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When Heartburn is More than Simple Indigestion

By Christopher S. Cutler, MD

How do you know when heartburn or “indigestion” is something more and needs to be treated? The gastroenterology specialists at Granite Peaks GI take time with their patients to determine if such symptoms may be a result of Gastroesophageal Reflux Disease (GERD). One of the red flags is heartburn occurring more than twice a week; although you can have GERD without the presence of heartburn. “If it is GERD, it needs to be diagnosed so further damage to the esophagus is minimized. There are also simple steps that can be taken to manage the disease and immediately improve one’s quality of life,” says Dr. Cutler, who explains more about the disease in the Q & A below.

What is GERD?

When we eat, food is carried from the mouth to the stomach through the esophagus. At the lower end of the esophagus where it joins the stomach there is a ring of muscle cells called the lower esophageal sphincter (LES). After swallowing, the LES relaxes to allow food to enter the stomach. Then, the LES contracts to prevent food and acid from traveling back up into the esophagus. GERD occurs when the LES weakens, allowing stomach contents and acid to back up into the esophagus, causing troubling symptoms or complications.

Who gets GERD and when should you see a doctor?

GERD affects ten million adults in the United States on a daily basis. People prone to developing it include those who are overweight, smokers or drinkers, and pregnant women. If symptoms are prolonged, or if you are unable to control the symptoms with lifestyle modifications and/or medications, you should see a gastroenterologist. Do so immediately if you have these warning symptoms: throwing up blood, passing black stool, difficulty swallowing, unexplained weight loss, or anemia.

What happens if you don’t treat GERD?

Untreated GERD may lead to the following complications: a narrowing of the esophagus which causes difficulty swallowing, ulcers which can cause bleeding, aspiration of acid into the lungs which may cause pneumonia or asthma, Barrett’s esophagus which is a precancerous lining of the esophagus, and esophageal cancer.

How is GERD treated? 

Lifestyle modifications, such as the following, can help decrease symptoms: raising the head of the bed (placement of 6-inch blocks under the head of the bed), waiting at least three to four hours after eating before lying down, avoiding tight-fitting clothing, avoiding smoking and alcohol, losing weight, and eating smaller, more frequent meals. Foods that can commonly aggravate GERD include: fatty foods, chocolate, peppermint, alcohol, caffeine, and citrus drinks. There may be other foods specific to each patient. Medication can also be used to help treat this condition, including antacids such as Mylanta or Maalox, H2 blockers such as Zantac or Tagamet, and proton pump inhibitors (PPIs) such as Prilosec or Prevacid.

How is GERD diagnosed? 

Your doctor may be able to diagnose this condition based upon your symptoms and response to therapy. If you have any of the classic warning symptoms mentioned above, your doctor may recommend an upper endoscopy. An upper endoscopy is a painless procedure performed under moderate sedation where a tiny lighted camera is passed through your mouth into your esophagus. Your gastroenterologist will be able to see whether there is damage to your stomach or esophageal tissue, and will be able to recommend a treatment plan to address your specific condition.

Talk to the experts at Granite Peaks Gastroenterology at our Sandy or Lehi office to help relieve your symptoms and determine the best course of action to treat your GERD.

Relief from Heartburn Pain (Infographic)

GERD (gastroesophageal reflux disease) is a common condition with symptoms such as heartburn, reflux, chest pain and difficulty swallowing. About 15 million Americans experience GERD symptoms daily.

GERD is caused by a weakening of the esophageal sphincter, allowing stomach contents to back up into the esophagus. The stomach contains acid and pepsin which, if allowed to contact the esophageal tissue, can irritate and cause erosions in the esophagus. Left untreated, reflux can cause esophageal inflammation, or lead to Barrett’s esophagus, a condition that increases the risk of esophageal cancer.

Don’t suffer with the burning irritation of GERD. Talk with a gastroenterologist to find the right solution for your symptoms.

 

heartburn infographic

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Heartburn – Should You Worry?

How do you know when heartburn is something you should see your doctor about? Heartburn may be a symptom of Gastroesophageal Reflux Disease (GERD). If it is GERD, it needs to be diagnosed so further damage to the esophagus is minimized. There are simple steps that can be taken to manage your acid reflux and immediately improve your quality of life.

 

What is GERD?

When we eat, food is carried from the mouth to the stomach through the esophagus. At the lower end of the esophagus where it joins the stomach there is a ring of muscle cells called the lower esophageal sphincter (LES). After swallowing, the LES relaxes to allow food to enter the stomach. The LES then tightens to prevent food and acid from traveling back up into the esophagus. GERD occurs when the LES weakens, allowing stomach contents and acid to back up into the esophagus, causing troubling symptoms and complications.

GERD-Symptom-Table-Granite-Peaks-Gastroenterology

 

Who gets GERD and when should you see a doctor?

