Judson Haims: Acid reflux and GERD

Acid reflux and GERD occur when acids from the stomach flow upwards into the esophagus. Often this happens because a circular muscle, called the lower esophageal sphincter, that separates the stomach from the esophagus, becomes impaired. When the lower esophageal sphincter enables stomach acids to enter the esophagus, it is called acid reflux. When acid reflux occurs frequently, more than twice a week, chances are the issue may develop into what is called gastroesophageal reflux disease (GERD). It is estimated that one in four people suffer from such occurrences of acid reflux and GERD.

Under normal circumstances, once food exits the esophagus, the lower esophageal sphincter closes behind and keeps stomach acids from entering the esophagus. When the lower esophageal sphincter does not close properly, the esophagus can become damaged as stomach acids may cause the lining of the esophagus to become irritated and inflamed. Untreated, this may lead to the development of esophageal cancer, respiratory problems, chest congestion and fluid in the lungs.

Knowing what and when to eat can mitigate flare-ups. Often, acid reflux and GERD develop after eating a large meal, lying down after a meal, or eating certain foods like spicy foods, fried foods, fatty foods, high acid drinks (citrus, tomato, pineapple juices) and alcohol.

Large meals and lying down after a meal have a tendency to expand the abdomen, which forces excessive pressure on the lower esophageal sphincter, which can enable stomach acids to enter the esophagus. Similarly, spicy, fried and fatty foods, along with high-acid drinks, also can enable acids to enter the esophagus as they cause the lower esophageal sphincter to become relaxed and thus “leaky.”

People who have concerns about acid reflux should know that lifestyle and dietary modifications are the first lines of defense. Incorporating the following foods into your diet may provide some help in alleviating symptoms:

— Whole grains

— Melons

— Lean proteins

— Beans, peas, brown rice and lentils

— Ginger

— Yogurt

— Vegetables and noncitrus fruits

If diet alone does not assist enough in addressing a remedy, there are over-the-counter and prescription medications that can provide relief. There are a few types of medications that provide relief of acid reflux and GERD: Antacids are available for less severe needs, while histamine H2-receptor antagonists (H2 blockers) and proton pump inhibitors are often reserved for more extreme needs.

Antacids work by neutralizing stomach acids and are most frequently used for occasional developments of milder acid reflux concerns. They often are used to relieve heartburn, indigestion or an upset stomach. Most antacids are made from combinations of salts such as magnesium carbonate and aluminum hydroxide. Side effects of these salts sometimes cause problems — magnesium carbonate may cause diarrhea, and aluminum hydroxide may cause constipation. So it’s important to know which product’s contents work best for you. Furthermore, you should be aware of interaction these medicines have with other drugs you may be taking. There is the possibility that antibiotics, antifungals and corticosteroids such as prednisone may have negative interactions.

Both H2 blockers and proton pump inhibitors stop the acid-making cells in the stomach and thus reduces the amount of acid produced. In doing so, they can also contribute to healing the stomach and esophagus. However, a recent article published in the National Center for Biotechnology Information stated that “widespread proton pump inhibitor use has led to emerging evidence of long-term adverse effects not described previously, including increased risk of kidney, liver and cardiovascular disease, dementia, enteroendocrine tumors of the gastrointestinal tract, susceptibility to respiratory and gastrointestinal infections and impaired absorption of nutrients.”

At best, medications only treat the symptom and not the cause. In principle, there are two root causes of acid reflux: microbial imbalance in the digestive tract and low acidity. Both have a relation with our gut bacteria. When there is an imbalance between good and bad bacteria in the gastrointestinal tract, it is called dysbiosis. While balancing good bacteria and bad bacteria can be tricky, nutritionists and medical professionals can help with insight.

There is much being learned about the interrelation between gut bacteria and acid reflux. Research findings from the National Center for Biotechnology Information and Gastroenterology & Endoscopy News are promising and indicate that a focus on foods and probiotics that promote a healthy gut play a key role in alleviating symptoms of acid reflux and disease progression.

Unaddressed, acid reflux and GERD may likely cause a negative effect on one’s health and impair quality of life. As with any health-related ailment, being proactive and educated is always best.

Judson Haims is the owner of Visiting Angels Home Care in Eagle County. He is an advocate for our elderly and available to answer questions. His contact information is and 970-328-5526.