September 24, 2025 • 36 mins
That burning sensation creeping up your chest after a delicious meal isn't just uncomfortable—it's your body sending you an important message. Dr. Holly Thacker breaks down the crucial differences between occasional acid reflux and chronic GERD, a condition affecting one in three adults that shouldn't be ignored.
Drawing from decades of clinical experience, Dr. Thacker explains how your lower esophageal sphincter functions as the gatekeeper between your stomach and esophagus, and why factors like age, pregnancy hormones, certain medications, and lifestyle choices can compromise this important barrier. You'll learn why that burning sensation happens and how it can lead to more serious complications when left untreated.
Whether you experience occasional heartburn or struggle with chronic reflux, this comprehensive guide provides the knowledge you need to take control of your digestive health. Subscribe to our podcast for more expert insights that help you Be Strong, Be Healthy, and Be in Charge!
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Episode Transcript
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Holly L. Thacker, MD (00:03):
Welcome to another episode of the Speaking
of Women's Health podcast.
I'm your host, dr Holly Thacker, and I am back in the Sunflower
House.
I am the Executive Director ofSpeaking of Women's Health and I
also direct our Center forSpecialized Women's Health, and
(00:24):
I have been seeing women in theoffice for decades.
Also, previously I did a lot ofhospital medicine and saw a lot
of critically ill patients anddid a lot of diagnostic
evaluations.
Now I currently specialize inmenopause women with complex
medical problems who are inmenopause, hormone therapy,
(00:47):
non-hormone therapy therapies,as well as osteoporosis.
But today I'm going to talkabout a very common problem that
affects a lot of people,including adults.
I even remember having it oncebriefly as a child, when I spent
the summer in mexico and Ithink I tried a cactus.
(01:11):
What exactly is acid reflux?
Well, imagine this You'reenjoying a delicious meal.
(01:33):
It may be a spicy Mexican meal,it might be an Indian curry
dish, maybe your favoriteItalian dish, and oh, by the way
, we have a lot of great recipeson Speaking on Women's Health,
so be sure to check those out onspeakingonwomenshealthcom if
you haven't.
So everything's going great,and then bam and it's not like
(01:56):
the bam that Emeril Agassi usedto do to kick it up a notch in
cooking.
It's a feeling of burningsensation creeping up your chest
.
Well, that's acid reflux foryou.
It's kind of like your stomachis throwing up a little bit in
your esophagus, your swallowingtube throwing a temper tantrum,
(02:17):
and it's not very comfortable tohave acid in your esophagus.
Or sometimes it even can go upinto your mouth and throat and
sometimes it can even get intothe lungs.
So when your stomach contents,they're supposed to stay in your
stomach, they're only supposedto go one way down, and so when
(02:39):
acid from inside your stomachflows backwards meaning up, it's
called gastroesophageal reflux,from the stomach to the
esophagus, refluxing backwards.
So that's not a good thing andnot only does it make you not
feel good, but it irritates andinflames the tissue and inflames
(03:02):
the tissue.
Almost everybody has experiencedan occasional episode of acid
reflux.
Could feel like indigestion,could feel like a burning
stomach pain after eating orheartburn.
Some people feel chest pain.
But if you're having substernalchest pain you can't just
(03:23):
assume it's reflux, becausereflux is not going to kill you
or not immediately like a heartattack can.
So don't ever blame unexplainedchest pain, shortness of breath
, exertional discomfort, onheartburn until you've been
evaluated by a physician and, ofcourse, this podcast is not
medical advice.
This podcast is not medicaladvice.
(03:49):
It's just information toempower you to be strong, be
healthy and be in charge.
So are acid reflux and GERDgastroesophageal reflux disease
the same thing?
Well, gerd is a little bit morechronic and severe form of acid
reflux, like what I experiencedas a child transiently was just
acid reflux, it was notgastroesophageal reflux disease.
(04:13):
So if you just have it two ormore times a week, then we start
to get concerned, particularlyif it lasts for more than two
weeks.
It's moderate to severe if itoccurs at least once a week.
And I can tell you one of themost common concerns or mistakes
(04:35):
, so to speak, I see is an adultwho's got acid reflux, but it's
actually GERD.
They've been prescribed an acidreflux, but it's actually GERD.
They've been prescribed an acidreflux medicine and they've
taken it for more than two weeksand they continue to take it
and they haven't had anydiagnostic evaluation.
So if you're over 40 and youhave these symptoms that are
(04:58):
persistent, you can't just takesomething to make yourself feel
better.
The pain should be telling youto evaluate your diet, your
general health and yourgastrointestinal health.
So how common is GERD?
Well, at least one in threepeople are affected, and they
may include backwash, which isthat acidy taste of food or
(05:20):
liquids backwashing in yourmouth.
It's also called regurgitation.
You might notice a very sourtaste in your mouth.
You may feel a burningsensation, because the acid can
literally burn the tissues inyour esophagus.
And if it's felt in your chest,that's why people call it
heartburn.
(05:41):
If it's closer to your stomach,which is usually on the upper
left side of your abdomen,people call that acid
indigestion.
The esophagus pain isinnervated by some of the same
nerves that innervate your heart, and so that's why you can't
tell the difference.
(06:01):
Some people just feel nausea,queasy, like you're losing your
appetite, and although you mayhave eaten several hours ago, it
might feel like your stomach isslow to empty.
And that, of course, happensquite a bit in pregnancy,
because the pregnancy hormonesreally slow the gastrointestinal
tract.
(06:21):
And some of these popularinjectable GLP-1 and JIP some
have more than one action.
Weight loss drugs, which areincredibly popular.
They're being compounded.
Spas are giving them.
I'm certainly not endorsing anyof that.
It's very concerning, I think.
(06:43):
Anytime you inject anything ortake anything in your body, um,
that's not food.
You know you should havemedical supervision, but these
drugs, just like pregnancyhormones, really slow the gut
down.
Some people feel like they justhave chronic sore throat or like
(07:04):
a lump in their throat.
Asthma can be flared andgastroesophageal reflux disease
can trigger asthma-like symptoms, including chronic coughing,
wheezing and shortness of breath.
And if acid particles get inyour airway it can make them
contract and go into spasm.
(07:25):
Reflex symptoms certainly maybe worse while doing certain
activities.
They can get worse at nightafter laying down, especially if
you've had a big meal or afatty meal which slows down your
stomach emptying.
In fact, you know, a helpfultrick for people trying to lose
weight is to ingest higher fat,higher protein and minimal carbs
(07:51):
.
There are no simple carbs intheir meal because the carbs
drive the insulin which driveyour hunger.
Carbs are digested faster andthen your stomach empties faster
, certainly bending over.
I usually get an inversion chairevery day to start my day to
stretch out, and I always do itbefore I eat or drink anything,
(08:11):
because I want my stomach emptyand you really ideally, as an
adult, want your stomach emptybefore you lay down to go to
sleep and unfortunately inAmerica it's a common habit to
not eat all that much during theday, to be busy running around
and then eat a big dinner andthen just keep constantly
snacking until bedtime.
