Acid Reflux Q&A with Dr. James Lopes
Chronic acid reflux, also known as Gastroesophageal Reflux Disease or GERD, is a common condition that affects up to 20% of all Americans. GERD is diagnosed when acid reflux occurs several times per week over the course of a month. It can be mild to severe and is considered distinct from occasional acid reflux. Dr. James Lopes answers some of our patients’ most pressing questions in today’s Q&A.
Who is most at risk for GERD?
Excess weight, along with poor dietary and exercise habits, are the primary risk factors for GERD. Pregnant women are also at high-risk – The common theme being greater than normal pressure on the abdomen forcing the stomach juices back into the esophagus. This, combined with weakened esophageal muscles (the Lower Esophageal Sphincter or LES) allow the back flow of stomach acid. This weakness can be congenital or acquired.
Does heartburn affect the heart?
The short answer is no – acid reflux and heart conditions are distinct. However, if the patient suffers from obesity, they may have both acid reflux and heart conditions at the same time. The term heartburn is used to describe the burning sensation in the center of the chest caused by GERD. Many people, especially those who are experiencing GERD for the first time, mistake this for heart disease.
Is heartburn dangerous?
Occasional heartburn is completely normal and to be expected. Once this progresses to GERD, most people experience discomfort on a regular basis that may or may not impede their lifestyle. However, the constant acidic attacks on the esophagus can lead to various serious medical conditions. Patients may develop asthma; the lining of the esophagus may become inflamed making it harder to swallow; and the esophagus can even change on a cellular level – known as Barrett’s Esophagus. The latter condition, in rare cases, may even lead to esophageal cancer.
What are the common symptoms of GERD?
The symptoms of GERD include chronic dry cough, asthma or asthma-like symptoms, a burning sensation in the chest, regurgitation, chronic bad breath, the yellowing of teeth and more. It is important to remember that other conditions share the same symptoms, so patients should see their physician or GERD specialist when symptoms arise.
Are there any medications to treat GERD?
When lifestyle changes such as improved diet and exercise fail to offer sufficient relief, the first course of action is medication. There are two commonly prescribed medications for GERD – The first suppresses the production of acid in stomach (called Proton-Pump Inhibitors) and second neutralizes acid (called Antacids). Medications, however, come with side effects and may become less effective over time. Further, they are not curative, meaning they only treat the symptoms and not the cause of the disease.
Are there surgical options to treat GERD?
Yes, there are several proven and minimally invasive options to treat GERD. Surgery is typically reserved for those that have not seen significant relief from medical therapy and for whom lifestyle changes have not made a difference.
The Nissen Fundoplication is a minimally invasive procedure that wraps the fundus (top) of the stomach around the lower part of the esophagus to create compression and reinforce the Lower Esophageal Sphincter. A partial fundoplication also known as a Toupet can also be performed with similarly excellent results. A consultation with one of us Advanced Surgical Associates will determine the best option for you.
GERD may also be caused by a hiatal hernia, a condition in which the stomach pushes through the diaphragm. A hiatal hernia may be a primary or secondary cause of the acid reflux and can be easily corrected with a minimally invasive repair.
Patients suffering from morbid obesity and poorly controlled GERD may consider bariatric surgery to improve or resolve both conditions. Further, it is not uncommon to repair a hiatal hernia at the same time as the primary bariatric procedure. The gastric bypass is far and away the most effective procedure for poorly controlled GERD. In fact, a small number of patients may see their acid reflux worsen after a gastric sleeve or gastric band, therefore those procedures may not be indicated.
Is there any way to prevent GERD?
Changing one’s lifestyle, in the form of improved diet and exercise, is the best way to minimize the risks of GERD. Eating several small meals each day versus three larger meals, as well as eating two hours or more before bedtime can also help. Avoiding caffeine, alcohol, spic and fatty foods and more can also lessen GERD symptoms. Ultimately, excess weight is the biggest causal factor, so reducing abdominal pressure by losing weight is important.
Medications and surgery are there for those patients who do not have sufficient relief from lifestyle changes alone. Patients can contact our office and schedule an appointment with one of our surgeons to learn more about their treatment options.