GERD affects 15 million adults in the U.S. on a daily basis. Those who suffer with it may find it most prevalent if they eat late at night, eat acidic or spicy foods, or lie down soon after eating. Those who are overweight, smoke, drink alcohol, or are pregnant may also be more prone to GERD symptoms. If symptoms occur more than once per week, are prolonged, or if you are unable to control the symptoms with lifestyle modifications and/or medications, you should see your gastroenterologist. Do so immediately if you have any of these warning symptoms:

– vomiting blood

– passing black stool

– difficulty swallowing

– unexplained weight loss

– anemia

– chest pain

 

What happens if you don’t treat GERD?

Untreated GERD may lead to the following complications:

– a narrowing of the esophagus which causes difficulty swallowing

– ulcers in the esophagus which can cause bleeding

– aspiration of acid into the lungs which may cause pneumonia or asthma

– Barrett’s esophagus which is a pre-cancerous lining of the esophagus

– esophageal cancer

 

How is GERD diagnosed?

Your doctor may be able to diagnose GERD based upon your symptoms and response to therapy.  If you have any of the classic warning symptoms mentioned above, your doctor may recommend an upper endoscopy.  An upper endoscopy is a painless procedure performed under light sedation where a tiny lighted camera is passed through your mouth into your esophagus.

 

How is GERD treated?

Lifestyle modifications that can help decrease symptoms include: raising the head of the bed (placement of 6 inch blocks under the head of the bed), waiting at least 3-4 hours after eating before lying down, avoiding tight-fitting clothing, avoiding smoking and alcohol, losing weight, and eating smaller meals.

Foods that can commonly aggravate GERD include:  fatty foods, chocolate, peppermint, alcohol, caffeine, and citrus drinks.  There may be other aggravating foods specific to each patient.

Medications can be used to help treat GERD, including antacids such as Mylanta and Maalox, H2 blockers such as Zantac and Tagamet, and proton pump inhibitors (PPIs) such as Prilosec and Prevacid.

 

Summary

In summary, occasional heartburn is usually not a cause for concern. But if you experience heartburn more than once per week, lifestyle modifications are not working, or if you have any of the warning symptoms listed above, please make an appointment with one of the specialists at Granite Peaks Gastroenterology in Sandy or Lehi.

Digestive Friendly & Not-So-Friendly Foods

Summer is notorious for bringing people together, whether it’s a barbecue, July 4th & July 24th celebrations, birthdays, and even weddings.  You can almost always expect a smorgasbord of foods that may or may not agree with your digestive system. The following is a list of friendly and not so friendly food choices that could leave you partying with your friends and family, or spending the event uncomfortable and aggravated with GERD heartburn or other related concerns.

Worst:

  • High-Fat/ Fried Foods: for many, high-fat foods and fried foods produce acid reflux and heart-burn. This can cause a pale-colored stool called steatorrhea which is excess fat in the feces.
  • Spicy Food: can often cause heartburn pain
  • Diary: Those who are lactose intolerant should steer clear from many diary items because they don’t usually have lactase, an enzyme that breaks down lactose, which is the sugar in milk. If diary causes gas, bloating, diarrhea, or other GI issues, consult with your primary care provider.
  • Alcohol: This relaxes the esophageal sphincter, causing acid reflux and heartburn, especially if combined with spicy and fatty foods. Alcohol can also inflame the stomach lining, impairing enzymes and preventing nutrients from being absorbed.
  • Berries: Berries are a great source of antioxidants, but can cause problems for people with diverticulitis, which are pockets in the large intestine. Seeds can get stuck in these pockets and may cause infection.

  • Chocolate:
    This could cause problems for people with Irritable Bowel Syndrome, and since chocolate contains milk, those with a lactose intolerance could also find gas, bloating and other symptoms after eating this tasty treat.
  • Coffee, Tea, Soft Drinks: These beverages can act as a diuretic and can over-relax the esophageal sphincter, causing acid reflux and heartburn.

Best:

  • Yogurt: Our GI tract contains trillions of bacteria that help break down and digest food. Yogurt contains some good bacteria to promote a healthy system. Look for products that say “Live & active cultures”.
  • Lean Meat & Fish: Easier for your body to digest than high-fat red meats and is not associated with colon cancer.
  • Whole grains: Americans need 20-30 grams of whole grains, but the average consumption is around 12 grams. Whole grains help you feel full longer and can help lower cholesterol. However, those with Celiac Disease must stay away from the whole grains which contain gluten.
  • Bananas: “A Banana A Day is a Healthy Way” and can restore normal bowel functions, electrolytes, and potassium.
  • Ginger: Ginger can relieve nausea, vomiting, motion sickness, morning sickness, gas, colic, and lack of appetite.

Go forth, and have a healthy and happy gastrointestinal tract through the summer. If you have uncomfortable reactions to foods, but you’re unsure why, call 801-619-9000 to schedule an appointment with one of our specialists. Granite Peaks can help get you back on track and enjoying your summer without discomfort.

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