Dr. Eisner Answers your GERD Questions: GERD & Marijuana Link?
Could marijuana smoking be the cause of GERD?
The effect of marijuana on the symptoms of gastroesophageal reflux disease is controversial. A study in 2002 showed that animals given a synthetic marijuana-like substance had an 80% reduction in transient relaxations of the lower esophageal sphincter, which is felt to be a significant cause of reflux. By reducing these relaxation episodes, symptoms of reflux should actually improve. Other smaller studies have shown that use of marijuana can actually worsen symptoms of gastroesophageal reflux disease by decreasing resting pressures of the lower esophageal sphincter.
I recently saw my gastroenterologist as my GERD symptoms have been worse. He has now recommended surgery. I had heard bad things about surgery in the past. Is this an acceptable option?
A very recent report out of Massachusetts General Hospital surveyed 200 patients that had underwent laparascopic anti-reflux surgery over a 10 year period. The results were almost universal near-normal quality of life scores, as well as considerable satisfaction with long-term results. The authors concluded that while some recent reports in the medical literature have questioned whether the long-term benefits of surgical repair outweigh the risks present in any sort of surgery, their surveys results indicate that, in appropriate selected patients, antireflux surgery is an excellent treatment alternative that provides very good results for patient quality of life. You should certainly speak with a surgeon to see if he feels that you would benefit from surgery.
Whenever I put on a few pounds, it seems like I experience more reflux symptoms. Am I just imagining this?
Recent research supports the link between obesity and gastroesophageal reflux disease. The risk markedly increases the larger the body mass. The mechanism is an increase in the pressure in the abdominal cavity forcing stomach contents to head towards the esophagus. This is similar to one of the ways that pregnancy causes worsening of gastroesophageal reflux. Patients that are overweight and suffer gastroesophageal reflux disease will frequently have relief of symptoms upon losing weight. Weight loss is an important behavorial modification that can lead to resolution of symptoms of gastroesophageal reflux disease.
I suffer from GERD. What types of food should I stay away from?
There are basically three ways that foods can worsen gastroesophageal reflux disease. Caffeine and alcohol can stimulate acid secretion. If there is more acid produced by the stomach, there is a greater chance of acid refluxing into the esophagus. Fatty foods tend to slow down contractions of the stomach. This also leads to acid being present in the stomach for a longer period of time, making it more likely to reflux into the esophagus. Finally, caffeine, chocolate and peppermints lower the pressure of the sphincter between the esophagus and stomach, allowing acid from the stomach to more readily reflux into the esophagus. A lot of patients with gastroesophageal reflux disease will be able to avoid medications if they stay away from the foods that tend to increase acid production and promote reflux.
I frequently wake up in the morning with a cough, and have seen a pulmonologist who finds nothing wrong. A friend suggested I take Prilosec and things have improved. Do I need to have any tests, or can I just assume the cough is from GERD?
If your cough has improved upon instituting Prilosec, it is likely related to gastroesophageal reflux disease. One of the drawbacks of having strong medications such as Prilosec available over the counter is that patients can take medications that might improve their condition, while masking a possible serious disorder. You should see a gastroenterologist and discuss your symptoms. Most likely, if you have been experiencing symptoms of gastroesophageal reflux disease for a period of time, he will want to do an endoscopy to rule out Barrett's esophagus, a pre-cursor of esophageal cancer