Gastroesophageal reflux (“reflux”) is that sensation of burning you feel in your chest or heart, sometimes accompanied with an unpleasant taste in the back of the mouth. More commonly known as “heartburn,” gastroesophageal reflux has nothing to do with your heart, but is due to stomach acids irritating the lining of your esophagus, which is the tube through which food travels from your mouth to your stomach.

Stomach acids are kept in the stomach through a valve-like structure called the esophageal sphincter (ES). If the ES is relaxed due to your body position (lying down) too soon after eating, this will cause gastroesophageal reflux. Other causes of gastroesophageal reflux include eating foods or drinks that stimulate the production of stomach acids (e.g., caffeine, alcohol, chocolate, peppermint), or foods that are naturally acidic like tomatoes or tomato-based foods and citrus fruits (oranges, lemons, etc). There are also lifestyle choices that can contribute to frequent gastroesophageal reflux such as being overweight, eating big meals, or eating too close to bedtime.

To prevent or reduce how often you experience gastroesophageal reflux, avoid eating the foods mentioned previously when it is close to bedtime. Lifestyle changes include: raising your head while sleeping (and not just with pillows, you need to raise the bedposts at least 6-8 inches higher to be effective); eating more frequent, smaller meals, or not eating less than 3 hours before going to sleep; and committing to a regimen of exercise and diet changes that will reduce your body weight to what is normal for your size and age.

A number of over-the-counter medications can help you manage gastroesophageal reflux. Simple antacids like Tums® or Milk of Magnesia® can counteract the acids in the stomach and relieve mild cases of reflux. Stronger over-the-counter medications include what are called H2 blockers like Tagement HB®, Pepcid AC®, and Zantac®. For those with more severe reflux, a class of drugs called proton-pump inhibitors may be more appropriate. Available without presicription as the generic forms of omeprazole (Prilosec®), the drug temporarily reduces acid production all together.

For highly frequent and/or severe gastroesophageal reflux, you should consult your doctor for prescription-strength medication. Without medication, reflux can lead to ulcers, to a more serious condition called Barrett’s esophagus, and possibly esophageal cancer. Clinical evidence indicates that reflux may also worsen respiratory (breathing) disorders like asthma, coughing, and pulmonary fibrosis.

If medications and lifestyle changes do not resolve the problem, there are surgical solutions for gastroesophageal reflux, namely a procedure called Nissen fundoplication, where the upper part of the stomach is wrapped around the ES to strengthen it and to better block stomach acids and food from re-entering the esophagus.

Not only adults experience gastroesophageal reflux; children are vulnerable to reflux for the same reasons as adults. Additionally, parents should look for symptoms that one would not normally associate with reflux, like a hoarse voice, wheezing, asthma-like symptoms, and vomiting. Treatment of reflux in children is similar to those with adults, and you should consult with your pediatrician if your child seems to be experiencing reflux often to rule out more serious conditions.

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