That is not good in general foryour health, for your gut and
(08:35):
if you have a lot of food inyour stomach it's not good
because that can predispose tothis reflux.
With age, especially over age37, the muscles become a little
bit weaker, so with age therecan be more reflux.
With weight gain, the belly'sbigger With pregnancy.
(08:56):
Pregnancy has high hormonelevels, including high
progesterone levels.
That further relaxes theesophageal sphincter.
A lot of women on menopausalhormones who have a uterus need
progesterone or progestins andthe natural progesterone is a
natural relaxant of thegastroesophageal muscles.
(09:16):
And since progesterone can beconverted into allopregnenolone,
which is a natural sedativehypnotic, can be converted into
allopregnenolone, which is anatural sedative hypnotic, we
always tell women to take theprogesterone with some food
after dinner, food to protectthe delicate hormone and help
with absorption, not because ithurts your stomach.
But there are women who getworsening reflux and so natural
(09:39):
progesterone or bioidentical ofall types of hormones isn't for
everyone and is not necessarilybetter.
And if you haven't heard mypodcast, I think it was in
season one on bioidenticalhormones.
Are they better or not?
What's all the hype about?
That's a good one to go back tolisten to.
So on the other spectrum of age, babies.
(10:01):
Babies can get acid reflux orGERD, and I've certainly had a
lot of babies in my life,expecting my fifth grandchild
any day now, and it's normal forbabies to spit up or
regurgitate.
There might be some acid in it,but usually not enough to
(10:22):
bother the baby.
Gerd is a more significant andsevere condition that can cause
complications with feeding ormore distress.
Babies are more likely to haveGERD if they're born prematurely
or with any kind of conditionthat affects their esophagus,
the swallowing tube, and so apediatrician or family medicine
(10:46):
doctor may check for GERD ifyour baby seems to be struggling
.
And some symptoms of GERD inbabies or small children can
include fussiness althoughbabies do fuss, especially when
tired or hungry.
Colic is excessive.
Fussiness, difficulty sleeping,refusing to feed can be
concerning small, recurrentvomiting episodes, wheezing or
(11:10):
hoarseness, and potentially badbreath.
So why does this happen?
What causes acid reflux?
Well, for acid to get into youresophagus, it has to get past
that valve at the bottom of youresophagus that usually keeps
things from coming up, theso-called lower esophageal
sphincter, the one that weakenswith age and weakens or gets
(11:33):
more relaxed with naturalprogesterone.
And your LES is a circularmuscle that opens when you
swallow and then closes afteryou're done.
It can open up to let a littlegas bubbles up if you're burping
or if you're having hiccups.
Acid reflux happens when yourLES weakens or relaxes enough to
(11:53):
let that acid pass up.
So don't lie down after eatinga large meal.
Many things can contribute toweakening your LES, either
temporarily or permanently, andsometimes occasional acid reflux
does turn into chronic GERD ifthese symptoms overlap.
If you have a hiatal hernia,that's when the top of your
(12:16):
stomach pushes up through thehole in the muscular diaphragm
where your esophagus passesthrough, it moves your LES above
your diaphragm, so then itloses further muscular support.
Heidel hernias are more commonwith age.
They can occur gradually orhappen all of a sudden.
Pregnancy, pregnant women andwe've had a whole nice group of
(12:42):
pregnant women at work and inour family and certainly
pregnant women have a higherincidence of reflux, in part due
to more progesterone, alsocarrying that extra weight and
having more pressure in theabdomen.
That puts a lot more pressureon the abdomen Obesity, which
unfortunately is continuing toincrease in all age groups, can
(13:07):
affect the lower esophagealsphincter tone and unfortunately
obesity lasts usually a lotlonger than the nine months of
pregnancy, of which only reallyfive months are women visibly
generally bigger.
So obesity is a commoncontributing factor to getting a
hiatal hernia.
And since fat tissue may helpor may affect your hormones and
(13:34):
being higher in body weight caninhibit appropriate ovulation,
which can reduce progesteroneexcretion, that can increase
hormonal imbalance and uterinehyperplasia and even uterine
cancer Smoking well you knowtobacco is pretty much bad for
most all things.
(13:55):
For the most part, certainly foryour lungs.
There are nicotine receptors inthe body and you know there are
some research studies lookinginto nicotine for ulcerative
colitis and COVID, chronic longCOVID, but for the most part
tobacco smoke, any type oftobacco products which are very
(14:17):
addictive, have so much morerisk than benefit and tobacco
does really relax your loweresophageal sphincter and whether
you're smoking yourself or justbreathing it in second hand,
smoking can trigger coughingwhich opens up.
When you cough, it opens upyour lower esophageal sphincter.
(14:39):
So if you smoke and youchronically cough, have weaker
diaphragm muscles so thereforeyou're more likely you guessed
it to get a hiatal hernia andsmoking slows down your
digestion and it causes yourstomach to make more acid.
It's, unfortunately, one reasonwhy I've heard women tell me
they want to keep smokingbecause it takes away their
(15:00):
appetite and helps keep theirweight down, but there's a lot
of other things you can do totame that appetite.
So if weight is your concern,go back and listen to some of
our great podcasts where I'veinterviewed weight loss experts
or covered this huge topic nopun intended in great detail,
because that's women's reallygreatest concern with age is
(15:24):
weight.
A lot of women think that's amenopausal symptom, which it
actually isn't.
It's an age and lifestylerelated symptom.
And if you're a smoker and youwant to be smoke-free, go back
and listen to the edition we hadon smoking cessation done by
our executive producer, leeKleckar, which was fabulous.
(15:44):
Other causes ofgastroesophageal reflux birth
defects like congenital defects,like esophageal atresia and
hernias can affect a baby'slower esophageal sphincter.
Connective tissue disease likescleroderma.
Prior surgery in the chest orupper abdomen.
(16:05):
Lots of medications can have arelaxing effect on muscles
Sometimes that's needed formuscle spasm, and
benzodiazepines are used foranxiety and muscle spasm and
insomnia, and sometimes usedpreoperatively.
They can be very addictive,though, and they can lower your
LES.
Calcium channel blockers, whichare used to help prevent
(16:28):
migraine headache, to treat highblood pressure, can do that.
Tricyclic antidepressants,which in low doses can be used
for sleep, for pain, and higherdoses for depression.
The big category of NSAIDsnon-steroidal anti-inflammatory
agents like aspirin andibuprofen definitely can
(16:52):
irritate both the stomach andthe LES.
Theophylline, which is kind ofan older medicine not used as
much because of othermedications supplanting it and
side effects.
It's a common asthma medicationthat can make heartburn worse.
And the progesterone, thenatural progesterone which is in
Prometrium, which is mixed inpeanut oil so you can't be
(17:14):
allergic to peanuts.
It's in BiJuva, thebioidentical estradiol, with 100
milligrams of progesterone incoconut oil, and that comes in
two doses a standard 1 milligram100 dose or a 50 milligram, 100
milligram, same dose ofprogesterone.
Do foods cause acid reflux?
Well, generally speaking alonethey're usually not enough, but
(17:39):
they certainly can contribute toit and some people are a lot
more sensitive to some foods andsubstances than others.
