Is it dangerous?
GERD is mostly uncomfortable—sometimes really uncomfortable. Occasionally the symptoms are severe enough that people head to the ER because they think they’re having a heart attack. (Better safe than sorry!) But over time, GERD can become serious: Acid can irritate and wear away the lining of the esophagus, causing inflammation, bleeding, and a precancerous condition called Barrett’s esophagus.
Can you have GERD if you don’t get heartburn?
Yes. Heartburn is the most common symptom, but it’s not the only one. Less typical ones include hoarseness, recurrent pneumonias, upper abdominal pain, and a chronic cough, says Yepuri.
Who’s at risk for GERD?
Anyone can get it, but people who are overweight, pregnant, have asthma or diabetes, smoke, or suffer from connective tissue disorders (such as scleroderma) are more likely to get GERD.
How is GERD treated?
“Usually symptoms are brought on by certain things you eat and drink, including spicy foods, caffeine, tomato-based sauces, and alcohol,” says Fernando. Cutting back on trigger foods and eating smaller meals may help. (This includes coffee.)
You also want gravity to work in your favor. That means don’t bend over to touch your toes or lie down too soon after eating. Elevating the head of your bed may help, too.
If dietary and lifestyle changes aren’t sufficient, over-the-counter antacids, like Tums, can help neutralize stomach acid. Not enough relief? You can take an H-2 antagonist, like Zantac, which will reduce the amount of acid you produce in the first place. If you’re still suffering, you may need to bring in the big guns: Proton pump inhibitors (PPIs), such as Prilosec, are stronger than H-2 blockers and allow time for damaged esophageal tissue to heal.
Are PPIs safe?
It’s unclear, especially when it comes to using them for the long-haul.”The studies and literature in this area are evolving, but concerns include decreased bone mineralization (with an increased fracture risk), low magnesium levels in the blood, an increased risk of pneumonia, and a bowel infection called clostridium difficile and other GI tract infections,” says Yepuri. A recent study, published in JAMA, also linked long-term PPI use to an increased risk of dementia.
Many PPIs are now available without a prescription, but if you plan to use them or are already taking one, it’s a good idea to ask your doctor to help you weigh the risks and benefits.
Is surgery an option?
Yes, though it’s generally considered a last resort. If you’re thinking about going the surgical route, ask your doctor about laparoscopic options, including one that uses a magnetic ring (Linx device) to strengthen the sphincter. You might also want to inquire about a minimally invasive technique called Stretta, which involves targeting the weakened sphincter with low levels of radiofrequency energy.