Part Three of a Three Part Series: Adults
First, it is important define two separate but related conditions: Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD). Gastroesophageal Reflux (GER) is a normal physiological event characterized by the sensation of food coming up the esophagus in the form of a wet burp. Many adults have GER after eating a large meal, drinking a carbonated beverage or eating too fast. On the other hand, Gastroesophageal Reflux Disease (GERD) is the abnormal backwashing of stomach contents and acid into the esophagus causing complications. GERD may cause esophagitis (irritation to the delicate lining of the esophagus), ulcers and respiratory issues.
Common symptoms: GER
GER symptoms may include:
o Sour taste in the mouth after a meal
o Sensation of food coming up the throat
o Fullness, bloating
Many adults report occasional GER symptoms and worry that they have GERD. It is important to watch for signs that occasional reflux symptoms are becoming more frequent (every day or a few times each week) or causing pain since occasional GER may very well progress to GERD over time. For example, an adult friend of mine complained that her throat burned every time she ate salad with vinegar dressing. She tried avoiding eating foods with vinegar and the symptoms decreased. A few months later, she reported that other foods started to cause frequent episodes of painful swallowing and a sore throat. She reported the pattern of GER symptoms to her doctor and was diagnosed with GERD.
GERD symptoms may include the symptoms of GER plus:
o Heartburn/chest pain
o Sore Throat
o Pain with swallowing
o Weight loss
o Poor sleep
o Heartburn after eating certain foods (spicy foods, high acid foods)
o Coughing or choking during and after a meal or at night
o Voice changes: deep voice, raspy voice, throat clearing
Gastroesophageal Reflux Disease or GERD is a common condition in adults. It may seem that the symptoms creep up slowly at first with a bit of heartburn here and there and progress to very severe, painful heartburn. It may be disappointing to have discomfort with previously preferred foods that happen to be reflux triggers such as spicy food (pizza, tacos) and high acid foods (coffee, cola and orange juice). Adults may develop serious complications from GERD such as esophagitis, ulcers and Barrett’s Esophagus.
o Wear loose, comfortable clothing.
o Avoid clothes that put pressure on the waist such as pants and pantyhose.
o Stop smoking
o Avoid second hand smoke
o Avoid physical activity after a meal
o Sleep on an elevated surface so the head is higher than the body using extra pillows, a wedge or bed blocks.
o Reduce stress
o Exercise to reduce stress and maintain a healthy weight
o Lose weight if overweight
Adults may need to limit or avoid:
o Caffeine: cola, coffee, tea, iced tea
o Energy drinks with sugar and caffeine
o Citrus: oranges, orange juice
o Tomatoes and tomato sauce
o Carbonated drinks: seltzer, soda
o Spicy food
o High fat foods and fried foods
o Alcohol: beer, wine, hard liquor
o Eat small, frequent meals
o Avoid eating before bedtime
o Eat slowly and chew well
o Acid Reducer
o Proton Pump Inhibitor
Over the counter and prescription medications may be recommended by the doctor. Check with the doctor on the best medication to use. An adult on multiple medications to treat other health conditions such as high blood pressure, cholesterol, heart disease, etc should consult with the doctor and pharmacist about potential drug interactions from taking GERD medications with other prescription medications. Unfortunately, some medications used to treat other chronic conditions may cause digestive discomfort.
Many adults and their doctors find that it is challenging to treat multiple health conditions and GERD. Adults with GERD and other health conditions need to play an active role in their health care. It is important to inform all doctors and specialists of your full medical history, all medications you are taking, including supplements and vitamins. It is vital to reveal lifestyle factors that may impact digestive health including eating habits, alcohol consumption and exercise.
Long Term Outlook
You are not alone. Most adults will get nods of sympathy if they pull out their over the counter acid reducer after lunch. The good news is adults with GER and GERD respond well to treatment. While it may be tempting to self treat with the variety of over the counter medications in the antacid aisle of the pharmacy, it is important to consult your doctor for a treatment plan. Some adults with GERD are at risk for complications from GERD including a precancerous condition called Barrett’s esophagus and may need to be monitored and tested on a regular basis.