And then if you mix it alltogether you could have an issue
.
And some of them are favorites,like chocolate.
If you didn't listen to mypodcast on why women crave
chocolate and the differentneurotransmitters that affect
(18:00):
the brain, that's a fun one togo back to.
Neurotransmitters that affectthe brain, that's a fun one to
go back to.
And chocolate dark chocolatehas antioxidants, has magnesium
and a little bit of iron too.
So it's not a junk food unlessit's mixed with a bunch of extra
sugar and other artificialflavors and sweeteners and
additives.
Coffee, coffee, tea or me, blackcoffee, green tea help reduce
(18:23):
fatty liver and we're having anepidemic of fatty liver.
Non-alcoholic liver diseaseDiado hepatitis, can lead to
cirrhosis in one in six womenwho don't even drink alcohol.
So coffee has a lot of healthbenefits.
It's probably primarily thecaffeine.
I have this disagreement withmy PhD son Stetson.
(18:44):
He it's probably primarily thecaffeine.
I have this disagreement withmy PhD son Stetson.
He thinks it's just thecaffeine.
But there are some otherantioxidants in the coffee bean.
And so when I tell patients ifthey're not overly sensitive to
caffeine or slow metabolizers,that from a metabolic and
anti-aging perspective and someevidence to suggest less
(19:07):
Parkinson's disease andAlzheimer's disease, that a cup
or two of black coffee a day.
And or if you don't like coffeeand I really don't like the
taste of coffee, but it's kindof a habit I just drink black
coffee in the morning becauseit's easy, it smells good, but I
don't really like the coffeebreath.
But green tea.
So a lot of times I do greentea and I wrote a really nice
(19:28):
column on green teas and it tookme years.
I knew it was good for me but Ialways thought green tea tasted
like dirty gym socks.
But then I found the Republicof Tea and they had some really
great flavors A lean one thathas a little cinnamon in it,
pomegranate green tea, blueberrygreen tea I've gotten a ginseng
(19:52):
green tea which is a little bitof perk me up, and then a
double matcha green tea andthere are a lot of anti-cancer
benefits.
And of course, no added sugar.
Just plain has a little bit ofcaffeine too.
But green tea and coffee, justlike chocolate, can also
(20:12):
increase heartburn in somepeople.
Alcohol and really alcohol isnot essential.
It is a neurotoxin, it is badfor the liver.
It does increase cancer of themouth and throat.
Don't even use alcoholmouthwash, but many people do
socially drink.
Unfortunately there are peoplethat do get addicted to alcohol
(20:36):
and up to 20% of people can, andhopefully in the future we can
have some more information onour Speaking of Women's Health
podcast on this and really anytopic that you want us to see
covering.
On the Speaking of Women'sHealth podcast, which you're
listening to, and I'm your host,dr Holly Thacker, we're in the
Sunflower House talking aboutall things GERD, but anything
(20:59):
that you listeners areinterested in.
If you go onspeakingofwomenshealthcom and
touch the contact part and sendus an email, that will let us
know what topics you listenersare interested in.
And for our listeners that aresubscribing and donating, which
this podcast is completely freeall of our social media is free.
(21:21):
We certainly really appreciateyou for helping to support us
getting this good, unbiasedhealth information out to women.
(21:46):
Garlic and garlic has a lot ofhealth benefits and onions my
husband likes to say that garlicand onion is my favorite
perfume.
He's not as much of a fan as Iam, but these things in high
doses can have an effect on yourLES.
Now, fatty foods do increasestomach acid and they take much
longer to digest, so there's alot more opportunity for acid to
escape, and if you're having aheavier meal for dinner, which
(22:08):
isn't as good, you should haveyour bigger meal earlier.
You may not clear out all thefood by the time it's time to
lay down, and that's especiallytrue if you're pregnant or on
these GLP antagonists.
What are the possiblecomplications of chronic acid
reflux?
Or on these GLP antagonists?
What are the possiblecomplications of chronic acid
(22:31):
reflux?
Well, there's a few that areconcerning, and a little bit of
acid may momentarily not feel sogood, but a lot of acid does
injure it.
Your organs, like your esophagus, can cause esophagitis, which
is inflammation in the lining ofthe esophagus.
Chronic esophagitis can causepain, ulcers, scarring and over
(22:56):
time it can cause intestinalmetaplasia, a precancerous
condition.
Barrett's esophagus is the namefor intestinal metaplasia of
your esophagus and it means thatthe lining of your esophagus
has changed to look more likeintestinal lining.
This change happens after longexposure and it's a risk factor
(23:18):
for esophageal cancer, which canbe deadly.
Esophageal stricture If youresophagus gets injured, it can
develop scar tissue to preventit from chronic inflammation.
Scar tissue can cause youresophagus to narrow, causing a
stricture making it hard toswallow.
Some people have to go in andhave the Schatzky ring dilated.
(23:46):
Laryngeal reflux is called LPRand that's when reflux travels
to your throat when you'resleeping.
It can cause swelling andhoarseness and vocal cord growth
and it's not good to aspiratestuff that belongs in your
stomach into your lungs.
It can make asthma worse,breathing problems worse.
Sometimes can even lead toreflux, can lead to pneumonia
(24:10):
and persons that haveneuromuscular disorders like
parkinson's disease, potentiallydisease, potentially myasthenia
gravis, although less likely,any kind of neurocognitive
problems, als, so-called LouGehrig's disease, anything that
can impair swallowing stroke.
(24:32):
We have to be even morevigilant about the whole chewing
and swallowing mechanism.
So how is acid reflux and GERDdiagnosed?
Well, your primary carephysician or your
gastroenterologist, if you'rereferred to one, might want to
do an esophagram x-ray to seehow your esophagus moves when
(24:55):
swallowing.
You drink this chalky liquidwhite material called barium.
You may have an upper endoscopy, a little lighted scope, very
small, with a camera drop downto your swallowing tube when
you're asleep under lightsedation and when I see patients
that are due for their coloncancer screening, which we push
(25:21):
down to the average age not highrisk, but average age to 45.
If you have a family history ofit you have to undergo it
sooner.
But if you've had stomach upset, some GERD, you've been taking
anti-acid medicine, even if it'snot been on a long-term basis,
it may be good to schedule yourupper endoscopy at the same time
you get your lower endoscopy.
You may need an esophageal pHtest which actually measures how
(25:45):
much acid is in your esophagusthrough a little small wireless
receiver.
Esophageal manometry actuallytests your muscle activity and
how.
There's little pressure sensorsthat are inserted through a
nasogastric tube.
There's little pressure sensorsthat are inserted through a
nasogastric tube.
So what do you do if you havereflux?
Well, first is food, and ofcourse many of us, including me,
(26:10):
love spicy tacos and chocolatedesserts.
In fact, stetson, who's been aguest, my son, no relation to me
the PhD, who many of thelisteners have asked for me to
bring him back, so I guess I'llhave to bring him back again in
upcoming season four we're inseason three right now.
(26:30):
He tells me that you don't haveto have tacos every Tuesday.
You know he likes to come overand eat, sometimes by himself
and most of the time nowadayswith his family.
