Merck Manual

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Commentary: What is GERD? 5 Tips to Prevent and Reduce Heartburn

Commentary
11/19/2020 Kristle Lee Lynch, MD, Perelman School of Medicine at The University of Pennsylvania

These days, plenty of people are dreaming about a nice meal out at a restaurant. Maybe a few shared appetizers for the table—something spicy or cheesy, plus a cocktail or a glass of wine. Then, ordering an indulgent main course and splurging on coffee and dessert. What most people aren’t fantasizing about is the inevitable heartburn and acid reflux some would experience after that decadent meal.

More than 60 million Americans experience heartburn at least once a month, according to the American College of Gastroenterology. Heartburn is a common symptom of gastroesophageal reflux disease (GERD). GERD is a condition that develops when reflux of gastric contents in the esophagus causes troublesome symptoms and/or complications.

GERD Should Not be Tolerated—or Ignored

Not everyone who has GERD has heartburn. Other less common symptoms of GERD include throat pain, difficulty swallowing, and cough. These symptoms, along with heartburn and chest pain, should not be ignored, especially if they’re occurring at times when you didn’t just indulge in a large meal.

In some cases, they may be a sign of other conditions. In younger individuals, they can be caused by eosinophilic esophagitis, an allergic condition of the esophagus that causes patients to have trouble swallowing. In older patients, symptoms could be a sign of esophageal cancer or heart issues. Additionally, GERD that goes untreated can also lead to complications, including inflammation of the esophagus, ulcers, and abnormal cells in the esophagus that may become cancerous.

If you’re experiencing prolonged symptoms related to GERD, it’s important to talk to a doctor and get to the bottom of what’s causing them.

Who’s at Risk for GERD?

There are several factors that increase the likelihood of GERD and related symptoms, particularly heartburn. Obesity, weight gain, and hiatus hernia can contribute to heartburn, along with smoking and certain drugs. Additionally, indulgences in life like chocolate, alcohol, and caffeine can relax the muscles of the esophagus and increase the risk of GERD.

Given those factors, there are things you can do to reduce your chances of suffering from heartburn and other GERD symptoms. Here are five tips that can help:

1. Stay Upright for at Least 4 Hours After Eating

When you’re sitting or standing, it’s easier for the contents of your stomach to stay there. Use gravity to your advantage and avoid lying down for four hours after eating a meal. By hour four, around 90 percent of the food you’ve eaten has been digested and is out of your stomach. That goes for lying on the couch or lounging in the evening as well as lying down to go to sleep. For some people, a wedge pillow helps them stay upright and comfortable.

2. Avoid Fats (and Fiber)

If you eat a whole pepperoni pizza, there’s a good chance you’re going to have heartburn. Smaller meals that avoid fatty and acidic foods are a good move. But watch your fiber intake as well. Foods high in fiber, like a big kale salad, are good for you, but they also take a long time to digest, which can lead to GERD symptoms after eating.

3. Skip the Tight Yoga Pants

Tight clothes can spell trouble when it comes to reflux. Anything that puts pressure on the stomach pushes its contents to go the wrong way. Opting for loose-fitting clothes with elastic bands can be a huge help in reducing heartburn and other symptoms.

4. Find a Medication that Works

There are several types of medication that can reduce stomach acid and prevent more frequent GERD symptoms. Talk to your doctor about which medications might be right for you, from over-the-counter meds to prescribed proton pump inhibitors or histamine-2 blockers.

5. Commit to Lifestyle Changes

For overweight sufferers of GERD, the single most effective way to find relief is to lose the weight. Research has shown that patients who treat their GERD through weight loss have higher life satisfaction scores and better quality of life than those on medication. 

If you’ve just enjoyed a decadent meal, some of these tips can help prevent or reduce the heartburn that may be looming. But for people suffering from GERD symptoms on a regular basis, it’s critical to talk to a doctor and develop a plan to address them. It’s the first step in enjoying life a bit more and preventing potentially serious medical complications.

To learn more about GERD, check out the Manuals page and the Manuals Quick Facts on the topic.

Kristle Lee Lynch MD

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