The What’s and Why’s of GERD and How to Make It Go Away

Nov 21, 2012 | Digestive Diseases, Gastroenterology

Maybe you just got back from celebrating with your friends or you wake up in the middle of the night with a strange burning pain in your chest. You had this sensation before. You saw your doctor and he or she did a full cardiac work-up and reassured you that the pain is not from your heart. You think back to what did you did earlier. Did you eat a bit heavier or richer than you normally do?  Did you drink a couple more drinks than you should have? You answer yes to both. You reach for you antacid and hope for relief.

If this sounds familiar, then you have gastroesophageal reflux or GERD, which is often called heartburn.

Heartburn is a symptom that is felt when there is a backflow of acid from the stomach up into the esophagus. The esophagus runs through the middle of the chest, behind the heart. The experience is a burning sensation, thus called heartburn. More than 60 million Americans experience heartburn at least once a month and some studies suggest that more than 15 million Americans experience heartburn symptoms each day.

Causes of Heartburn

To understand GERD, it is first necessary to understand what causes heartburn. Most people will experience heartburn when the lining of the esophagus comes in contact with too much stomach juice for too long a period of time. This stomach juice consists of acid, digestive enzymes and other injurious materials. The prolonged contact of acidic stomach juice with the esophageal lining injures the esophagus and produces a burning discomfort.

Normally, a muscular valve at the lower end of the esophagus called the lower esophageal sphincter or “LES”—keeps the acid in the stomach and out of the esophagus. In GERD, this sphincter relaxes too frequently, which allows stomach acid to reflux, or flow backward into the esophagus.

Common Symptoms of GERD 

GERD can present in several ways. Some of the common symptoms are:

* Burning feeling in the chest just behind the breastbone that occurs after eating and lasts a few minutes to several hours.

* Chest pain, especially after bending over, lying down, or eating.

* Burning in the throat or a hot, sour, acidic or salty-tasting fluid at the back of the throat.

* Difficulty swallowing or a feeling of food “sticking” in the middle of the chest or throat.

* Chronic cough, sore throat or hoarseness.

Steps to Avoid GERD

Now that you know what GERD is, here’s how can you take care of it:

* Avoid foods and beverages that contribute to heartburn, such as chocolate, coffee, peppermint, greasy or spicy foods, tomato products, and alcoholic beverages.

* Stop smoking. Tobacco inhibits saliva, which is the body’s major buffer. Tobacco may also stimulate stomach acid production and relax the muscle between the esophagus and the stomach, permitting acid reflux to occur.

* Lose weight if you are overweight.

* Do not eat two to three hours before sleep.

* For infrequent episodes of heartburn, take an over-the-counter antacid or an H2 blocker, some of which are now available without a prescription.

When Symptoms Aren’t Easily Controlled

When symptoms of heartburn are not controlled with modifications in lifestyle and over-the-counter medicines are needed two or more times a week, or symptoms remain unresolved or get worse (including trouble swallowing, choking, weight loss or bleeding from an esophageal ulcer), you should see your doctor.

The doctor may prescribe acid blocker medications such as Prilosec, Prevacid, Nexium, Zegrid or Protonix. These medications are known as proton pump inhibitors. Because these medications completely shut down the production of acid in our stomach, they may make you feel better and may allow you to eat foods that cause GERD.

In recent studies, however, we now realize that long-term use of these medications may increase our risk to other illnesses, such as nutritional deficiencies, hip fractures and infections. So it is important to follow the lifestyle modifications outlined above as much as you can to see if you can ease your symptoms without long-term use of proton pump inhibitors.

But it is important to do something under a doctor’s supervision. When GERD is not treated, in the long run serious complications can occur, such as severe chest pain that can mimic a heart attack, esophageal stricture, bleeding from esophageal ulcers, Barrett’s esophagus and even esophageal cancers.

Now you know what, why and how to manage your GERD.

Lisa Ganjhu, DO is a Gastroenterologist and Hepatologist at St. Luke’s Roosevelt Hospital Center.