And then he said he just has toremind me because I might
forget.
I don't, I don't know why hethinks I'm.
I'm forgetting gnome, hisfather, who's my husband, and I
(26:51):
like Mexican food, oh, and I,how stuffed jalapenos are my
favorite and of course, I lovechocolate.
Um, and I like a lot of rich,tasty foods, but for some people
they can really be triggers andI like to put hot sauce on a
lot of foods.
I remember taking my nephewKeaton who's now all grown with
a son, my nephew Samuel Gray outat a barbecue joint and he was,
(27:19):
you know, daring me to get the,to get the 101 fire alarm hot
sauce which I took and atewithout a problem.
But some people can't even takeeven the tiniest spice.
So there's a lot of geneticsusceptibility and some of it
gets worse or changes with age.
So if you can't tolerate allthat spice, try to do something
(27:41):
blander, more gentler, like leanmeats, bananas, oatmeal.
Some people find they can reallyreduce their acid reflux just
with lifestyle changes likegetting rid of the alcohol and
tobacco, elevating the head ofthe bed so that your stomach is
lower than your chest, andwhenever I suggest this to
(28:02):
patients they say, oh, don'tworry, doc, I have two pillows,
but that actually scrunches upyour stomach and makes it worse.
So having a bed electronic thatkind of tilts you so your
stomach is less lower than yourchest is the best.
Pillows are not enough.
You can get a six inch cinderblock and put it, you know,
equally under the head of yourbed.
(28:23):
Um, losing weight.
Even five or 10 pounds can makea big difference on the stomach
and apparently 13 pounds is themagic number to really take
some of the pressure off, uh,your lower joints if you're
having a lot of joint pain, someof the pressure off your lower
joints if you're having a lot ofjoint pain.
But if you have chronic GERD orreflux you may need medications
(28:45):
.
Now there are over-the-counterso-called antacids like Tums and
Rolaids.
Those are really actually justcalcium carbonate and some
people feel better with that.
But you don't want to take toomuch calcium.
They're not a long-termsolution and sometimes calcium
(29:11):
can actually stimulate acidsecretion.
If you do need to take calciumand you don't have very much
stomach acid because maybeyou're taking a proton pump
inhibitor, then you have to takecalcium citrate, which does not
require acid to be absorbed.
And if you've ever had kidneystones and you're not a big
dairy ingester and you have totake a calcium supplement, then
calcium citrate usually thecitrate salt, is best at helping
(29:32):
to reduce kidney stones.
Alginates Alginates arenaturally occurring sugars
derived from seaweed and theyhelp block acid reflux by
floating on top of the acid,kind of creating a physical
barrier between the acid andyour esophagus and you can get
alginates by themselves or youcan get over-the-counter
(29:54):
antacids with these alginates.
Now there is a whole slew ofprescription medications that
can be used.
Some of the H2 histaminereceptor blockers reduce stomach
acid by just directly reducingacid that's made in the stomach.
It tells your body what they dois they reduce acid in the
(30:19):
stomach by blocking the chemicalthat tells your body to make
stomach acid, which is histamine, and you can take them a little
more frequently than antacids.
Your body can adapt to theirside effects and don't always
work long term.
Tagamet was one of the firstones and that's now over the
(30:40):
counter.
It has a lot of drug-druginteractions.
Renetadine or Zantac was apopular one and that went over
the counter.
Then it was pulled from themarket because how it was being
manufactured apparently wascontaminated with carcinogens
Yikes.
You can certainly get Pepsid,famotidine, pepsid AC.
(31:02):
They make a chewable one thatcan help transient acid reflux
problems.
Now PPIs are much stronger.
They're PPIs.
They're generally prescription.
There may be a lower dose nowover the counter prescription.
(31:23):
There may be a lower dose nowover the counter and your
clinician may prescribe themfirst line if there's signs of
damage to your esophagus andthey're about 90% effective.
So PPIs like Prilosec andPrevacid definitely reduce B12
absorption and we're not happyabout that.
So you also do need acid tohelp digest food and also ward
off infection.
(31:43):
So I don't think it's a goodidea to take the PPIs for more
than two weeks unless you'vereally been evaluated and you've
done a lot of lifestyle issues.
A lot of times they're given inthe hospital when people are in
intensive care unit and they mayincrease certain types of
pneumonia.
Because, again, stomach acid isvery important in your general
(32:07):
health, just like your gutmicrobiome.
So prebiotics and probioticscan be very important for your
gut health.
Baclofen is a muscle relaxantand it's also prescribed to
reduce muscle spasms.
Sometimes it might help reducethat frequency of LES relaxation
, but it's certainly not firstline treatment by any means and
(32:31):
it can be sedating.
So medicines can reduce thesymptoms.
It doesn't totally stop it.
You might need more definitivetreatment.
Sometimes it can be a procedureto tighten the lower esophageal
sphincter.
It could be more involvedsurgery like nissen
fundoplication, which is themost common surgery for GERD.
(32:54):
Now it's done laparoscopically,which means smaller incisions
and usually a shorter recoverytime.
A surgeon actually takes thetop of your stomach to wrap it
around that lower esophagealarea to help secure it and
stitch it to keep a tighterjunction.
This is also the same processthat's used to fix a hiatal
(33:17):
hernia.
There's a LINX device L-I-N-Xit's a newer procedure implant
that's a tiny ring of magnetsthat help keep that junction
closed.
Certainly, take home tips foryou and your family.
Eat smaller meals.
Get smaller plates.
You don't want to overstimulateyour stomach, you don't want to
(33:40):
overeat.
Eat dinner earlier.
Be a blue hair.
I have a good friend, she andher husband.
They want to go out to eat withus at 4 pm.
So that only means the weekendsbecause I am not home from the
office by then.
But eating dinner is better anda lot of times if you go out to
restaurants you get a cheaperprice.
(34:01):
In fact I was telling a friendthe other day who was going to
New Orleans that you know theyhave great restaurants there,
lots of rich food and veryexpensive food, and when my
husband and I visited there wewent for lunch.
You get the same great food,but it's usually slightly
smaller portions and much lessexpensive.
And then if you're having a bigheavy meal, just have that at
(34:22):
lunch and then you can just havea late snack for dinner.
Gravity plays a very importantrole in keeping the food down,
so you don't want to be doinghandstands and backflips and
going on your reversion tableafter eating a big meal,
sleeping on your left side,because that keeps your stomach
position lower.
Raising the head of the bedupwards is very helpful.
(34:45):
Reducing abdominal pressure byweight loss, delivering that
baby wearing loose, fittingclothing don't wear any tight
corsets and not smoking.
And getting rid of alcohol thatreally can be very, very
helpful.
Try those over-the-counterantacids with the alginates on
(35:09):
hand A lot of times.
These small tweaks can really,really make a big difference.
And if you're having symptomsthat persist or you've been
taking a medicine for more thantwo weeks straight, it's time to
make an appointment.
You might need to see agastroenterologist that
specializes in the digestivesystem.
So I hope this podcast didn'tgive you heartburn.
(35:34):
I hope it helped alleviate yoursymptoms or at least educate
you in case one of your lovedones in the future is suffering
with these symptoms.
