To your health: Portion control can lessen symptoms of GERD this holiday

By Alfred Casale - To Your Health | November 21st, 2017 6:00 am

This is going to be an unusual Thanksgiving for the Casales. My daughter, Kate, is expecting her second child in about two weeks. So, Mary’s already in Chicago to be on “Rowan duty” just in case things move along sooner than predicted. I’ll celebrate here with friends. Some things, though, are likely to be the same as all previous Thanksgivings — like a little overeating.

Most of us overdo it a little at Thanksgiving dinner because it’s so hard to pass up that second helping of turkey with all the trimmings. However, if you are one of the more than 60 million Americans suffering from gastroesophageal reflux disease (GERD), you may want to skip a second slice of pumpkin pie. Frequent overeating is one of the common causes of acid reflux that can lead to GERD.

Occasional heartburn and indigestion are not a cause for alarm. If you experience those symptoms frequently, however, you may be dealing with GERD. This is definitely a reason to talk to your doctor.

What is GERD?

GERD is a disorder of the digestive system that affects the ring of muscle between the esophagus and stomach. This muscle is called the lower esophageal sphincter (LES), and its job is to allow food to pass into the stomach while keeping acids from flowing back into the esophagus.

When this muscle is not working properly, you’ll experience heartburn. It usually feels like a burning pain that starts behind your breast bone, extending up into your throat. You may also have a bitter taste in your mouth.

The burning sensation and other unpleasant symptoms are caused by stomach acid flowing back into the esophagus where it doesn’t belong. When this condition becomes chronic, it’s referred to as GERD.

What causes it?

The diaphragm is the thin sheet of muscle that separates the abdomen from the chest. It has several holes that allow blood vessels and the esophagus (swallowing tube) to travel through it. Sometimes the esophagus’ hole, the hiatus, is too loose and allows the top of the stomach to slip up into the lower chest. This is a hiatal hernia. This can predispose to GERD, but the most common culprit causing GERD is overeating.

When you overeat, your stomach stretches to accommodate all the extra food. This stretching puts the LES into direct contact with stomach acids, which can damage it. If this happens frequently, the LES can lose strength and will no longer be able to keep stomach acid out of the esophagus and in the stomach where it belongs.

Some of the foods we eat may also contribute to GERD. Chocolate, peppermint, fried and fatty foods, coffee and alcoholic beverages may trigger reflux and heartburn. Cigarette smoking also relaxes the LES and may contribute to GERD.

In addition, people struggling with obesity, women who are pregnant, and anyone with a hiatal hernia may be more likely to experience acid reflux and GERD.

How is it treated?

Doctors usually recommend changes to a person’s lifestyle and diet to help alleviate the symptoms of GERD. You will be asked to eliminate some of the foods that commonly trigger acid reflux, and to quit smoking. If you are obese or overweight, exercise and weight loss will help.

Unfortunately for anyone looking forward to a big Thanksgiving meal, reducing the symptoms of GERD means reducing your portion sizes at meals. It’s also recommended that you eat your last meal of the day at least two to three hours before going to bed.

Elevating the head of your bed a few inches can alleviate your symptoms as well. This allows gravity to do the work of your LES muscle, keeping stomach acid out of your esophagus to reduce your heartburn.

If these lifestyle changes do not help your GERD, your doctor may recommend antacids or medications called H2 blockers or proton pump inhibitors. In rare cases where lifestyle changes and medical treatments do not help, some patients may need surgery to help the LES function properly.

If you’re experiencing symptoms of acid reflux or GERD, it’s important to talk to your doctor. If left untreated, GERD can lead to bleeding of the esophagus, ulcers and esophageal cancer.

Happy Thanksgiving! Enjoy and be smart!

Over the next few weeks, I’ll tell you more about grandbaby number two … we still don’t know if it’s a boy or girl!

Alfred Casale To Your Health Casale To Your Health

By Alfred Casale

To Your Health

Dr. Alfred Casale, a cardiothoracic surgeon, is Associate Chief Medical Officer for Geisinger Health and Chair of the Geisinger Cardiac Institute. Readers may write to him via [email protected]