Healthy Habits for Bonsall & Fallbrook Folks: GERD is an irritating acid reaction

Megan Johnson McCullough

Special to the Village News

Gastroesophageal reflux disease is that irritating acid that can build in the stomach and esophagus. Many people experience it from time to time, but chronic heartburn, chest pain, difficulty swallowing, feeling like there is a lump in the throat and even regurgitation can become a persistent hindrance to life. They can have a lingering cough and sleep disruptions. So what causes it to occur in those unlucky individuals?

When we swallow, there is muscle called the lower esophageal sphincter that surrounds the esophagus and relaxes so that food and liquid can enter the stomach. Then the sphincter closes back up. If this relaxing action takes place abnormally, stomach acid will flow back up into the esophagus. It causes inflammation.

Certain lifestyle habits can increase the risk for GERD including smoking, eating really large meals late at night, eating fat-filled or fried foods, drinking alcohol or coffee and taking aspirin. Obesity and pregnancy also increase risk.

The inflammation that GERD causes can be detrimental. The esophagus starts to narrow causing esophageal stricture because stomach acid causes the formation of scar tissue. The scar tissue essentially narrows the food pathway and swallowing becomes a problem. Esophageal ulcers can also occur. The stomach acid wears away at tissue which can cause an open sore to form. This sore can bleed which is not only painful, but again, makes swallowing difficult. Esophageal cancer or Barrett's esophagus is also possible since the tissue of the esophagus has changed.

Physical examination by a doctor should be done to diagnose GERD. An endoscopy takes place where a doctor inserts a flexible tube into the throat with a camera and light that can look at the esophagus and stomach. This examination can detect the inflammation. An ambulatory probe test can be done and a monitor is placed in the esophagus to determine patterns of the stomach acid. An esophageal manometry test measures the muscle contractions in the esophagus. An X-ray of the digestive system can also be done. The person drinks a chalky liquid that lines the digestive tract. The doctor can see a silhouette of the esophagus.

From testing a doctor can determine appropriate treatment. Over the counter remedies include antacids like Mylanta, Rolaids or Tums, but they won't heal the inflammation if there is a chronic problem. There are medications that can reduce the production of acid. These are called H-2 receptor blockers. Common examples are Pepcid AC and Zantac.

Medications called proton pump inhibitors can help heal the esophageal tissue. There are also prescription strength treatments. These medications are known for causing a decrease in Vitamin B-12 so energy might start lacking. Nausea is also common. Baclofen is used to increase the frequency of the muscle contractions to allow food to pass.

If medications don't help, then surgery can be done. Fundoplication would tighten the muscle of the sphincter to prevent reflux. LINX can be inserted which is a magnetic bead device which has the force to keep acid from flowing up.

No one wants to live each day rationing out the amount of Tums they take to suppress discomfort. A missed workout, missed day at work, lack of sleep or just not feeling good, means it's time to address the issue. Acid is toxic to the environment so we certainly don't want it in our body.

Megan Johnson McCullough, Ed.D., recently earned her doctorate in physical education and health science, is a professional natural bodybuilder and is a National Academy of Sports Medicine master trainer.