All right, folks, that's a wrapfor today's episode.
Remember this is a commonproblem.
There's lots of ways to feelbetter.
Thanks for tuning in.
Don't forget to subscribe toour podcast.
(35:57):
Follow us, it's free.
Thanks again for listening andgive us a five-star rating.
Share this podcast with yourfriends and family and I'll see
you next time in the SunflowerHouse.
Remember be strong, be healthyand be in charge.
Welcome to another episode of the Speaking
of Women's Health podcast.
I'm your host, dr Holly Thacker, and I am back in the Sunflower
House.
I am the Executive Director ofSpeaking of Women's Health and I
also direct our Center forSpecialized Women's Health, and
(00:24):
I have been seeing women in theoffice for decades.
Also, previously I did a lot ofhospital medicine and saw a lot
of critically ill patients anddid a lot of diagnostic
evaluations.
Now I currently specialize inmenopause women with complex
medical problems who are inmenopause, hormone therapy,
(00:47):
non-hormone therapy therapies,as well as osteoporosis.
But today I'm going to talkabout a very common problem that
affects a lot of people,including adults.
I even remember having it oncebriefly as a child, when I spent
the summer in mexico and Ithink I tried a cactus.
(01:11):
What exactly is acid reflux?
Well, imagine this You'reenjoying a delicious meal.
(01:33):
It may be a spicy Mexican meal,it might be an Indian curry
dish, maybe your favoriteItalian dish, and oh, by the way
, we have a lot of great recipeson Speaking on Women's Health,
so be sure to check those out onspeakingonwomenshealthcom if
you haven't.
So everything's going great,and then bam and it's not like
(01:56):
the bam that Emeril Agassi usedto do to kick it up a notch in
cooking.
It's a feeling of burningsensation creeping up your chest
.
Well, that's acid reflux foryou.
It's kind of like your stomachis throwing up a little bit in
your esophagus, your swallowingtube throwing a temper tantrum,
(02:17):
and it's not very comfortable tohave acid in your esophagus.
Or sometimes it even can go upinto your mouth and throat and
sometimes it can even get intothe lungs.
So when your stomach contents,they're supposed to stay in your
stomach, they're only supposedto go one way down, and so when
(02:39):
acid from inside your stomachflows backwards meaning up, it's
called gastroesophageal reflux,from the stomach to the
esophagus, refluxing backwards.
So that's not a good thing andnot only does it make you not
feel good, but it irritates andinflames the tissue and inflames
(03:02):
the tissue.
Almost everybody has experiencedan occasional episode of acid
reflux.
Could feel like indigestion,could feel like a burning
stomach pain after eating orheartburn.
Some people feel chest pain.
But if you're having substernalchest pain you can't just
(03:23):
assume it's reflux, becausereflux is not going to kill you
or not immediately like a heartattack can.
So don't ever blame unexplainedchest pain, shortness of breath
, exertional discomfort, onheartburn until you've been
evaluated by a physician and, ofcourse, this podcast is not
medical advice.
This podcast is not medicaladvice.
(03:49):
It's just information toempower you to be strong, be
healthy and be in charge.
So are acid reflux and GERDgastroesophageal reflux disease
the same thing?
Well, gerd is a little bit morechronic and severe form of acid
reflux, like what I experiencedas a child transiently was just
acid reflux, it was notgastroesophageal reflux disease.
(04:13):
So if you just have it two ormore times a week, then we start
to get concerned, particularlyif it lasts for more than two
weeks.
It's moderate to severe if itoccurs at least once a week.
And I can tell you one of themost common concerns or mistakes
(04:35):
, so to speak, I see is an adultwho's got acid reflux, but it's
actually GERD.
They've been prescribed an acidreflux, but it's actually GERD.
They've been prescribed an acidreflux medicine and they've
taken it for more than two weeksand they continue to take it
and they haven't had anydiagnostic evaluation.
So if you're over 40 and youhave these symptoms that are
(04:58):
persistent, you can't just takesomething to make yourself feel
better.
The pain should be telling youto evaluate your diet, your
general health and yourgastrointestinal health.
So how common is GERD?
Well, at least one in threepeople are affected, and they
may include backwash, which isthat acidy taste of food or
(05:20):
liquids backwashing in yourmouth.
It's also called regurgitation.
You might notice a very sourtaste in your mouth.
You may feel a burningsensation, because the acid can
literally burn the tissues inyour esophagus.
And if it's felt in your chest,that's why people call it
heartburn.
(05:41):
If it's closer to your stomach,which is usually on the upper
left side of your abdomen,people call that acid
indigestion.
The esophagus pain isinnervated by some of the same
nerves that innervate your heart, and so that's why you can't
tell the difference.
(06:01):
Some people just feel nausea,queasy, like you're losing your
appetite, and although you mayhave eaten several hours ago, it
might feel like your stomach isslow to empty.
And that, of course, happensquite a bit in pregnancy,
because the pregnancy hormonesreally slow the gastrointestinal
tract.
(06:21):
And some of these popularinjectable GLP-1 and JIP some
have more than one action.
Weight loss drugs, which areincredibly popular.
They're being compounded.
Spas are giving them.
I'm certainly not endorsing anyof that.
It's very concerning, I think.
(06:43):
Anytime you inject anything ortake anything in your body, um,
that's not food.
You know you should havemedical supervision, but these
drugs, just like pregnancyhormones, really slow the gut
down.
Some people feel like they justhave chronic sore throat or like
(07:04):
a lump in their throat.
Asthma can be flared andgastroesophageal reflux disease
can trigger asthma-like symptoms, including chronic coughing,
wheezing and shortness of breath.
And if acid particles get inyour airway it can make them
contract and go into spasm.
(07:25):
Reflex symptoms certainly maybe worse while doing certain
activities.
They can get worse at nightafter laying down, especially if
you've had a big meal or afatty meal which slows down your
stomach emptying.
In fact, you know, a helpfultrick for people trying to lose
weight is to ingest higher fat,higher protein and minimal carbs
(07:51):
.
There are no simple carbs intheir meal because the carbs
drive the insulin which driveyour hunger.
Carbs are digested faster andthen your stomach empties faster
, certainly bending over.
I usually get an inversion chairevery day to start my day to
stretch out, and I always do itbefore I eat or drink anything,
(08:11):
because I want my stomach emptyand you really ideally, as an
adult, want your stomach emptybefore you lay down to go to
sleep and unfortunately inAmerica it's a common habit to
not eat all that much during theday, to be busy running around
and then eat a big dinner andthen just keep constantly
snacking until bedtime.
That is not good in general foryour health, for your gut and
(08:35):
if you have a lot of food inyour stomach it's not good
because that can predispose tothis reflux.
With age, especially over age37, the muscles become a little
bit weaker, so with age therecan be more reflux.
With weight gain, the belly'sbigger With pregnancy.
(08:56):
Pregnancy has high hormonelevels, including high
progesterone levels.
That further relaxes theesophageal sphincter.
A lot of women on menopausalhormones who have a uterus need
progesterone or progestins andthe natural progesterone is a
natural relaxant of thegastroesophageal muscles.
