Reflux Q & A

What are the signs and symptoms of reflux?

The most common signs and symptoms of reflux include, but are not limited to:

• Bad breath

• Metallic or bitter taste in your mouth

• Vomiting

• Burning in your chest or upper abdomen

• Globus (constant feeling that there is a lump in your throat)

• Chronic tickle or cough

• Hoarseness or laryngitis

• New onset or worsening asthma

• Chronic sinus issues

• Painful swallowing

• Awareness of food sticking to or going down your esophagus

All these signs and symptoms may worsen with bending or laying down.

What causes GERD?

Reflux occurs when the lower esophageal sphincter, the muscle separating the esophagus and stomach, remains open. Causes of GERD can be divided into two sections:

Mechanical causes

The most common mechanical causes include:

• Obesity

• Pregnancy

• Abdominal bloating

• Bending over after eating

• Delayed stomach emptying

• Tight clothing including control top garments

• Hiatal hernia, a common prolapse of the stomach above the diaphragm

• Incompetent lower esophageal sphincter

Non-mechanical causes

Non-mechanical causes can include any of the following:

• Mints

• Caffeine in coffee, tea, chocolate and energy drinks

• Alcohol

• Fatty foods

• Tobacco

• Medications like hormonal birth control and antidepressants

How do you diagnose reflux?

Listening to the patient's complaints and symptoms is usually sufficient to diagnose gastroesophageal reflux.

If symptoms improve with simple lifestyle changes and a short course of over-the-counter treatments, then the diagnosis is usually correct.

Dr. Woolrich might recommend an upper endoscopy to examine the lining of the esophagus and obtain biopsy samples to assess microscopic damage.

Additional studies such as PH testing, esophageal manometry and a barium video-esophagram might need to be performed if the diagnosis is unclear.

What are the complications of gastroesophageal reflux?

If severe or chronic, the backwash of acid and bile can irritate the lining of the esophagus. This may progress to metaplasia, a precancerous change of the tissue known as Barrett's esophagus.

Some other complications of GERD include:

• Bleeding from esophageal inflammation

• Pain and bleeding from esophageal ulcers

• Stricture formation (narrowing of the esophageal diameter from inflammatory scarring)

• Barrett's esophagus

• Cancer of the esophagus

Effective and early treatment with Dr. Woolrich can help you avoid these complications.

How can GERD be prevented and treated?

 Lifestyle changes might be sufficient in treating and preventing gastroesophageal reflux disease but medication might be required.

Lifestyle changes

Lifestyle changes may include:

• Not bending or lying down for at least 3 hours after eating

• Losing weight

• Avoiding tight clothes

• Decreasing mints, caffeine, alcohol and fatty foods

• Enzyme supplements such as Lactaid® pills, Sucraid®, or Beano®

• Avoiding gluten and other bloating foods

• Stopping smoking

• Sleeping at a 45-degree angle by raising the head of the bed

Over the counter remedies

If lifestyle changes are not sufficient, consider some of the following over-the-counter solutions:

• Antacids that neutralize the acidity such as TUMS® and Mylanta®

• Acid reducers, or H2 antagonists, such as Zantac® and PEPCID®

• Acid blockers known as proton pump inhibitors such as Nexium® and Prilosec®

Prescription medication

If over the counter medications do not control your symptoms, then Dr. Woolrich will order prescription strength acid reducers or blockers.

Endoscopic and surgical procedures might be needed if the above fail to control the symptoms and complications.

If you have been suffering from reflux, want to discuss your problem, and seek out the appropriate treatment, call Dr. Woolrich at her private office or schedule an appointment online today.