Gastroesophageal reflux disease (GERD) is one of the most common upper digestive conditions which affects as many as 4 out of 10 Americans. This only accounts for people withs symptomatic GERD and the condition may be much more prevalent when silent reflux is taken into consideration. For about 10% of these people, GERD symptoms are a daily problem.
How To Spot GERD
Most of us think that we can spot GERD the moment it occurs. Heartburn is the typical sign of GERD and when it starts, especially after eating, we are usually certain that it must be due to reflux. However, GERD is not always this obvious and sometimes burning chest pain may have nothing to do with the digestive system. In fact it could be a heart condition instead.
GERD is also commonly referred to as a acid reflux. We all experience acid reflux now and then in life but for some people it is a chronic problem. It is a result of the lower esophageal sphincter (LES) and the diaphragm muscles around it weakening. Normally this prevents the backward flow of the acidic stomach contents (acid + digestive enzymes). However, when the sphincter is weakened, the acid may flow backwards up into the esophagus.
Read more on what is GERD.
When does GERD occur?
Some people are more prone to GERD than others. People who have one or more of these risk factors are more likely to suffer from GERD:
- Overweight or obese
- Hiatal hernia
- Certain medication
It is important to note that GERD can affect any person, even children and babies. Some dietary and lifestyle factors can trigger GERD or worsen it.
- Overeating or not eating for long hours.
- Consuming alcoholic beverages.
- Eating chocolate and fatty foods.
- Lying down flat after meals.
- Strenuous physical activity after eating.
- Nighttime, especially around 3AM when gastric acid secretion increases.
People with chronic gastroesophageal reflux disease (GERD) may experience symptoms at any time even without any of these triggers. Sometimes simple actions like bending over to pick up an object from the floor can allow the stomach acid to seep out into the esophagus.
Read more on acid reflux diet.
The burning central chest pain is considered a characteristic sign of GERD. It is a result of the acid irritating and injuring the inner lining of the esophagus. However, in silent acid reflux this typical burning sensation may not be felt. Sometimes when the acid reaches high up in the esophagus then a person may experience a burning pain in the throat as well.
Nausea is another common sign of GERD. The irritation of the esophagus by the stomach acid and digestive enzymes leads to the sensation of wanting to vomit. Depending on how intense the nausea is a person may sometimes vomit. It is important not to confuse reflux with vomiting. Reflux is often a passive process where fluid flows backward whereas vomiting is forcefully as the gut contents are pushed upwards.
It is not uncommon to experience repeated belching with GERD. This is usually short-lived and many people experience some relief with belching. The gas passed out is usually air that is swallowed and sometimes gas produced during chemical digestion is also expelled. Usually belching occurs with indigetion which is a collection of upper digestive symptoms such as bloating and abdominal discomfort. Reflux may accompany indigestion.
Saliva is alkaline and when the acidic stomach contents enter the esophagus, the salivary glands produces large amounts of saliva. By swallowing this saliva, some of the acid can be neutralized. This excess saliva sometimes collects in the mouth. It is also referred to as water brash. The excessive salivation also encourages swallowing which helps to push the acid and enzymes downwards back into the stomach.
The acid can reach as high as the throat and causes inflammation of the throat. This is commonly reported as a sore throat or a sensation of a lump in the throat. There may also be hoarseness of the voice if the acid enters the airways and this can also lead to a dry cough. Since GERD worsens at night when the stomach acid increases and with lying flat, many people report a morning sore throat.
Depending on how high up the digestive tract the acid reaches, it may be possible to taste the acidic stomach contents. It typically has a sour taste. If large volumes of reflux reaches the mouth it feels warm and may cause burning in the mouth. It can also contribute to bad breath and the usual morning breath odor may be extremely offensive if there was severe acid reflux during the night.
Response to Antacids
If the above mentioned symptoms eases or resolves with the use of antacids, then it is likely to be GERD. Antacids neutralize the stomach acid and even alkaline substances like milk may provide temporary relief. Acid-suppressing drugs like proton pump inhibitors reduced acid production. It is also effective although it may not provide immediate relief like antacids but tends to have a longer lasting effect.
NOTE: If the symptoms do not respond to antacids then it is important to consider heart conditions as a possible cause. Sometimes heart conditions may occur without the typical symptoms apart from a burning chest pain. Always speak to a doctor whether it is GERD or a heart condition.
It is not uncommon for cardiac (heart-related) pain to be mistaken for GERD and vice versa. Although cardiac pain is usually experieced as crushing or suffocating central chest pain, it can sometimes be felt as a burning chest sensation similar to GERD. The following signs and symptoms are more likely to be present with a heart attack and other cardiac conditions:
- Difficulty breathing or shortness of breath.
- Excessive perspiration.
- Left-sided pain involving the arm, neck, jaw or upper abdomen.
- Lightheadedness or dizziness.
- Confusion and change in consciousness.
It is important to seek immediate medical attention if any of these signs and symptoms are present. Antacids and other acid medication will not assist. Delaying medical attention can lead to serious complications and even death.