When I was in university, I had a close friend named Chamari. Chamari would often complain of stomach aches and heartburn after eating, especially after eating a good spicy Sri Lankan meal or after having dinner. She thought it was just indigestion. But as time went on, the heartburn became so severe that it would even disturb her sleep at night.
"Doctor Priya, I have a burning sensation in my chest every night. I have a sour-tasting discharge in my mouth. I can't get better even with regular medicine," Chamari asked me one day.
I calmly explained to Chamari: "Chamari, what you've been ignoring, thinking it's just normal indigestion, is a condition called GERD (Gastroesophageal Reflux Disease) . This is a condition in which stomach acid flows back up into the throat. This is a very common disease among young people these days. But don't worry, it can be completely controlled with small lifestyle changes and proper medical treatment."
🚨 Red Flags that require immediate medical attention
Although acid reflux is usually not life-threatening, you should see a doctor immediately if you experience any of the following severe symptoms:
- Severe difficulty swallowing food or saliva or pain when swallowing (Dysphagia/Odynophagia).
- Rapid weight loss for no reason (Unexplained Weight Loss).
- Frequent vomiting or vomiting blood.
- Black (tarry) stools (a sign of bleeding in the stomach or esophagus).
Why does GERD occur? The reasons are simple
At the junction of our esophagus and stomach is a ring-shaped muscle called the LES (Lower Esophageal Sphincter) . It acts like a "valve" that only opens in one direction.
When we eat, this valve opens to allow food to pass into the stomach, and then closes tightly once the food has passed, preventing the strong acids in the stomach from flowing back up into the throat.
But if for some reason this LES valve becomes weak or does not close at the right time, stomach acid can easily leak into the esophagus. This is called acid reflux .
There are several main reasons why this valve becomes weak:
1. Hiatal Hernia: The upper part of the stomach protrudes into the chest through a hole in the diaphragm, causing the valve to malfunction.
2. Obesity and pregnancy: The valve opens more frequently due to increased pressure in the abdomen.
3. Wrong eating habits: Eating a large meal at once and lying down immediately after eating.
4. Alcohol, smoking and drugs:Smoking relaxes the LES valve, and over-the-counter painkillers like ibuprofen can also damage the stomach walls.
Medical tests to diagnose acid reflux disease
Doctors recommend the following tests to accurately diagnose the condition:
- Upper Endoscopy: A tube with a small camera is inserted through the mouth to examine the walls of the esophagus for inflammation, lesions, or signs of cancer.
- Ambulatory pH Monitoring: A test performed using a small device that measures the amount of acid flowing into the throat over a 24-hour period.
- Esophagram (barium x-ray): This test uses a barium swallow test to take x-rays of the esophagus to detect narrowing or hernias.
How to control acid reflux disease?
To recover from this disease permanently, both lifestyle changes and drug treatment must be done in balance:
1. Essential lifestyle changes:
- Small meals: Instead of eating a large meal to fill your stomach at once, eat several small meals frequently.
- Gap between meals and sleep: Avoid lying down or going to sleep for at least 3 hours after dinner.
- Elevating the head of the bed: Raising the head of the bed about 6 inches will prevent acid from rising due to gravity (using pillows alone is not enough).
- Weight control: Reduce unwanted belly fat.
2. Medical Treatment:
- PPIs (Proton Pump Inhibitors): Drugs like Omeprazole or Esomeprazole greatly reduce the production of acid in the stomach.
- H2 Blockers (H2 Receptor Blockers): Drugs like Famotidine also control acid.
- Antacids: Liquid medications that provide immediate relief from chest pain.
Do's & Don'ts
| ✔️ Things to do (Do) | ❌ Don'ts |
|---|---|
| If chest pain persists, see a doctor and get a proper treatment plan. | Avoid eating tomatoes, citrus fruits, chocolate, caffeine (tea/coffee), and spicy foods with a lot of fat. |
| Wear loose clothing; avoid tight belts, especially around the stomach. | Avoid lying down or bending over and doing heavy work immediately after eating. |
| If you continue to have a strange cough or hoarseness in your throat, tell your doctor, as it could also be due to acid reflux. | Do not take PPI pills for months on end without medical advice (can affect the kidneys). |
❓ Some other questions you may have (FAQ)
How to differentiate between heartburn and heart attack pain? ▼
Chest pain usually occurs when lying down after eating and is relieved by antacids. However, heart attack pain is a squeezing, heavy feeling in the chest that spreads to the left arm or jaw, and is accompanied by shortness of breath and sweating. If in doubt, an ECG should be performed immediately.
What happens if GERD is left untreated for a long time? ▼
If left untreated, acid can damage the esophagus, causing Esophagitis. Over time, the esophagus can become narrowed (Esophageal Stricture), making it difficult to swallow, and in extreme cases, Barrett's Esophagus, which increases the risk of cancer, can develop.
Can acid in the throat cause tooth decay? ▼
Yes, the strong hydrochloric acid in the stomach can inadvertently flow into the mouth at night, dissolving the enamel layer of the teeth, causing tooth decay and tooth decay.
Is surgery necessary to fully recover from GERD? ▼
No, more than 90% of patients recover with proper diet and acid-control pills prescribed by a doctor. Surgery (e.g. Fundoplication) is only necessary for patients with very severe or herniated hernias that do not respond to any medication.
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