Heartburn, Acid Reflux and Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents leak back, or reflux, into the esophagus. The LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach. The esophagus carries food from the mouth to the stomach.

When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn. The fluid may even be tasted in the back of the mouth, and this is called acid indigestion. Occasional heartburn is common but does not necessarily mean one has GERD. Heartburn that occurs more than twice a week may be considered GERD, and it can eventually lead to more serious health problems. Anyone, including infants, children, and pregnant women, can have GERD.

What are the symptoms of GERD?

The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning, or trouble swallowing. You may feel like you have food stuck in your throat or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.

Having liquids or gas occasionally reflux is considered normal. When it happens frequently, particularly when not trying to belch, and causes other symptoms, then it is considered a medical problem or disease. However, it is not necessarily a serious one or one that requires seeing a physician.

The stomach produces acid and enzymes to digest food. When this mixture refluxes into the esophagus more frequently than normal or for a longer period of time than normal, it may produce symptoms. These symptoms, often called acid reflux, are usually described by people as heartburn, indigestion, or "gas". The symptoms typically consist of a burning sensation below and behind the lower part of the breastbone or sternum.

What causes GERD?

No one knows why people get GERD. A hiatal hernia may contribute. A hiatal hernia occurs when the upper part of the stomach is above the diaphragm, the muscle wall that separates the stomach from the chest. The diaphragm helps the LES keep acid from coming up into the esophagus. When a hiatal hernia is present, it is easier for the acid to come up. In this way, a hiatal hernia can cause reflux. A hiatal hernia can happen in people of any age; many otherwise healthy people over 50 have a small one.

Other factors that may contribute to GERD include alcohol use, being overweight, pregnancy and smoking. Also, certain foods can be associated with reflux events, including citrus fruits, chocolate, drinks with caffeine, fatty and fried foods, garlic and onions, mint flavorings, spicy foods, and tomato-based foods, like spaghetti sauce, chili, and pizza.

How is GERD treated?

If you have had heartburn or any of the other symptoms for a while, you should see your doctor. You may want to visit an internist, a doctor who specializes in internal medicine, or a gastroenterologist, a doctor who treats diseases of the stomach and intestines. Depending on how severe your GERD is, treatment may involve one or more of the following lifestyle changes and medications or surgery.

Lifestyle Changes: If you smoke, stop. Do not drink alcohol. Lose weight if needed. Eat small meals. Wear loose-fitting clothes. Avoid lying down for 3 hours after a meal. Raise the head of your bed 6 to 8 inches by putting blocks of wood under the bedposts — just using extra pillows will not help.

Medications: Your doctor may recommend over-the-counter antacids, which you can buy without a prescription, or medications that stop acid production or help the muscles that empty your stomach.

• Antacids, such as Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids, and Riopan, are usually the first drugs recommended to relieve heartburn and other mild GERD symptoms. Many brands on the market use different combinations of three basic salts — magnesium, calcium, and aluminum — with hydroxide or bicarbonate ions to neutralize the acid in your stomach. Antacids, however, have side effects. Magnesium salt can lead to diarrhea, and aluminum salts can cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects. Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can also be a supplemental source of calcium. They can cause constipation as well.
• Foaming agents, such as Gaviscon, work by covering your stomach contents with foam to prevent reflux. These drugs may help those who have no damage to the esophagus.
• H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75), impede acid production. They are available in prescription strength and over the counter. These drugs provide short-term relief, but over-the-counter H2 blockers should not be used for more than a few weeks at a time. They are effective for about half of those who have GERD symptoms. Many people benefit from taking H2 blockers at bedtime in combination with a proton pump inhibitor.
• Proton pump inhibitors include omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium), which are all available by prescription. Proton pump inhibitors are more effective than H2 blockers and can relieve symptoms in almost everyone who has GERD.
• Another group of drugs, prokinetics, helps strengthen the sphincter and makes the stomach empty faster. This group includes bethanechol (Urecholine) and metoclopramide (Reglan). Metoclopramide also improves muscle action in the digestive tract, but these drugs have frequent side effects that limit their usefulness.

Because drugs work in different ways, combinations of drugs may help control symptoms. People who get heartburn after eating may take both antacids and H2 blockers. The antacids work first to neutralize the acid in the stomach, while the H2 blockers act on acid production. By the time the antacid stops working, the H2 blocker will have stopped acid production. Your doctor is the best source of information on how to use medications for GERD.

What are the long-term complications of GERD?

Sometimes GERD can cause serious complications. Inflammation of the esophagus from stomach acid causes bleeding or ulcers. In addition, scars from tissue damage can narrow the esophagus and make swallowing difficult. Some people develop Barrett's esophagus, where cells in the esophageal lining take on an abnormal shape and color, which over time can lead to cancer. Also, studies have shown that asthma, chronic cough, and pulmonary fibrosis may be aggravated or even caused by GERD.

HerbaCall Acid Reflux Testimonials

• Jihad Farraj says "I started taking Quick start with the Aloe Vera, FloraFiber, and HerbaLifeline. Two weeks later, I noticed that I stopped taking the Rolaids and my heartburn was gone."
• In an HerbaCall testimonial, Heidi Warden tells us that Zantac, Prilosec Prevacid and Nexium didn't help her acid reflux, but Herbalife's Herbal Aloe Drink did!
• Phil P. writes that he suffered from acid reflux for 15 years and consumed gallons of antacids. "After about 7 days of drinking Herbalife Herbal Aloe, I noticed that I wasn't gulping down the Mylanta anymore. The acid reflux was gone."
• Mark Neumuth tells HerbaCall "I tried Prilosec and other drugs to cure my acid reflux and soothe my stomach but nothing worked...until I began Herbalife's ultimate program! Within a week my acid reflux had subsided and I no longer had those mysterious stomach problems!"

How can Herbalife help relieve GERD?

Herbalife's ShapeWorks programs can help you lose weight, lowering your risk of GERD. According to many HerbaCall testimonial writers, Herbalife's Herbal Aloe Drink has brought great relief to many people who suffer from acid reflux.

Want more information and more Herbalife testimonials?

Visit the HerbaCall Resource Centers for more detailed information on many health conditions, news, and research links. HerbaCall has many testimonials on Acid Reflux and other conditions. Herbalife products can calm your digestive system!