How To Prevent GERD?

Gastroesophageal reflux disease (GERD) is a common condition that can significantly impact people’s quality of life. In this article, we will start by discussing what GERD is and its symptoms, and then we will look at how you can prevent its development. Lastly, we will look into the types of treatments available for the condition and when to seek medical attention. 

There are many measures that you can take in your daily life to prevent GERD. These include maintaining a healthy lifestyle, by keeping a healthy weight, stopping smoking, and being physically active. There are also considerably simple measures that you can take to alleviate GERD’s symptoms, such as elevating the head of the bed and avoiding large meals. 

In the following sections, we will discuss measures to prevent and alleviate GERD’s symptoms in more detail and also understand better how the condition develops. If you suffer from GERD or know someone who does, learning about what you can do to manage the disease is a great way to improve   the quality your of life. 

What is GERD?

As previously mentioned, GERD is a common condition of the digestive system that affects millions of people around the world, with a prevalence of around 20% in North America and Europe.¹ To understand what the disease is, we need to consider how our digestive system is organized: the food that we ingest goes from our mouth to our stomach through a tube called the oesophagus. In our stomach, there is stomach acid, which helps us to digest the food we eat. When this acid and other stomach contents flow back from the stomach to the oesophagus, people experience acid reflux. When acid reflux occurs repeatedly over a longer period of time, it can lead to GERD.^2,3 People with GERD often experience a worse quality of life and have higher morbidity when compared with people who do not suffer from GERD.^2,3 Therefore, it is essential to properly treat and manage the condition. In this context, the vast majority of people respond well to treatment combining lifestyle changes and medication, but a minority of people require surgery to alleviate GERD symptoms.^2,3

Symptoms of GERD

People suffering from GERD might experience a range of symptoms, the most common ones being heartburn and chest pain. Other symptoms include: ^1-3

• Abdominal pain
• Feeling of having a bump in the throat (also called globus sensation)
• Bad breath
• Chronic sore throat
• Persistent cough
• Laryngitis or hoarseness
• Feeling bloated or nauseated
• Vomiting
• Breathing difficulties, including shortness of breath and asthma worsening

Some people experience alarming symptoms of GERD, which require further evaluation by a medical doctor. Alarming symptoms include, but are not limited to, unintentional weight loss, difficulties swallowing (dysphagia), pain while swallowing (odynophagia), bleeding and anemia. It is also important to notice that if left untreated, GERD can lead to serious health complications, such as esophagitis and Barrett’s oesophagus.^1,3

Common signs and symptoms of GERD

The most common signs and symptoms of GERD are heartburn and chest pain, which usually present as follows:^1,3

• Heartburn: it is the most common symptom of GERD, and it refers to a burning feeling in the chest, that can radiate and be accompanied by a sour taste in the mouth, and often gets worse while lying down or bending over
• Chest pain: it is extremely important to differentiate between cardiac and non-cardiac causes of chest pain because of the potential severity of cardiac chest pain. In this context, GERD is a common cause of non-cardiac chest pain, and it is hard to differentiate it from cardiac pain. Therefore, if you experience chest pain, seek medical attention right away

Causes of GERD

The main cause of GERD is the frequent reflux of stomach acid and other stomach contents from the stomach to the oesophagus.^1,3 In order to understand what causes this reflux, we need to comprehend what happens in normal situations: when we swallow food, a sphincter called the lower oesophagal sphincter, located between the oesophagus and the stomach opens to let the food go from the oesophagus to the stomach, and closes to prevent stomach content from going back from the stomach to the oesophagus. When this sphincter is weakened or relaxed in improper moments, people experience reflux. 

It is well known that this process can be caused or worsened by several factors, including:^1.3

• Being overweight or obese
• Smoking
• Pregnancy
• Stress
• Consumption of certain food and beverages, such as caffeine, alcohol, and spicy food
• Use of certain medications, such as nonsteroidal anti-inflammatories (e.g., ibuprofen)
• Hiatus hernia

How to get rid of acid reflux?

