—Damaris, San Diego, California
Yes, most cases of acid reflux, sometimes referred to as gastroesophageal reflux disease, or GERD, can be cured. When faced with this diagnosis, I like to treat both symptoms and root causes.
What are the symptoms of acid reflux?
Common symptoms involve sour stomach or stomach pain (indigestion) accompanied by a periodic sense of acid washing back up the esophagus from the stomach (called reflux, or water brash). Some people don’t have any pain but may come in complaining of a nagging cough. Others may have chest pain so severe they think they’re suffering angina (heart attack pains).
Symptoms are usually worse when lying down, since gravity is less able to help keep stomach contents in the stomach. Symptoms may also be exacerbated by caffeine, acidic foods, alcohol, and smoking.
What’s the cause?
The literal cause of reflux is failure of a sphincter, a muscular valve separating the stomach from the esophagus. When working properly, the gastroesophageal sphincter opens to allow swallowed food to travel into the stomach, then closes tightly to prevent the strongly acidic contents of the stomach, which has a protective lining, from scalding the esophagus, which is less well protected against acids. Chronically elevated stomach acid levels can lead to inflammation of the sphincter, preventing it from closing as effectively.
The most common root cause is stress; however, diet, lifestyle, and medications can also be factors.
What are some treatment options?
Treatment strategies focus on lowering stomach acid levels. Usually, prescriptions include a class of drugs called proton pump inhibitors. These are very effective at controlling acid reflux symptoms, especially in otherwise healthy young people.
In addition to rapid benefits in symptom control, lowering stomach acidity supports healing of the stomach lining and the inflamed sphincter, allowing this valve to more effectively prevent reflux. It’s best to start with a higher dose until symptoms have been well controlled for a good length of time, and then step down to a regular dose for another few weeks, but speak with your health care provider for their specific suggestions for you. Depending on the contributing factors, symptoms may or may not come back after treatment. If they do, they’re usually recognized in an earlier phase, when they’re easier to treat.
Complete treatment of GERD includes addressing root causes as much as possible, such as stress and lifestyle. Changes such as stress management, diet modifications, and medication changes usually help to cement the gains made with acid-lowering medication.
It’s usually a good idea to go to the doctor if you have GERD symptoms that last more than a week and/or aren’t responding to usual medications. Most cases can be managed successfully, but careful evaluation, sometimes including referral to a specialist, is sometimes recommended, especially if symptoms are severe or continuously recur.
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