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Feeling the Burn? | NIH News in Health

Feeling the Burn? | NIH News in Health

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November 2018

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Options for Acid Reflux

You’ve probably felt it. After a meal, a burning sensation rises through your chest, or up to your throat. This feeling can come from reflux: when acid and food rise up from the stomach into the esophagus, which is the tube that connects your stomach to your throat.

Occasional reflux is normal. Most people may not even feel it. Sometimes it’s mild, with occasional heartburn after large meals. Reflux can also cause coughing, wheezing, or problems swallowing.

Anyone can experience reflux. But reflux two or more times a week for a few weeks may be gastrointestinal reflux disease (GERD). GERD affects around 20% of people in the U.S. at some point in their lives.

“Reflux becomes GERD when the symptoms start to negatively affect someone’s daily quality of life,” says Dr. John Pandolfino, an expert on reflux at Northwestern University.

GERD usually isn’t dangerous. But it can cause discomfort, pain, and fear of eating, Pandolfino explains. Severe GERD can damage the lining of the esophagus, which can raise the risk of esophageal cancer. Although that risk is low, people should discuss reflux symptoms with their doctor.

Fortunately, there are many options for treating reflux and GERD. Some lifestyle choices may simply prevent it. For example, certain foods can trigger reflux in some people. See the Wise Choices box for tips to reduce reflux.

One of the most effective treatments for GERD is weight loss. In Pandolfino’s clinic, people with GERD are automatically assigned a health coach who helps them with diet and lifestyle changes.

“We help them lose about 10 to 15 pounds, and then see if we can get them off their medication,” he says. “Our success rate has been very good. We can get about a third of people off medication when they lose a little bit of weight. And about 50% experience a dramatic improvement in their symptoms.”

But medications can still help many people with GERD. They work in different ways, and you may need a combination to control your symptoms.

Doctors often first recommend antacids to relieve heartburn and other mild symptoms. Drugs called H2 blockers may provide relief if an antacid alone isn’t enough. These can stop your stomach from making acid in the short-term.

A type of drug called proton pump inhibitors (PPIs) may be recommended if other drugs don’t help control your reflux. PPIs reduce the amount of acid the stomach makes. They’re very effective. But people who take PPIs for a long time or in high doses may be more likely to have side effects. Sometimes, the benefits of these medications can outweigh the side effects. Talk with your doctor about the long-term use of medications for GERD.

If GERD persists despite drugs and lifestyle changes, surgery to strengthen the opening between the stomach and esophagus may be an option. This is especially useful when reflux is caused by a physical problem, like a hernia. A hernia happens when an organ squeezes through a weak muscle in your body.

Researchers are working on developing less-invasive procedures for people who need surgery. Pandolfino and other researchers are also looking for better ways to use existing tests to choose treatments.

“Reflux is such a mixed bag of symptoms and complications. We’d like to be able to better tailor therapy based on these studies,” he says.

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