(09:16):
And since progesterone can beconverted into allopregnenolone,
which is a natural sedativehypnotic, can be converted into
allopregnenolone, which is anatural sedative hypnotic, we
always tell women to take theprogesterone with some food
after dinner, food to protectthe delicate hormone and help
with absorption, not because ithurts your stomach.
But there are women who getworsening reflux and so natural
(09:39):
progesterone or bioidentical ofall types of hormones isn't for
everyone and is not necessarilybetter.
And if you haven't heard mypodcast, I think it was in
season one on bioidenticalhormones.
Are they better or not?
What's all the hype about?
That's a good one to go back tolisten to.
So on the other spectrum of age, babies.
(10:01):
Babies can get acid reflux orGERD, and I've certainly had a
lot of babies in my life,expecting my fifth grandchild
any day now, and it's normal forbabies to spit up or
regurgitate.
There might be some acid in it,but usually not enough to
(10:22):
bother the baby.
Gerd is a more significant andsevere condition that can cause
complications with feeding ormore distress.
Babies are more likely to haveGERD if they're born prematurely
or with any kind of conditionthat affects their esophagus,
the swallowing tube, and so apediatrician or family medicine
(10:46):
doctor may check for GERD ifyour baby seems to be struggling
.
And some symptoms of GERD inbabies or small children can
include fussiness althoughbabies do fuss, especially when
tired or hungry.
Colic is excessive.
Fussiness, difficulty sleeping,refusing to feed can be
concerning small, recurrentvomiting episodes, wheezing or
(11:10):
hoarseness, and potentially badbreath.
So why does this happen?
What causes acid reflux?
Well, for acid to get into youresophagus, it has to get past
that valve at the bottom of youresophagus that usually keeps
things from coming up, theso-called lower esophageal
sphincter, the one that weakenswith age and weakens or gets
(11:33):
more relaxed with naturalprogesterone.
And your LES is a circularmuscle that opens when you
swallow and then closes afteryou're done.
It can open up to let a littlegas bubbles up if you're burping
or if you're having hiccups.
Acid reflux happens when yourLES weakens or relaxes enough to
(11:53):
let that acid pass up.
So don't lie down after eatinga large meal.
Many things can contribute toweakening your LES, either
temporarily or permanently, andsometimes occasional acid reflux
does turn into chronic GERD ifthese symptoms overlap.
If you have a hiatal hernia,that's when the top of your
(12:16):
stomach pushes up through thehole in the muscular diaphragm
where your esophagus passesthrough, it moves your LES above
your diaphragm, so then itloses further muscular support.
Heidel hernias are more commonwith age.
They can occur gradually orhappen all of a sudden.
Pregnancy, pregnant women andwe've had a whole nice group of
(12:42):
pregnant women at work and inour family and certainly
pregnant women have a higherincidence of reflux, in part due
to more progesterone, alsocarrying that extra weight and
having more pressure in theabdomen.
That puts a lot more pressureon the abdomen Obesity, which
unfortunately is continuing toincrease in all age groups, can
(13:07):
affect the lower esophagealsphincter tone and unfortunately
obesity lasts usually a lotlonger than the nine months of
pregnancy, of which only reallyfive months are women visibly
generally bigger.
So obesity is a commoncontributing factor to getting a
hiatal hernia.
And since fat tissue may helpor may affect your hormones and
(13:34):
being higher in body weight caninhibit appropriate ovulation,
which can reduce progesteroneexcretion, that can increase
hormonal imbalance and uterinehyperplasia and even uterine
cancer Smoking well you knowtobacco is pretty much bad for
most all things.
(13:55):
For the most part, certainly foryour lungs.
There are nicotine receptors inthe body and you know there are
some research studies lookinginto nicotine for ulcerative
colitis and COVID, chronic longCOVID, but for the most part
tobacco smoke, any type oftobacco products which are very
(14:17):
addictive, have so much morerisk than benefit and tobacco
does really relax your loweresophageal sphincter and whether
you're smoking yourself or justbreathing it in second hand,
smoking can trigger coughingwhich opens up.
When you cough, it opens upyour lower esophageal sphincter.
(14:39):
So if you smoke and youchronically cough, have weaker
diaphragm muscles so thereforeyou're more likely you guessed
it to get a hiatal hernia andsmoking slows down your
digestion and it causes yourstomach to make more acid.
It's, unfortunately, one reasonwhy I've heard women tell me
they want to keep smokingbecause it takes away their
(15:00):
appetite and helps keep theirweight down, but there's a lot
of other things you can do totame that appetite.
So if weight is your concern,go back and listen to some of
our great podcasts where I'veinterviewed weight loss experts
or covered this huge topic nopun intended in great detail,
because that's women's reallygreatest concern with age is
(15:24):
weight.
A lot of women think that's amenopausal symptom, which it
actually isn't.
It's an age and lifestylerelated symptom.
And if you're a smoker and youwant to be smoke-free, go back
and listen to the edition we hadon smoking cessation done by
our executive producer, leeKleckar, which was fabulous.
(15:44):
Other causes ofgastroesophageal reflux birth
defects like congenital defects,like esophageal atresia and
hernias can affect a baby'slower esophageal sphincter.
Connective tissue disease likescleroderma.
Prior surgery in the chest orupper abdomen.
(16:05):
Lots of medications can have arelaxing effect on muscles
Sometimes that's needed formuscle spasm, and
benzodiazepines are used foranxiety and muscle spasm and
insomnia, and sometimes usedpreoperatively.
They can be very addictive,though, and they can lower your
LES.
Calcium channel blockers, whichare used to help prevent
(16:28):
migraine headache, to treat highblood pressure, can do that.
Tricyclic antidepressants,which in low doses can be used
for sleep, for pain, and higherdoses for depression.
The big category of NSAIDsnon-steroidal anti-inflammatory
agents like aspirin andibuprofen definitely can
(16:52):
irritate both the stomach andthe LES.
Theophylline, which is kind ofan older medicine not used as
much because of othermedications supplanting it and
side effects.
It's a common asthma medicationthat can make heartburn worse.
And the progesterone, thenatural progesterone which is in
Prometrium, which is mixed inpeanut oil so you can't be
(17:14):
allergic to peanuts.
It's in BiJuva, thebioidentical estradiol, with 100
milligrams of progesterone incoconut oil, and that comes in
two doses a standard 1 milligram100 dose or a 50 milligram, 100
milligram, same dose ofprogesterone.
Do foods cause acid reflux?
Well, generally speaking alonethey're usually not enough, but
(17:39):
they certainly can contribute toit and some people are a lot
more sensitive to some foods andsubstances than others.
And then if you mix it alltogether you could have an issue
.
And some of them are favorites,like chocolate.
If you didn't listen to mypodcast on why women crave
chocolate and the differentneurotransmitters that affect
(18:00):
the brain, that's a fun one togo back to.
Neurotransmitters that affectthe brain, that's a fun one to
go back to.
And chocolate dark chocolatehas antioxidants, has magnesium
and a little bit of iron too.
So it's not a junk food unlessit's mixed with a bunch of extra
sugar and other artificialflavors and sweeteners and
additives.
