In a little over a week, most of us expect to be celebrating the Thanksgiving holiday by sharing a feast with family and friends.   While we may look forward to the turkey, mashed potatoes, and pumpkin pie, it is doubtful anyone looks forward to the heartburn that often follows. This is likely the reason why Thanksgiving week has been designated as National GERD Awareness week.

GERD, or gastroesophageal reflux disease, affects more than 21 million Americans, or about 5-7% of the population.   It occurs when the muscle between the esophagus and the stomach does not close properly and the contents of the stomach leak back into the esophagus.   When refluxed stomach acid comes in contact with the lining of the esophagus, it results in a burning sensation in the chest or throat, commonly known as heartburn.

The term “heartburn” is a misleading one, because acid indigestion has nothing to do with the heart. However, some of the symptoms may be similar to a heart attack, such as chest pain.   In fact, every year, over 5 million people are admitted to the hospital with chest pain, but more than half of them have noncardiac pain.   Of those experiencing noncardiac chest pain, up to 60% are diagnosed as having GERD.

According to the American Gastroenterological Association, 60 million Americans have symptoms of heartburn or GERD at least once each month. An estimated 20% of Americans suffer from this condition at least once a week.   Although occasional heartburn is not a serious health problem, persistent heartburn that occurs more frequently may be a sign of GERD, which is a serious concern.   Stomach acid in the esophagus can cause esophagitis, ulcers, narrowing of the esophagus (creating difficulty and discomfort swallowing), Barrett's syndrome (a precancerous condition), and esophageal cancer.

While chronic heartburn is the most common symptom of GERD, it is possible to have this condition without experiencing heartburn.   Other symptoms of GERD include belching, difficulty or pain when swallowing, bad breath, sour taste in the mouth, chronic sore throat, hoarseness, inflammation of the gums, erosion of tooth enamel, dry cough, or a sudden excess of saliva.   GERD seems to be related to hiatal hernias, although the relationship is not clear.   Also, GERD is frequently found in association with asthma, chronic cough, and pulmonary fibrosis; these conditions can be aggravated and may even be caused by GERD.

No one knows why GERD develops in some people but not in others. Anyone, including infants and children, can have this condition.   In fact, GERDoccurs frequently in infants, but is often overlooked.   In the young, GERD can cause vomiting, coughing, and respiratory problems.   The good news is that when GERD occurs in infants, it is usually the result of immature digestive systems and they tend to outgrow the condition.

Easing the discomfort of GERD is similar for adults and small children.   To reduce the problem with reflux in infants and small children, frequent burping during feeding, keeping the infant in an upright position for 30 minutes after eating, and avoiding giving the young child caffinated soda, chocolate, peppermint, fried and fatty foods, spicy foods (including pizza), or acidic foods, such as oranges or tomatoes. Adults with GERD should avoid the same foods (including pizza, chili, spaghetti sauce, garlic, and onions.)   It is advisable to raise the head while sleeping, and to stop eating 2 to 3 hours before bedtime.

While GERD is not caused by lifestyle decisions, doctors usually recommend making lifestyle changes to minimize the discomfort of the condition.   These include quitting if you smoke, avoiding alcohol, eating small meals, losing weight if needed, wearing loose-fitting clothes, refraining from lying down for 3 hours after meals, and raising the head of the bed 6 to 8 inches.   (This should be done by placing wood blocks under the bedposts, as using extra pillows is not effective.)

In addition to lifestyle changes, doctors often treat GERD with a variety of prescription and over-the-counter medications.   If the condition is not relieved or becomes worse, surgery may be an option.   Anyone who experiences the symptoms of GERD, does not get relief from antacids, or has heartburn more than 2 or 3 times a week should consult with a physician.   GERD is a treatable disease.

The International Foundation for Functional Gastrointestinal Disorders offers a GERD brochure which can be ordered by calling 1-888-964-2001.   To learn more about GERD, contact the American College of Gastroenterology at (703) 820-7400 ( www.acg.gi.org ), the American Gastroenterological Association at (301) 654-2055 ( www.gastro.org ), or the Pediatric/Adolescent Gastroesophageal Reflux Association (PAGER) at (301) 601-9541 ( www.reflux.org ).