Dr. Eston WengerQ: I have chronic heartburn and it's making me very uncomfortable. What can I do other than take antacids?
A: The first step is to talk to your doctor to try to identify the cause of your gastroesophageal reflux disease. One of the biggest risk factors for GERD is a hiatal hernia. Another risk factor is obesity. Age and some medications such as non-steroidal anti-inflammatory drugs (NSAIDS) can make reflux worse.
Treating GERD is usually a multistep process starting with lifestyle changes to see if the patients finds relief without surgical intervention. Avoiding certain foods like fatty or spicy foods can have a positive impact on GERD, as can cutting out alcohol. Increasing your exercise can help by lowering your weight, if that is a cause of your GERD. Quitting smoking also improves GERD symptoms as well as other health issues.
Often, patients find that sleeping with their head in an elevated position, stomach below the esophagus, helps keep stomach contents where they're supposed to be. Eating smaller meals more frequently and eating only until you are satiated rather than full reduces the pressure on the esophageal entrance to your stomach.
For most patients, lifestyle changes can make an enormous positive impact on GERD symptoms. Medications can be part of this type of treatment plan, as well.
If lifestyle changes don't help and symptoms escalate, then I would recommend discussing your reflux with your GI doctor or general surgeon who teats GERDS. Tests, such as an upper endoscopy and or upper GI study, would be needed for a full evaluation. From your symptoms and test findings, your doctor can decide if reflux surgery is right for you.
- Dr. Eston Wenger, Surgical Associates of Cleveland; member of Bradley County Medical Society