Heartburn is always uncomfortable, and sometimes very painful. It is also very common. According to the American College of Gastroenterology, an estimated “60 million Americans experience heartburn at least once a month and some studies have suggested more than 15 million Americans experience heartburn symptoms each day.”

With numbers like those in mind, the International Foundation for Gastrointestinal Disorders (IFFGD) created GERD Awareness Week back in 1999. Now in its 22nd year, GERD Awareness Week—this year from November 18th-24th—seeks to encourage people experiencing chronic heartburn symptoms, which may be GERD-related, to learn more about their condition and to consult with their physicians to avoid what could become a more serious and complex health issue down the road.

What is the difference between heartburn, acid reflux and GERD?

Heartburn is a misnomer as it does not involve the heart, but rather the stomach and esophagus, and is actually a symptom of acid reflux and GERD.

Acid reflux, which causes the burning sensation in the chest we collectively refer to as “heartburn,” occurs when the lower esophageal sphincter (LES)—a circular muscle that connects the esophagus and stomach, and that tightens after food passes into the stomach—becomes weak and allows the stomach acid that digests your food to move backwards into the esophagus. Not designed for digestive acids, the lining of the esophagus is far more sensitive than that of the stomach. The resulting pain can be so severe that it is sometimes mistaken for a heart attack.

Gastroesophageal reflux disease (GERD) develops when acid reflux becomes a more serious and chronic problem. Whereas acid reflux is normally sporadic and affects most people at some point, a GERD diagnosis is common if acid reflux causes esophageal inflammation or occurs more than twice a week for a sustained period of time. Prolonged damage to the lining of the esophagus from acid reflux can result in esophageal cancer.

What are the symptoms of acid reflux and GERD?

Acid reflux and GERD cause a wide array of symptoms that can include:

• bad breath
• sore throat
• cough
• dysphagia (the feeling of having food stuck in your throat)
• regurgitation
• nausea or vomiting
• tightness in the chest
• black or bloody stool

What causes GERD?

While Gastroesophageal Reflux Disease always results from a weakened or dysfunctional lower esophageal sphincter and can occur in people of all ages, GERD can have a number of different causes. The most common causes of GERD are:

• obesity or being overweight, the result of increased pressure on the abdomen.
• pregnancy, also as a result of increased pressure on the abdomen.
• smoking, or being exposed to secondhand smoke
• consuming alcohol
• hiatal hernia, which occurs when the upper portion of the stomach bulges through an opening in the diaphragm and lowers pressure on LES
• esophageal dysmotility, which causes difficulty swallowing, and can result from dysfunction of the upper esophageal sphincter (UES), the body of the esophagus, or the LES.

What can I do if I have recurring or chronic acid reflux?

If you are experiencing chronic acid reflux symptoms, Door County Medical Center’s Heartburn & Reflux Center of Door County has many options for you! 

The Heartburn & Reflux Center offers several minimally invasive tests, which can determine whether or not you are suffering from GERD. These include:

• The Bravo^TM  Reflux Testing System: This system involves placing a small capsule on the esophageal wall. The capsule then monitors esophageal pH levels and determines whether acid from the stomach is moving past the LES and into the esophagus.
• Esophageal Manometry: With this procedure, which lasts between 10-15 minutes, a small tube is passed through your nose, down your esophagus and into your stomach. Sensors on the tube determine the function of the esophageal muscle and the LES by measuring pressure while swallowing small amounts of water.
• Esophagram: This is a type of x-ray that assists in exploring the anatomy of the esophagus and stomach—can also be used to establish whether a hiatal hernia is present and to help determine its size.

How can I manage my symptoms?

Every case of acid reflux and GERD is different, and treatment options also vary from person to person. Often, the root causes of GERD, and the management of symptoms, can be addressed with lifestyle changes, including:

• Losing weight
• Changing diet
• Quitting smoking
• Quitting alcohol consumption

Along with lifestyle changes, over-the-counter and prescription medications can also help manage the symptoms of acid reflux and GERD. Common medications include: Antacids like Tums, Rolaids and Mylanta; H2 Blockers like Pepcid and Tagamet and Proton Pump Inhibitors (PPIs) like Omeprazole and Nexium.

What if lifestyle changes and medications don’t work?

For more serious cases of GERD, where lifestyle changes and medications have proven ineffective, surgery may be required. For such cases, Door County Medical Center now offers several minimally invasive procedures for GERD. These include:

• Botox injections: These are an excellent alternative for patients with esophageal disorders that don’t want to, or can’t have, a minimally invasive procedure. Botox injections assist in relaxing the esophageal body or LES by interfering with nerve signals to the esophageal muscle tissue.
• The Heller myotomy: This minimally invasive procedure that addresses esophageal dysmotility and dysphagia. With a Heller myotomy, a small incision is made to the muscular layer of the lower portion of the esophagus and upper portion of the stomach, opening and relieving pressure on an overly tight lower esophageal sphincter.
• Fundoplication surgery: This is a type of surgical procedure that attaches the uppermost part of the stomach (the fundus) to the lower esophageal sphincter in order to increase pressure on that muscle, reduce a potential hiatal hernia, and restore the natural, physiological anatomy of the LES. The Heartburn & Reflux Center of Door County offers two types of fundoplication procedures—the Transoral Incisionless Fundoplication and the Nissen Fundoplication (used when a hiatal hernia is also present).

•

Don’t let recurring heartburn go unchecked! As noted above, chronic acid reflux can lead to more serious health issues down the road. If you, or someone you know, is experiencing acid reflux on a regular basis, or the symptoms of reflux have begun to impact quality of life, contact the Heartburn & Reflux Center of Door County at: 920-746-1060. For more information on the different options for treatment the Heartburn & Reflux Center offers please visit our website at: https://www.dcmedical.org/medical-services/heartburn-reflux-center-of-door-county.