What Is GERD?
Gastroesophageal reflux disease (GERD) is typically a chronic digestive disorder that causes stomach acid or acidic stomach contents to come back up into the esophagus. This is known as acid reflux. The reflux occurs as a result of a malfunction of the lower esophageal sphincter (LES). The LES is a circular tube of muscle located between the esophagus and stomach. When you swallow, the LES relaxes and makes an opening so food and liquid can enter the stomach. Once the contents are in the stomach, the LES contracts and the opening closes. When the LES fails to close all the way, stomach acid and content can creep back up into the esophagus.
Symptoms of GERD
If you have GERD, you may frequently experience a sour or bitter taste in your throat and mouth. Other symptoms of GERD include:
- bad breath
- difficulty swallowing
- breathing problems
Risk Factors for GERD
Many people experience acid reflux, especially after eating a large meal or spicy foods. However, if acid reflux happens more than twice per week, it may indicate you have GERD. People at the greatest risk of developing GERD include those who:
- drink heavily
- are obese
- are pregnant
- are stressed
- have dry mouth
- have asthma
- have diabetes
- have stomach disorders, such as gastroparesis
- have connective tissue disorders, such as scleroderma
Complications of GERD
Over time, damage to your esophagus can lead to serious health problems, such as:
- narrowing of the esophagus, or esophageal stricture
- open sores in the esophagus, or esophageal ulcers
- precancerous changes in the esophagus, or Barrett’s esophagus
Certain foods, medications, beverages, and activities often trigger the symptoms of GERD.
Foods that trigger the symptoms of GERD include:
- chocolate and peppermint, which both tend to relax the LES and allow stomach acid to come back up into the throat
- spicy foods, which can boost the production of stomach acid
- fried and high-fat foods, which take a long time to digest and can increase the risk of reflux
- citrus fruits, garlic, and tomato-based foods, which all increase the production of stomach acid
Beverages that trigger these symptoms include carbonated drinks, which can irritate the esophagus and caffeinated drinks, which can promote the production of stomach acid. Alcohol and regular or decaffeinated coffee are also triggers. They can boost the production of stomach acid.
Medications that trigger these symptoms include fish oil supplements nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen.
Activities that can trigger symptoms include:
- eating late at night (especially a large meal), which increases the likelihood of experiencing acid reflux
- lying down within an hour after eating, which increases the risk for acid reflux
- wearing tight-fitting clothes, which puts pressure on the stomach
- smoking, which can promote the production of stomach acid
- physical activity, especially when vigorous, can increase the production of stomach acid
GERD and Sex
For many people, sex is a physical activity that can trigger GERD symptoms. It can cause heartburn, acid reflux, and shortness of breath before or during sexual intercourse. This can make sex less enjoyable.
There are things you can do before, during, and after sex to help prevent GERD symptoms.
Before having sex, you should do the following:
- Avoid common foods, medications, and beverages that trigger symptoms.
- Don’t eat a big meal. Eat lightly or wait to have sex until your food has digested.
- Take antacids, such as Tums or Mylanta.
During sex, you should do the following to avoid GERD symptoms.
- Be open with your partner about how you’re feeling. If you suspect that you might have a GERD flare-up, consider delaying sex and getting intimate in a different way.
- Avoid sexual positions that involve lying flat, as this can make GERD symptoms worse.
- Avoid sexual positions that put pressure on the stomach, as this can boost the production of stomach acid and increase the risk for acid reflux.
- Stick to sexual positions that are semi-upright or fully upright, such as sitting in a chair or standing.
- Stop having sex if your GERD symptoms begin to flare up. Continued exertion can make them worse.
After sex, you should do the following:
- Evaluate how you’re feeling. Keep track of when you experience GERD symptoms during sex, and see if those symptoms correspond to any foods, medications, or beverages that you had beforehand. Once you identify your triggers, you can make sure to avoid them in the future.
- Report any GERD symptoms that you’ve experienced during sex to your doctor. They may prescribe antihistamines or prescription-strength acid reflux medications known as protein-pump inhibitors.
GERD symptoms can be frustrating and uncomfortable, but you can still have a satisfying sex life despite your condition. Learning more about your triggers can make it possible to avoid GERD symptoms before, during, and after sex.
You Asked, We Answered
- What are some home remedies for GERD symptoms?
Thanks for your question. While hard scientific data on natural remedies for GERD are lacking, the following products are recommended by both medical doctors and naturopathic practitioners as having potentially beneficial properties for those suffering from GERD or heartburn: ginger (including ginger ale and ginger root tea), chewing gum, probiotics, baking soda, aloe vera juice, slippery elm (an herb), and licorice (in modest amounts). It is still advisable that you consult with your doctor, especially if you don’t get full relief within a few days.- Steve Kim, M.D.