There are a few considerably simple measures that you can take in your daily life in order to get rid of acid reflux:

• Elevate the head of your bed by around 15 cm, in a way that your chest is above your waist level
• Avoid caffeine, and fatty or spicy foods
• Avoid heavy meals, prefer to have a larger number of smaller meals throughout the day
• Eat healthy food every four hours
• Wait two to three hours before lying down after eating
• Eat slowly, chew your meal thoroughly, and avoid talking while you eat
• Stop eating when you feel satisfied
• Avoid using tight clothes, especially when eating
• Keep a healthy lifestyle, including maintaining a healthy weight, stopping smoking, and avoiding alcohol consumption

How to prevent GERD?

The main risk factors for developing GERD include older age, being overweight or obese, smoking, and sedentarism.^1,3 Therefore, there are measures that you can take to prevent GERD from developing. These include:

• Maintaining a healthy weight, mainly not being overweight or obese
• Stop smoking
• Being physically active
• Avoiding the use of certain medications, such as nonsteroidal anti-inflammatories

These measures should be taken in parallel with the measures mentioned above to get rid of acid reflux because  by preventing reflux, you also prevent the development of GERD or alleviate its symptoms.

Treatment

The lifestyle changes and measures mentioned above on how to get rid of acid reflux and how to prevent GERD are essential parts of the treatment of the condition. Such measures are already enough to alleviate GERD symptoms in many people. However, for some people, pharmacological treatment is also necessary.^1,3

Currently, the first class of medication, that is usually used to treat GERD, is the proton pump inhibitors (PPIs), which include omeprazole and lansoprazole. The treatment usually takes four to eight weeks, depending on the severity of the condition. If after taking the medication correctly, as prescribed by your doctor, and following the lifestyle changes recommendations, your symptoms do not get better, your doctor might order tests to better evaluate the condition or try a different class of medication, such as H2 receptor agonists (e.g., cimetidine and famotidine). Both types of medication – PPIs and H2 receptor agonists – act by decreasing the secretion of stomach acid but through different paths. Lastly, even though it is uncommon, some people require surgical treatment for GERD, such as laparoscopic fundoplication.^1,3

Successful treatment of GERD can significantly improve people’s quality of life. Therefore, consult with your general practitioner if you have signs and/or symptoms of GERD and share your concerns.

When to seek medical attention?

There are a few situations in which people suffering from GERD should seek medical attention, including emergency and non-emergency medical attention.

You should seek immediate healthcare attention in an emergency healthcare service if you experience chest pain since this symptom can be caused by GERD but also by serious cardiac issues, such as a heart attack.^1,3

On the other hand, you should seek non-emergency medical attention, by making an appointment with your general practitioner as soon as possible, for example, if:

• You suffer from severe symptoms of GERD
• You feel like the GERD symptoms are getting worse
• You suffer from symptoms of GERD for three or more weeks
• You take over-the-counter medication for GERD symptoms frequently
• You experience any alarming signs or symptoms, such as unintentional weight loss, difficulties swallowing (dysphagia), or pain while swallowing (odynophagia)

A medical doctor can evaluate your condition, assess the possibility of a different diagnosis, or prescribe another treatment if necessary.

Summary

As discussed above, GERD is a common disease of the digestive system in which the contents of the stomach flow back to the oesophagus (the tube that connects the mouth to the stomach). The most common symptoms of GERD include heartburn and chest pain, but the condition can cause a range of other symptoms, including abdominal pain, sore throat, cough, and nausea. There are several risk factors for developing GERD that are related to lifestyle habits, such as being sedentary and smoking. Therefore, you can take important steps in your daily life to prevent GERD, including being physically active and stopping smoking. There are also considerably simple measures that you can take to avoid acid reflux, such as elevating the head of the bed and avoiding large meals.

The treatment for GERD involves lifestyle changes, and sometimes includes the use of medication. For a minority of cases, surgical treatment is needed. Importantly, you should seek immediate medical attention if you experience chest pain and consult with your general practitioner if you suffer from severe, persisting, or worsening GERD symptoms, if you take over-the-counter medication for GERD symptoms frequently, or if you have any alarming symptoms.