What Is GERD? (And How to Manage It Long-Term)

It's common to have acid reflux – you know, the experience of burping up part of a recently-ingested meal and feeling your throat burn – now and then. But if your throat feels like it's on fire 24/7? And if you're constantly fighting a (losing) battle with your body … trying to stave off chest pain and debilitating nausea? Then you might have something called "gastroesophageal reflux disease" (GERD for short). Okay, so, admittedly, simply knowing the name of the condition you might have isn’t particularly useful. 

That's why this article is going to cover everything you need to know about GERD – from what it is to its causes, and finally to all the things you can do for long-term management and prevention. 

What is GERD?

What is GERD?

For starters, GERD refers to a condition where stomach acid frequently flows back into the esophagus (i.e., the hollow, muscular tube that connects your throat to the stomach). This “backwash” can then irritate the esophageal lining – resulting in all the unpleasant symptoms you’re likely already familiar with: trouble swallowing, feeling like there’s a lump in your throat, icky “fiery-hot” burps, and chest pain (1, 2). And as if these symptoms aren’t bad enough already, research indicates that, when left untreated, GERD can lead to a condition called Barrett’s esophagus, which increases your risk for developing esophageal cancer (3, 4, 5). 

Ugh! So … why is your stomach acid “rebelling” against you? How does it even end up in your esophagus anyway?

What causes GERD?

In short: you can blame your lower esophageal sphincter. As its name implies, it's a band of muscle located at the base of the esophagus, which opens to allow things you swallow to go into your stomach. Then, it's supposed to close (entirely!) again. But for individuals with GERD, it'd appear that the lower esophageal sphincter may not shut as quickly or efficiently as it did in the past – offering stomach acid the opportunity to “sneak back up” into the esophagus. 

The problem with relying on heartburn medication

The problem with relying on heartburn medication

The temptation to reach for heartburn medication – which often provides near-instant relief – is often too great to resist. But you might want to keep this in mind the next time you feel like popping one of those "little purple pills". Several studies have linked proton pump inhibitors (PPIs) to several severe and potentially life-threatening side effects over the years. These include an increased risk of heart disease, certain cancers, dementia, lung disorders, kidney damage, pneumonia, bacterial infections, and even premature death. Whew. Such a long list (6, 7). However, it is important to note that the benefits of making sure your heartburn is controlled, outweighs the potential risks of the potential cellular changes (ie. cancer) that can occur if heartburn goes uncontrolled for any significant amount of time. 

According to this 2017 observational study published in the journal BMJ, U.S. veterans who got new PPI prescriptions were 23% more likely to die than people who didn’t take acid-suppression drugs (8). 23%! Is the “benefit-cost ratio” worth it? Definitely not, especially since there are plenty of lifestyle adjustments you can make that’ll prove effective in easing GERD symptoms. 

Lifestyle changes to better manage GERD

#1: Lose weight 

Wait. Lose weight? That’s right: obesity is the leading cause of frequent heartburn (9, 10, 11, 12). The hypothesis is that excess weight increases abdominal pressure, which further stresses the already-weak lower esophageal sphincter – in turn, increasing the likelihood of stomach acid leakage (or backflow). But, of course, a little disclaimer: whether you do or don't want to lose weight to control your GERD symptoms is totally personal. If you don't want to, that is perfectly fine. There are other lifestyle changes you can make that'll help. But if you want to, well, great! 

The first thing you need to know is that you'll have to stick to a calorie deficit. That means eating fewer calories than your body burns daily (13). There are several dietary strategies out there that'll help you with that – like intermittent fasting and the ketogenic diet. No matter which you choose, though, remember to have patience. Weight loss takes time. That said … there’s also no harm in “supplementing” your efforts with Dr. Danielle’s Alpha Lipoic Acid. According to this 2017 analysis of 12 studies published in Obesity Reviews, individuals who took alpha-lipoic acid lost an average of 2.8 pounds more than those taking a placebo over an average of 23 weeks (14). Talk about a weight-loss hack! 

#2: Ditch the stress

It feels like your chest is beating out of your chest. Your forehead is slick with sweat. And yet … you're not even exercising. Instead, you're simply sitting in your office chair. If that's a common occurrence for you, it's high time you found ways to dial the stress levels way back. That's because studies show that stress and anxiety can provoke acid reflux (or make the symptoms worse) (15, 16, 17). For example, this 2018 study involving more than 19,000 individuals found that those with anxiety were more likely to experience GERD symptoms (18). What’s up with the relationship, though? 

