Prevention
Gastroesophageal reflux (GER)—also known as acid reflux or heartburn—affects most people at least once in their lives. When heartburn becomes frequent or chronic, it’s known as gastroesophageal reflux disease (GERD).

Rates of both GER and GERD have been on the rise for more than three decades in the United States. Factors for the increase include an aging population (acid reflux is more likely to occur in older people), poor eating habits (such as eating too quickly or consuming spicy or high-fat foods), and smoking.

Another major factor is the increase in obesity, according to Victor S. Sierpina, M.D., author of The Healthy Gut Workbook. Obese people are more than twice as likely to suffer from more frequent and more severe GERD than the general population.

Eating disorders such as anorexia and bulimia nervosa also contribute to the rise in GERD. "People who induce vomiting, or have in the past, can have an increased risk of heartburn," says Jacqueline L. Wolf, M.D., an associate professor of medicine at Harvard Medical School.

Lifestyle Changes

Acid reflux occurs when stomach acid backs up into the esophagus (the muscular tube that connects the throat and stomach). The most common symptom is a burning sensation in the chest (heartburn). Other symptoms may include a sour or regurgitated food taste in the back of the mouth.

Occasional or mild acid reflux can usually be prevented by adopting a few changes in lifestyle, which include:

  • avoiding lying down for three hours after a meal
  • eating smaller meals more frequently throughout the day
  • losing excess weight
  • quitting smoking
  • raising the head of the bed six to eight inches by placing wooden blocks under the bedposts
  • wearing loose-fitting clothing to avoid pressure on the abdomen

Several types of food can contribute to acid reflux as well. Foods to avoid include:

  • alcohol
  • citrus fruits
  • coffee
  • carbonated beverages (such as colas)
  • chocolate
  • fatty or fried foods
  • garlic
  • onions
  • peppermint
  • spearmint
  • tomato sauce

Medication

In addition to frequent heartburn, symptoms of GERD, the more serious form of acid reflux, may include difficulty swallowing, coughing or wheezing, and chest pain. While many people can resolve most of their symptoms with the above lifestyle changes, some people may require medications to prevent their symptoms.

These include:

   antacids (such as Tums)

•   H2-receptor blockers (such as Pepcid AC or Tagamet HB)

•   mucosal protectants (such as Carafate)

   proton pump inhibitors (including prescription medications such as Aciphex, Dexilant, Nexium, omeprazole/sodium bicarbonate, Protonix and Zegerid, and the over-the-counter PPIs Prilosec and Prevacid 24HR)

A Word About Proton Pump Inhibitors

Proton pump inhibitors are the most effective treatments for chronic acid reflux and generally are considered very safe. They work by suppressing gastric acids and, unlike other medications, only need to be taken once a day to prevent symptoms. However, there are downsides to the long-term use of these drugs.

Over time, proton pump inhibitors can deplete the body of vitamin B12. Stomach acid is one of the body's defenses against infection. Eliminating it may lead to an increased risk of infection and bone fractures, especially of the hip, spine, and wrist. Also, proton pump inhibitors can be expensive, often costing more than $100 each month.

Surgery

Surgery is only necessary in rare cases, according to researchers at John Hopkins University. The most common surgery to treat acid reflux is a procedure known as Nissen fundoplication. A surgeon lifts a portion of the stomach and tightens it around the junction where the stomach and esophagus meet. This is to increase pressure in the lower esophageal sphincter (LES).

The procedure is performed with a laparoscope and requires the patient to remain in the hospital one to three days. Complications are rare and the results are extremely effective. Only two percent of patients experience renewed acid regurgitation (compared to 13 percent of those on medications). However, surgery may lead to increased bloating and flatulence or trouble swallowing.

Contact your doctor if lifestyle changes and medication aren’t working for you.