
been linked to relapses of GERD.
The National Institute of Diabetes 6. What If Nothing Works? In cases that dont respond to medi-
cation or to lifestyle modifications,
patients can opt for surgery. A mini-
mally invasive procedure known
as a Nissen fundoplication involves
wrapping the stomach around the
lower esophageal sphincter. Other
possibilities involve endoscopic pro-
cedures that tighten or strengthen
the lower esophageal sphincter.
The procedures dont require major
recovery time. DiPalma cautions that even surgery may not entirely eliminate
GERD. So its best to continue with
lifestyle changes and possibly medi-
cations as needed. Your doctor is
the best person to help advise you. and Digestive and Kidney Diseases
also recommends avoiding alcohol;
losing weight if necessary; eating
small, more frequent meals; and
avoiding foods that are spicy, acidic
(like oranges and tomatoes), fried
or high in fat. Rackley has made similar changes in her life. As a result, she
says, my problems are very well-
controlled. Although her GERD
has not gone away entirely, she
has only occasional flare-ups, and
those respond to medication. Her lifestyle changes also include stress-management techniques
and regular exercise. Im a big fan
of yoga, she says, laughing, as
long as I save the inverted poses
for a couple of hours after eating! FdVVWI0700_46-48_GERD.indd 48 FdVVWI0700_46-48_GERD.indd 48 7/30/07 5:34:06 PM 7/30/07 5:34:06 PM

Comments