THURSDAY, Jan. 5 (HealthDay News) -- Heartburn and acid reflux
strike many people as an annoying and painful but ultimately
harmless problem -- a result of overindulgence and gluttony that
must be endured, much like a hangover after a night of
drinking.
But frequent bouts of heartburn and reflux constitute a real
medical condition known as gastroesophageal reflux disease, or
GERD, and GERD is on the rise worldwide.
"The overall prevalence is increasing over the past decades," said Dr. Ronnie Fass, a medical advisory board member for the International Foundation for Functional Gastrointestinal Disorders who's also a professor of medicine at the University of Arizona and chief of gastroenterology at the Southern Arizona VA Health Care System.
The increase has occurred "not only in the United States, but in
Asian countries, where GERD was unheard of," Fass said. "But we are
the trailblazers. We are leading the world."
If left untreated, GERD can lead to bleeding or ulcers in the
esophagus, a buildup of scar tissue that makes swallowing difficult
and, in extreme cases, esophageal cancer, according to the U.S.
National Institutes of Health.
"People consider heartburn part of the eating experience," Fass said. "They have to understand the presence of heartburn denotes a real medical problem."
Frequent reflux or heartburn are apparently a regular occurrence
for Americans. "We believe up to 20 percent of the population
experiences symptoms once a week, and 7 percent have daily
symptoms," he said.
Heartburn and acid reflux occur when acidic digestive juices
from the stomach get past a ring of muscle known as the lower
esophageal sphincter, which acts as a valve separating the stomach
from the esophagus.
People experience heartburn when the digestive juices eat away
at the lining of the esophagus. Sometimes the acid refluxes all the
way up through the esophagus to the mouth, causing people to taste
digestive juices or food in the back of their mouth.
Doctors consider people to be suffering from GERD if they
experience persistent reflux, meaning at least twice a week,
according to the NIH. Anyone at any age can have GERD, although
symptoms tend to be different for children 12 and younger, who may
have asthma-like symptoms, a dry cough or difficulty
swallowing.
Most of the time, GERD stems from one of two causes -- what you
eat and how much you weigh -- but excessive weight is the most
prominent, said Dr. Kenneth R. DeVault, chairman of the
gastroenterology department at the Mayo Clinic in Jacksonville,
Fla., and co-author of the American College of Gastroenterology's
guidelines for treating GERD.
"The most consistent factor is probably weight gain and obesity," DeVault said. "It's become pretty clear that a small amount of weight gain produces an increase in reflux symptoms. I'm not talking a large amount; I'm talking about 5 or 10 pounds, probably. Even if you're already overweight, increasing your weight will increase your risk of reflux over the next several months."
Excess weight can press on the stomach, forcing acid past the
valve into the esophagus. And, as Fass explained, the problem isn't
just the belly flab evident on people who are obese or overweight.
Rather, the accumulation of fat around the organs inside the body
contributes by increasing pressure on the stomach, making reflux
much more likely to occur, he said.
GERD also can be caused, or exacerbated, by a person's diet. But
foods contribute to reflux in different ways.
Caffeine, for example, has been shown to relax the esophageal
sphincter, increasing the chances of reflux, DeVault said.
Eating fatty foods can also contribute to reflux because fats
slow the emptying of the stomach, meaning "there's more material
left in the stomach that can be refluxed," he said.
Acidic, spicy or strongly flavored foods also can contribute to
reflux by increasing the amount of acid in the stomach, according
to the NIH. Citrus fruits or juices, tomatoes, mint, garlic, onions
and chocolate are among the main offenders.
Also, lifestyle changes can usually reduce the possibility of
reflux, the two experts said. These include:
- Making a concerted effort to lose weight, by exercising and
adopting a healthy diet.
- Learning which foods are more likely to trigger excess acid or
reflux, and then avoiding them.
- Eating the final meal of the day two to three hours before
bedtime, thus reducing the amount of food in the stomach that would
press against the esophageal valve.
- Elevating the head of the bed, if nighttime reflux is a
problem, as this can reduce the pressure of stomach acid and
contents on the valve.
If reflux symptoms persist, however, DeVault stressed that more
needs to be done to avoid damage to the esophagus.
"If they have frequent heartburn symptoms, more than weekly, and have had it for many years, they need to see a physician," he said.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney
Diseases has more on
GERD.
For more on the effects of GERD, read about
one woman's story.