Well, scientists have suggested 3 possible physical reasons for this: 1) stress can reduce pressure in the lower esophageal sphincter, 2) stress can cause muscle tension in the muscles around the stomach, which pushes the acid back up, and 3) high anxiety levels may increase stomach acid production. Regardless of the actual mechanism, though, one thing remains clear. You need to chill. And if you're looking for a super-easy way to lower your stress (almost instantly), look no further than Dr. Danielle’s Stress Lift. It's formulated with a potent mix of "tried-and-tested", stress-busting herbs, including ashwagandha and Siberian Rhodiola root (19, 20). 

#3: Cut down on alcohol intake 

Quick question. Are you drinking too much alcohol? For reference (because you’re likely wondering): according to the Dietary Guidelines for Americans, drinking in moderation means having one drink per day for people assigned female at birth or 2 drinks a day for people assigned male at birth. Meaning? You’ve may have been overdrinking during your usual happy hour meetups with friends and colleagues. And that spells disaster for your GERD – at least, according to this 2019 meta-analysis (21). It found that people who drank more alcohol (or more regularly in general) had a greater likelihood of GERD. 

There are several reasons why this might be so. The first is that alcohol is a known irritant to the gastrointestinal tract; it can directly irritate the tissues in the esophagus (22, 23). More likely than not, though, it’s the fact that alcohol appears to relax the muscles around the stomach (24). And that, in turn, increases the likelihood of your stomach contents “creeping up” the esophageal tract. Takeaway? Cut back on the amount of alcohol that you drink. Oh, and while you’re doing that, don’t forget to apologize to your liver for all the abuse you’ve put it through with Dr. Danielle’s Liver Assist. Just so you know: the active ingredient found within (milk thistle) is regularly used as a complementary therapy by individuals who have liver damage due to conditions like alcoholic liver disease, hepatitis, and even liver cancer (25, 26, 27)! Bonus: milk this may actually aid in weight loss as well

#4: Identify food triggers  

First things first. The specific food triggers for GERD symptoms differ from person to person  (28). For example, your friend who also has GERD may feel perfectly fine after eating 2 tubs of fried chicken – but doing the same might leave you dry heaving right outside the restaurant. That's why you should keep a personal food diary, where you log down various foods you eat and the resulting symptoms (if any). That said, paying extra attention to the foods many people with GERD find most irritating (e.g., citrus-y fruits, coffee, garlic, peppermint, and carbonated beverages) can be an excellent place to start. 

Worried about all that inflammation you’ll rack up in the gut as you figure out your trigger foods? Not to worry. You can count on Dr. Danielle’s Gut Assist to soothe your gastrointestinal tract. Its formulation contains L-glutamine, which has been shown to improve the growth and survival of intestinal cells even during stress – along with another “hero ingredient”, aloe vera, a natural soothing remedy shown to help improve even IBS symptoms (29, 30, 31). 

#5: Be mindful of meal portions  

The successful management of GERD isn’t just about the specific types of foods you eat (or don’t) during mealtimes, either. It’s also about the amount of food you eat. Or, more specifically, the fact that you shouldn’t be overeating at the table. That’s because overeating causes your stomach to expand beyond its normal size – which translates into additional stress on your lower esophageal sphincter. In addition, research shows that the more food you eat, the more stomach acid your body will produce in response (how else does it all get digested?) (32) That’s a double whammy for your gastrointestinal tract that’s bound to end in fiery pain. 

But, of course, there will always be occasions where you can’t help but overeat (e.g., visiting your grandparents or attending social gatherings). That’s where Dr. Danielle’s Digestive Enzymes come into play (33, 34). 

Check in with a doctor where necessary 

If you’ve tried all the tactics mentioned in the article … yet, see no improvements in your GERD symptoms, make sure to check in with your doctor. It is important to make sure GERD is under control so that it does not lead to more serious and life changing side effects. Yes, GERD can interfere with your quality of life and your ability to engage in certain activities (e.g., vigorous exercise), but it is usually very treatable. So, don't hesitate to reach out for help!  

To Your Health and Happiness, Doctor Danielle

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