You may have heard it referred to as “heartburn” or “acid indigestion” but the formal diagnosis is gastroesophageal reflux disease or GERD for short. As the name indicates, the contents of the stomach reflux or back up into the esophagus causing burning and a feeling of fullness in the chest. This condition affects millions of people and can make life pretty miserable.  
     Under normal conditions, the food we eat gets chewed and swallowed and passes down the esophagus to the stomach. There is a ring of muscle at the top of the stomach that is supposed to close tightly so the stomach can churn the food together with stomach acid to begin the digestion process. In GERD, this ring of muscle fails to close completely and the highly acidic stomach contents can back up into the esophagus. The esophagus is not designed to be in contact with acid like the stomach is, so it gets irritated. This chronic irritation can lead to esophageal erosion and eventually to esophageal cancer, if left untreated.
     Symptoms include: heartburn, burping, dry cough, hoarseness, earache and the feeling that something is stuck in the esophagus or difficulty swallowing.
     Some causes of reflux are being overweight, stress, smoking, drinking alcohol or too much caffeine. Certain foods may make the reflux more likely: peppermint, fried or fatty foods, and chocolate. Taking excessive doses of vitamin C can increase the stomach acid and aggravate the situation.  Frequently, the diagnosis of hiatal hernia goes hand in hand with GERD. A small portion of the stomach slips up through the diaghram and forms a pouch where food can get caught. 

There are some practical approaches that can be taken to alleviate reflux:

• Eat smaller, more frequent meals. Leaving the stomach empty too long or overfilling the stomach will increase the chances of reflux.
• Eat at least three hours before lying down to sleep. This gives the meal time to pass out of the stomach and into the small intestine
• Use bricks or blocks of wood to prop up the head of the bed 6 to 10 inches. If the body is horizontal, the stomach acid can easily move up the esophagus while we are sleeping. Positioning the body at an angle is very helpful.
• Lose 10 to 20 pounds if you are overweight. This is one of the most effective tools for treating GERD and hiatal hernia.
• Learn some effective stress management techniques. Stress causes the stomach to produce more acid and produce less protective mucous so the acid can damage the lining of the stomach and the esophagus. 
• Limit fried, greasy or spicy foods. High fat foods take longer to empty from the stomach. Eat the larger meal of the day at breakfast or lunch when you will stay upright for several hours afterward.
• Using over-the-counter antacids before meals and before bed can be useful.

    If you have any of these symptoms, check with your doctor. GERD is manageable and lifestyle changes can usually cure the problem.