PCH General Surgeon
Are you one of the 10 percent of Americans that suffer from heartburn symptoms at least once a week? Have Tums, Rolaids and other acid reducers quit providing relief for you? Does the suffering seem to increase with each occasion?
You may be experiencing gastro esophageal reflux disease, or GERD. GERD is a condition in which the food or liquid contents in your stomach leak backward from the stomach in the esophagus. This leakage can irritate the esophagus causing what we often refer to as heartburn or acid reflux.
Heartburn is the most common term used for the pain most experience. Heartburn is a sub-sternal, under the middle of the chest, burning that occurs after meals and can worsen when lying down.
Common symptoms of heartburn include the sensation that food is trapped behind the breastbone, a burning pain in the chest and nausea after eating.
When you eat, food passes from the mouth to the throat, or esophagus, into the stomach. At the top of the stomach is a ring of muscle fibers called the lower esophageal sphincter (LES). These fibers contract once food enters the stomach to prevent food from moving backwards.
If this muscle does not close well, food, liquid and stomach acids can move back up the esophagus causing reflux. Recurrent reflux can damage the esophagus, which can lead to the development of cancer in severe cases if left unchecked.
Often, individuals experience heartburn after large meals, exercise and even some medications can trigger the discomfort. Some individuals possess risk factors for reflux. Such factors include obesity, smoking, alcohol and the presence of hiatal hernias. All of these can increase the intensity of heartburn and the chance of GERD. Many women experience an increase in symptoms during pregnancy but they usually diminish after delivery.
A hiatal hernia is a condition in which part of the stomach moves above the diaphragm. It is often more common with adults over 50. Not all reflux cases are caused by a hernia, but those that do have a hiatal hernia often suffer from reflux.
If you are experiencing frequent heartburn and over-the-counter items, like Tums and Rolaids, are no longer providing relief, it is time to speak with your physician. He or she may ask you to keep a food log to identify any food triggers.
Foods such as alcohol, caffeine, carbonated beverages, chocolate, citrus fruits and juices, tomatoes, spicy or fatty foods, full-fat dairy products, peppermint and spearmint are common trigger foods for most people. Any food that appears to be associated with the burning sensation should be noted and then avoided.
Your physician may also ask you to try a few simple lifestyle adjustments to help alleviate or prevent the discomfort. Avoiding exercise right after a meal, wearing loose fitting clothing, especially around the waist, limiting meals and snacks before bedtime, quitting tobacco products, eating smaller meals, losing weight and reducing stress can help to lessen the frequency and intensity of heartburn.
Most people respond to lifestyle changes and medications. However, if you still experience frequent heartburn after monitoring your diet and making lifestyle changes, your physician may recommend having an esophagogastroduodenoscopy, or more commonly known as EGD, to identify the cause and the severity of your issue.
An EGD is an outpatient procedure that takes place in a surgery center, because of the sedation. The surgeon inserts a thin tube with a camera on one end into your mouth and then down the esophagus into the stomach and small intestine. The camera provides the surgeon with images that can help to diagnosis the problem site and the severity so the proper treatment can be prescribed.
Some prescription medications can help and will relieve symptoms. Following the results of your EGD, your physician may choose to begin a prescription to help correct the source of the issue.
If you experience bleeding, choking, hoarseness, loss of appetite or feeling full quickly when eating, trouble swallowing or weight loss, consult your physician right away.
Dr. L.G. Palanca is a General Surgeon with Putnam Surgical Specialties inside of Putnam County Hospital. A graduate of Indiana University, Dr. Palanca has extensive experience in general surgery procedures dealing with the appendix, colon, esophagus, gallbladder, hemorrhoids, hernias, and stomach. Contact his office at 658-2710.