Gastroesophageal reflux disease (GERD)
One of the most common causes of heartburn is called gastroesophageal reflux disease (GERD). It occurs when stomach acid backs up into the esophagus, the tube connecting the mouth and stomach, usually because the ringlike muscles that prevent backflow stop working properly.
In addition to heartburn, GERD may cause nausea, a sour taste in the mouth, difficulty swallowing, a sore throat, coughing, and tightness in the chest.
Medications to treat GERD reduce stomach acid. Antacid pills and liquids have been around the longest. More recently, proton-pump inhibitors (PPIs), such as omeprazole (Prilosec) or lansoprazole (Prevacid), and H2 blockers, such as cimetidine (Tagamet) or ranitidine (Zantac), have become available, many over the counter.
Long-term use of PPIs is linked to a risk of bone fractures, low vitamin B12, and pneumonia. Some recent studies have suggested that long-term PPI use may increase the risk of dementia, heart attack, and chronic kidney disease, although this has not been proved.
Don’t fool yourself into thinking medication allows you to frequently eat foods that once caused heartburn. “If medication controls your symptoms, then it’s probably okay to have a ‘trigger’ food occasionally. But if you do that too often, the heartburn will return”, says Dr. Kyle Staller, a gastroenterologist at Harvard-affiliated Massachusetts General Hospital. You may not have to take a medication to control GERD symptoms. Eating smaller meals and avoiding food triggers can help. “Weight loss and quitting smoking will help most”, says Dr. Staller.