Coffee, coffee, tea or me, blackcoffee, green tea help reduce
(18:23):
fatty liver and we're having anepidemic of fatty liver.
Non-alcoholic liver diseaseDiado hepatitis, can lead to
cirrhosis in one in six womenwho don't even drink alcohol.
So coffee has a lot of healthbenefits.
It's probably primarily thecaffeine.
I have this disagreement withmy PhD son Stetson.
(18:44):
He it's probably primarily thecaffeine.
I have this disagreement withmy PhD son Stetson.
He thinks it's just thecaffeine.
But there are some otherantioxidants in the coffee bean.
And so when I tell patients ifthey're not overly sensitive to
caffeine or slow metabolizers,that from a metabolic and
anti-aging perspective and someevidence to suggest less
(19:07):
Parkinson's disease andAlzheimer's disease, that a cup
or two of black coffee a day.
And or if you don't like coffeeand I really don't like the
taste of coffee, but it's kindof a habit I just drink black
coffee in the morning becauseit's easy, it smells good, but I
don't really like the coffeebreath.
But green tea.
So a lot of times I do greentea and I wrote a really nice
(19:28):
column on green teas and it tookme years.
I knew it was good for me but Ialways thought green tea tasted
like dirty gym socks.
But then I found the Republicof Tea and they had some really
great flavors A lean one thathas a little cinnamon in it,
pomegranate green tea, blueberrygreen tea I've gotten a ginseng
(19:52):
green tea which is a little bitof perk me up, and then a
double matcha green tea andthere are a lot of anti-cancer
benefits.
And of course, no added sugar.
Just plain has a little bit ofcaffeine too.
But green tea and coffee, justlike chocolate, can also
(20:12):
increase heartburn in somepeople.
Alcohol and really alcohol isnot essential.
It is a neurotoxin, it is badfor the liver.
It does increase cancer of themouth and throat.
Don't even use alcoholmouthwash, but many people do
socially drink.
Unfortunately there are peoplethat do get addicted to alcohol
(20:36):
and up to 20% of people can, andhopefully in the future we can
have some more information onour Speaking of Women's Health
podcast on this and really anytopic that you want us to see
covering.
On the Speaking of Women'sHealth podcast, which you're
listening to, and I'm your host,dr Holly Thacker, we're in the
Sunflower House talking aboutall things GERD, but anything
(20:59):
that you listeners areinterested in.
If you go onspeakingofwomenshealthcom and
touch the contact part and sendus an email, that will let us
know what topics you listenersare interested in.
And for our listeners that aresubscribing and donating, which
this podcast is completely freeall of our social media is free.
(21:21):
We certainly really appreciateyou for helping to support us
getting this good, unbiasedhealth information out to women.
(21:46):
Garlic and garlic has a lot ofhealth benefits and onions my
husband likes to say that garlicand onion is my favorite
perfume.
He's not as much of a fan as Iam, but these things in high
doses can have an effect on yourLES.
Now, fatty foods do increasestomach acid and they take much
longer to digest, so there's alot more opportunity for acid to
escape, and if you're having aheavier meal for dinner, which
(22:08):
isn't as good, you should haveyour bigger meal earlier.
You may not clear out all thefood by the time it's time to
lay down, and that's especiallytrue if you're pregnant or on
these GLP antagonists.
What are the possiblecomplications of chronic acid
reflux?
Or on these GLP antagonists?
What are the possiblecomplications of chronic acid
(22:31):
reflux?
Well, there's a few that areconcerning, and a little bit of
acid may momentarily not feel sogood, but a lot of acid does
injure it.
Your organs, like your esophagus, can cause esophagitis, which
is inflammation in the lining ofthe esophagus.
Chronic esophagitis can causepain, ulcers, scarring and over
(22:56):
time it can cause intestinalmetaplasia, a precancerous
condition.
Barrett's esophagus is the namefor intestinal metaplasia of
your esophagus and it means thatthe lining of your esophagus
has changed to look more likeintestinal lining.
This change happens after longexposure and it's a risk factor
(23:18):
for esophageal cancer, which canbe deadly.
Esophageal stricture If youresophagus gets injured, it can
develop scar tissue to preventit from chronic inflammation.
Scar tissue can cause youresophagus to narrow, causing a
stricture making it hard toswallow.
Some people have to go in andhave the Schatzky ring dilated.
(23:46):
Laryngeal reflux is called LPRand that's when reflux travels
to your throat when you'resleeping.
It can cause swelling andhoarseness and vocal cord growth
and it's not good to aspiratestuff that belongs in your
stomach into your lungs.
It can make asthma worse,breathing problems worse.
Sometimes can even lead toreflux, can lead to pneumonia
(24:10):
and persons that haveneuromuscular disorders like
parkinson's disease, potentiallydisease, potentially myasthenia
gravis, although less likely,any kind of neurocognitive
problems, als, so-called LouGehrig's disease, anything that
can impair swallowing stroke.
(24:32):
We have to be even morevigilant about the whole chewing
and swallowing mechanism.
So how is acid reflux and GERDdiagnosed?
Well, your primary carephysician or your
gastroenterologist, if you'rereferred to one, might want to
do an esophagram x-ray to seehow your esophagus moves when
(24:55):
swallowing.
You drink this chalky liquidwhite material called barium.
You may have an upper endoscopy, a little lighted scope, very
small, with a camera drop downto your swallowing tube when
you're asleep under lightsedation and when I see patients
that are due for their coloncancer screening, which we push
(25:21):
down to the average age not highrisk, but average age to 45.
If you have a family history ofit you have to undergo it
sooner.
But if you've had stomach upset, some GERD, you've been taking
anti-acid medicine, even if it'snot been on a long-term basis,
it may be good to schedule yourupper endoscopy at the same time
you get your lower endoscopy.
You may need an esophageal pHtest which actually measures how
(25:45):
much acid is in your esophagusthrough a little small wireless
receiver.
Esophageal manometry actuallytests your muscle activity and
how.
There's little pressure sensorsthat are inserted through a
nasogastric tube.
There's little pressure sensorsthat are inserted through a
nasogastric tube.
So what do you do if you havereflux?
Well, first is food, and ofcourse many of us, including me,
(26:10):
love spicy tacos and chocolatedesserts.
In fact, stetson, who's been aguest, my son, no relation to me
the PhD, who many of thelisteners have asked for me to
bring him back, so I guess I'llhave to bring him back again in
upcoming season four we're inseason three right now.
(26:30):
He tells me that you don't haveto have tacos every Tuesday.
You know he likes to come overand eat, sometimes by himself
and most of the time nowadayswith his family.
And then he said he just has toremind me because I might
forget.
I don't, I don't know why hethinks I'm.
I'm forgetting gnome, hisfather, who's my husband, and I
(26:51):
like Mexican food, oh, and I,how stuffed jalapenos are my
favorite and of course, I lovechocolate.
Um, and I like a lot of rich,tasty foods, but for some people
they can really be triggers andI like to put hot sauce on a
lot of foods.
