Gastro-esophageal Reflux Disease (GERD)

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Male anatomy of human organs in x-ray view

Most of us these days complain about having acidity or heart burn this condition where one feels pinching ache in the center of body (stomach) and then a burning sensation from stomach to throat is called gastro-esophageal reflux. Sixty percent of the adult population will experience some type of gastro-esophageal reflux disease (GERD) within a 12 month period and 20 to 30 percent will have weekly symptoms.

Acid reflux happens when your stomach acid backs up into your esophagus. Your esophagus is the muscular tube that connects your throat and stomach. If you experience it more than twice a week, you may have gastro-esophageal reflux disease (GERD). In addition to frequent heartburn, symptoms of GERD include difficulty swallowing, coughing or wheezing, and chest pain. Research in the journal Digestive Diseases and Sciences suggests that rates of GERD are rising.

Stress and GERD

It’s still debatable whether or not stress actually increases the production of stomach acid or physically creates a worsening in acid. Currently, many scientists believe that when you’re stressed, you become more sensitive to smaller amounts of acid in the esophagus. In 1993, researchers published in the American Journal of Gastroenterology that reflux patients who were anxious and stressed reported having more painful symptoms related to acid reflux, but none of the patients showed an increase in gastric acid. In other words, though people consistently reported feeling more discomfort, the scientists didn’t find any increase in total acid produced. Another study from 2008 added further support to this idea. When researchers exposed people with GERD to a stressful noise, they also found that it increased their symptoms by making them more sensitive to acid exposure.

So it’s just in our heads?

Does this mean that the symptoms are all in your head? Not likely. Researchers theorize that stress may cause changes in the brain that turn up pain receptors, making you physically more sensitive to slight rises in acid levels. Stress can also deplete the production of substances called “prostaglandins,” which normally protect the stomach from the effects of acid. This could increase the perception of discomfort.
Stress, coupled with exhaustion, may present even more body changes that lead to increased acid reflux. Regardless of what exactly happens in the brain and the body, those who suffer from acid reflux know that stress can make them feel uncomfortable, and treating lifestyle factors is important.

What can be done?

Adopting coping techniques for managing stress in your life can help reduce your risk of conditions such as heart disease, stroke, obesity, IBS, and depression. The better you deal with stress, the better you feel.

• Get exercise. Exercise helps loosen up tight muscles, gets you away from the office or other stressful
environment, and releases natural, feel-good hormones. Exercise can also help you lose weight, which can
help reduce the pressure on your abdomen.
• Watch your diet. This is particularly important if you’re under stress, as you’re likely to be more
sensitive to heartburn-triggering foods like chocolate, caffeine, citrus fruits and juices, tomatoes, spicy
foods, and fatty foods.
• Get enough sleep. Stress and sleep form a cycle. Sleep is a natural stress reducer and less stress can lead
to better sleep. To help avoid heartburn symptoms while you snooze, keep your head elevated.
• Practice relaxation techniques. Try out guided imagery, yoga, tai chi, or using music to relax.
• Learn to say “no.” Prioritize people and activities. It’s OK to turn down those that don’t rate high on
your priority list.
• Laugh. Watch a funny movie, go see a comedian, or get together with friends. Laughter is one of the best
natural stress relievers.
• Spend time with your pet. If you don’t have a pet, consider getting one. Pets can help calm and rejuvenate
you.
• Enjoy a massage.

Asthma and GERD

People with asthma are twice as likely as those without asthma to develop the chronic form of acid reflux known as gastro-esophageal reflux disease (GERD) at one time or another. In fact, research has shown that more than 75 percent of adults with asthma also have GERD. The exact connection between GERD and asthma isn’t entirely clear. However, researchers have a few theories as to why the two conditions may coincide.
Why GERD May Trigger Asthma?

One possibility is that the repeated flow of stomach acid into the esophagus damages the lining of the throat and the airways to the lungs. This can lead to breathing difficulties as well as a persistent cough. The frequent exposure to acid may also make the lungs more sensitive to irritants, such as dust and pollen, which are all known to trigger asthma.

Another possibility is that acid reflux may trigger a protective nerve reflex. This nerve reflex causes the airways to tighten in order to prevent the stomach acid from entering the lungs. The narrowing of the airways can result in asthmatic symptoms, such as shortness of breath.

Why Asthma May Trigger GERD?

Just as GERD can make asthma symptoms worse, asthma can exacerbate and trigger symptoms of acid reflux. Pressure changes that occur inside the chest and abdomen during an asthma attack, for example, are believed to aggravate GERD. As the lungs swell, the increased pressure on the stomach may cause the muscles that usually prevent acid reflux to become lax. This allows stomach acid to flow back up into the esophagus.

Your asthma may be connected to GERD if:

• asthma symptoms begin in adulthood
• asthma symptoms get worse following a large meal or exercise
• asthma symptoms occur while drinking alcoholic beverages
• asthma symptoms happen at night or while lying down
• asthma medications are less effective than usual

Lifestyle changes

Since certain medications can be ineffective in treating GERD and asthma simultaneously, the best treatment for these conditions may consist of lifestyle and home remedies.
Controlling Asthma Symptoms

To relieve asthma symptoms, you may want to consider trying:
• ginkgo extract
• natural herbs, such as butterbur and dried ivy
• fish oil supplements
• yoga
• deep breathing exercises

Make sure to consult with your doctor before you try any herbs, supplements, or alternative treatments. Your doctor may be able to recommend an effective treatment plan that can help prevent your asthma and GERD symptoms.
Controlling general GERD Symptoms

To help control or prevent GERD symptoms, you can try:
• losing excess weight
• quitting smoking
• avoiding foods or drinks that contribute to acid reflux, such as:
o alcoholic or caffeinated beverages
o chocolate
o citrus fruits
o fried foods
o spicy foods
o high-fat foods
o garlic
o onions
o mints
o tomato-based foods, such as pizza, salsa, and spaghetti sauce
o eating smaller meals more often instead of eating larger meals three times a day
o eating meals at least three to four hours before bedtime
o using a wedge pillow or raising the head of the bed 6 to 8 inches by placing blocks underneath
bedposts
o wearing loose clothing and belts

Data adopted from following: http://www.healthline.com/health/gerd/statistics#3, http://www.healthline.com/health/gerd/stress#2, http://www.healthline.com/health/gerd/preventing-heartburn#1, http://www.healthline.com/health/gerd/asthma#6

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