Pancreatic Cancer: A Fighting Chance

Sep 13, 2012 | Cancer, Digestive Diseases, Endocrinology, Gastroenterology, Surgery

Guest blog post by Michael Wayne, DO.

Pancreatic cancer is a silent killer. Unfortunately, the majority of patients have an advanced stage of the disease by the time they come to a doctor’s office with complaints. Science does not yet have any early markers, such as simple, reliable blood or urine tests, to help detect this deadly cancer or to determine if you are at risk for pancreatic cancer.

Still, there are things to keep in mind that can possibly give you a better edge on the odds:

* If you have a family history of pancreatic cancer, you should speak to your doctor about genetic testing and/or other possible screenings.

* If you have unexplained weight loss, new onset of diabetes as an adult or a worsening of previously controlled diabetes, talk to your doctor about the possibility of pancreatic cancer screening. When patients have any of the symptoms mentioned above, they should get either a CT scan or an MRI of the abdomen.

* Unexplained back pain can be another presenting sign of pancreatic cancer and should be investigated thoroughly.

If anything abnormal is found in the imaging tests, then there are other tests we can do to determine if this is pancreatic cancer. If we suspect pancreatic cancer, hopefully we can catch it at an early stage when it is more likely to be treated successfully.

Michael Wayne, DO is surgical director at the Center for Digestive Health and the Chief of Pancreato-biliary Surgery at Beth Israel Medical Center.

Food for Beautiful Eyes

Updated on Jun 30, 2022 | Diet and Nutrition, Digestive Diseases, Gastroenterology, Holistic Health

You probably have heard that carrots are good for your eyes. You may have also heard that putting teabags or cucumbers on your eyes helps soothe puffy eyes or dark circles. Food can do even more for your eyes when you eat the right things! Beautiful eyes can be as easy as a stroll through the grocery store.

The key to outer beauty really starts with what you put in your body. In fact, when you eat well, you’ll notice that your eyes are the first to show improvement. Let’s take a stroll through the grocery store.

First stop, the produce section

Notice all the bright colors of the vegetables and fruit. They are nature’s pharmacy and are loaded with vitamins, minerals and antioxidants. Key food for beautiful eyes are those high in antioxidants such as Vitamins A, C, E and K, as well as those high in the minerals selenium and zinc. Other lesser know antioxidants, lutein and zeaxanthin, will help to protect the retina and skin around your eyes from dangerous overexpose to the sun’s UV radiation.

Eat 2 to 4 servings of raw fruit or vegetables per day, especially carrots, sweet potatoes, spinach, kale, bell peppers, papaya, mangos, oranges and berries. Raw fruits and vegetable retain full antioxidant strength and the brighter the produce the better. If you want to cook your veggies, sauté them lightly in Vitamin-E-rich olive oil.

Next, the bakery!

As you move to the back of the grocery store, you’ll see the bakery. Zero in on the whole-grain breads, which are chockfull of zinc and selenium. The section may have also have nuts. Pick up some almonds and walnuts, which are rich in powerful antioxidants and are very nutritious.

Off to the meat and fish section.

Stick to lean meats, which provide Vitamin A, zinc and selenium. Try to eat more fish, which is a great source of omega 3 fatty acids and Vitamin E. Smaller and fatty fish are the healthiest.

Now comes the dairy section.

Make sure to pick up some low-fat milk, cheese and eggs, all of which contain vitamin A, selenium and zinc.

Avoid!

The main beauty zappers are caffeine, alcohol, salt and cigarettes. Caffeine in drinks like coffee, soda and energy drinks affect your sleep patterns so you don’t get your 7 to 8 hour of beauty rest. If you need caffeine to get through the day, try green tea since it also s antioxidants.

Salt and alcohol make you to retain fluid and cause puffy eyes. Smoking will promote crow’s feet and wrinkles around your eyes.

Beautiful eyes are as easy as walking around the perimeter of the grocery store. Avoid the middle aisles or at least walk cautiously. Eat across the rainbow of whole foods and at the end of the rainbow you will have beautiful and healthy eyes!

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