I remember taking my nephewKeaton who's now all grown with
a son, my nephew Samuel Gray outat a barbecue joint and he was,
(27:19):
you know, daring me to get the,to get the 101 fire alarm hot
sauce which I took and atewithout a problem.
But some people can't even takeeven the tiniest spice.
So there's a lot of geneticsusceptibility and some of it
gets worse or changes with age.
So if you can't tolerate allthat spice, try to do something
(27:41):
blander, more gentler, like leanmeats, bananas, oatmeal.
Some people find they can reallyreduce their acid reflux just
with lifestyle changes likegetting rid of the alcohol and
tobacco, elevating the head ofthe bed so that your stomach is
lower than your chest, andwhenever I suggest this to
(28:02):
patients they say, oh, don'tworry, doc, I have two pillows,
but that actually scrunches upyour stomach and makes it worse.
So having a bed electronic thatkind of tilts you so your
stomach is less lower than yourchest is the best.
Pillows are not enough.
You can get a six inch cinderblock and put it, you know,
equally under the head of yourbed.
(28:23):
Um, losing weight.
Even five or 10 pounds can makea big difference on the stomach
and apparently 13 pounds is themagic number to really take
some of the pressure off, uh,your lower joints if you're
having a lot of joint pain, someof the pressure off your lower
joints if you're having a lot ofjoint pain.
But if you have chronic GERD orreflux you may need medications
(28:45):
.
Now there are over-the-counterso-called antacids like Tums and
Rolaids.
Those are really actually justcalcium carbonate and some
people feel better with that.
But you don't want to take toomuch calcium.
They're not a long-termsolution and sometimes calcium
(29:11):
can actually stimulate acidsecretion.
If you do need to take calciumand you don't have very much
stomach acid because maybeyou're taking a proton pump
inhibitor, then you have to takecalcium citrate, which does not
require acid to be absorbed.
And if you've ever had kidneystones and you're not a big
dairy ingester and you have totake a calcium supplement, then
calcium citrate usually thecitrate salt, is best at helping
(29:32):
to reduce kidney stones.
Alginates Alginates arenaturally occurring sugars
derived from seaweed and theyhelp block acid reflux by
floating on top of the acid,kind of creating a physical
barrier between the acid andyour esophagus and you can get
alginates by themselves or youcan get over-the-counter
(29:54):
antacids with these alginates.
Now there is a whole slew ofprescription medications that
can be used.
Some of the H2 histaminereceptor blockers reduce stomach
acid by just directly reducingacid that's made in the stomach.
It tells your body what they dois they reduce acid in the
(30:19):
stomach by blocking the chemicalthat tells your body to make
stomach acid, which is histamine, and you can take them a little
more frequently than antacids.
Your body can adapt to theirside effects and don't always
work long term.
Tagamet was one of the firstones and that's now over the
(30:40):
counter.
It has a lot of drug-druginteractions.
Renetadine or Zantac was apopular one and that went over
the counter.
Then it was pulled from themarket because how it was being
manufactured apparently wascontaminated with carcinogens
Yikes.
You can certainly get Pepsid,famotidine, pepsid AC.
(31:02):
They make a chewable one thatcan help transient acid reflux
problems.
Now PPIs are much stronger.
They're PPIs.
They're generally prescription.
There may be a lower dose nowover the counter prescription.
(31:23):
There may be a lower dose nowover the counter and your
clinician may prescribe themfirst line if there's signs of
damage to your esophagus andthey're about 90% effective.
So PPIs like Prilosec andPrevacid definitely reduce B12
absorption and we're not happyabout that.
So you also do need acid tohelp digest food and also ward
off infection.
(31:43):
So I don't think it's a goodidea to take the PPIs for more
than two weeks unless you'vereally been evaluated and you've
done a lot of lifestyle issues.
A lot of times they're given inthe hospital when people are in
intensive care unit and they mayincrease certain types of
pneumonia.
Because, again, stomach acid isvery important in your general
(32:07):
health, just like your gutmicrobiome.
So prebiotics and probioticscan be very important for your
gut health.
Baclofen is a muscle relaxantand it's also prescribed to
reduce muscle spasms.
Sometimes it might help reducethat frequency of LES relaxation
, but it's certainly not firstline treatment by any means and
(32:31):
it can be sedating.
So medicines can reduce thesymptoms.
It doesn't totally stop it.
You might need more definitivetreatment.
Sometimes it can be a procedureto tighten the lower esophageal
sphincter.
It could be more involvedsurgery like nissen
fundoplication, which is themost common surgery for GERD.
(32:54):
Now it's done laparoscopically,which means smaller incisions
and usually a shorter recoverytime.
A surgeon actually takes thetop of your stomach to wrap it
around that lower esophagealarea to help secure it and
stitch it to keep a tighterjunction.
This is also the same processthat's used to fix a hiatal
(33:17):
hernia.
There's a LINX device L-I-N-Xit's a newer procedure implant
that's a tiny ring of magnetsthat help keep that junction
closed.
Certainly, take home tips foryou and your family.
Eat smaller meals.
Get smaller plates.
You don't want to overstimulateyour stomach, you don't want to
(33:40):
overeat.
Eat dinner earlier.
Be a blue hair.
I have a good friend, she andher husband.
They want to go out to eat withus at 4 pm.
So that only means the weekendsbecause I am not home from the
office by then.
But eating dinner is better anda lot of times if you go out to
restaurants you get a cheaperprice.
(34:01):
In fact I was telling a friendthe other day who was going to
New Orleans that you know theyhave great restaurants there,
lots of rich food and veryexpensive food, and when my
husband and I visited there wewent for lunch.
You get the same great food,but it's usually slightly
smaller portions and much lessexpensive.
And then if you're having a bigheavy meal, just have that at
(34:22):
lunch and then you can just havea late snack for dinner.
Gravity plays a very importantrole in keeping the food down,
so you don't want to be doinghandstands and backflips and
going on your reversion tableafter eating a big meal,
sleeping on your left side,because that keeps your stomach
position lower.
Raising the head of the bedupwards is very helpful.
(34:45):
Reducing abdominal pressure byweight loss, delivering that
baby wearing loose, fittingclothing don't wear any tight
corsets and not smoking.
And getting rid of alcohol thatreally can be very, very
helpful.
Try those over-the-counterantacids with the alginates on
(35:09):
hand A lot of times.
These small tweaks can really,really make a big difference.
And if you're having symptomsthat persist or you've been
taking a medicine for more thantwo weeks straight, it's time to
make an appointment.
You might need to see agastroenterologist that
specializes in the digestivesystem.
So I hope this podcast didn'tgive you heartburn.
(35:34):
I hope it helped alleviate yoursymptoms or at least educate
you in case one of your lovedones in the future is suffering
with these symptoms.
All right, folks, that's a wrapfor today's episode.
Remember this is a commonproblem.
There's lots of ways to feelbetter.
Thanks for tuning in.
Don't forget to subscribe toour podcast.
(35:57):
Follow us, it's free.
Thanks again for listening andgive us a five-star rating.
Share this podcast with yourfriends and family and I'll see
you next time in the SunflowerHouse.
Remember be strong, be healthyand be in charge.
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