Belching is a sign of appreciation for a fine meal in some cultures. But it’s not such a positive thing when it’s accompanied by heartburn, coughing and throat irritation—the classic symptoms of GERD (gastroesophageal reflux disease).
“GERD is a digestive disorder that occurs when the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach, does not function properly. More than 60 million Americans experience acid reflux at least once a month,” explains Dr. Steve Fern, a gastroenterologist with Missouri Baptist Medical Center.
“Some people with acid reflux disease also have a syndrome called dyspepsia,” Fern says, adding that dyspepsia is a general term for stomach discomfort. “Symptoms of dyspepsia include burping, nausea after eating, stomach fullness or bloating, or upper abdominal pain and discomfort.”
It may be tempting to assume that frequent heartburn equals GERD and begin self-medicating with over-the-counter remedies. However, having frequent heartburn assessed by a physician is a better idea, says Dr. Kiranmaye Tiriveedhi, a Mercy Clinic gastroenterologist. “We may suggest an over-the-counter medication initially, but we also can assess the symptoms and determine if additional tests are needed,” she says.
Fortunately, GERD can be successfully treated, offering relief. “Proton-pump inhibitors, such as Prevacid, Prilosec, Protonix and Nexium, are the most effective medicines to treat GERD. Antacids such as Zantac or Pepcid may work for those with milder cases,” says Dr. Jeffrey Kreikemeier, St. Luke’s Hospital gastroenterologist.
Surgery is a treatment option for GERD, though Kreikemeier notes that it is performed less frequently these days because of effective and safe medical therapies. “Diet and lifestyle changes also can be a tremendous help and a much simpler option than surgery,” he says. “The surgical procedure involves wrapping a portion of the upper stomach around the distal esophagus to decrease reflux of acid. It should be noted that more than 50 percent of patients who undergo surgery end up taking acid-lowering medicines again in the years following surgery.”
Usually, GERD does not cause long-term complications. In some cases, continued esophageal damage can lead to scarring, which may cause the esophagus to narrow. The narrowing creates strictures and makes it difficult to swallow, Fern notes.
“You may have dysphagia, a sensation that food is stuck in your esophagus. In some cases, cells in the lining of the esophagus develop an abnormal shape and color in response to the constant acid irritation. This is Barrett's esophagus, which can develop into cancer.” Fern adds that cardiac problems can also mimic heartburn and you should not confuse the two. “Unexplained chest pain should be evaluated by an exercise stress test or EKG prior to an evaluation for gastrointestinal problems.”