Dr. Eisner Q&A #8

Question #1 - GERD and Exercise: Sometimes when I exercise I get an upset stomach, which leads to burping. After a while the symptoms go away. Could this be caused by GERD?

Answer: Some types of exercise can worsen GERD symptoms. Any type of exertion that increases pressure in the abdomen can cause gastric contents to reflux into the esophagus. This is similar to the affect of pregnancy and obesity on GERD. It is therefore prudent to wait an hour prior to doing exercise that can increase abdominal pressure.

Question #2 - GERD and Cough: I have had a dry cough off and on for years and someone just asked me whether it was related to acid reflux. I did not know that acid reflux could be related to a cough.  Has anyone heard of anything like that?   

Answer: Cough can be an atypical manifestation of GERD. There are two proposed mechanisms. One is the reflux of gastric contents going up the esophagus and causing episodes of micro-aspiration into the bronchi. The second is because of the position of the trachea adjacent to the esophagus; reflux of liquid up the esophagus can have an effect on the trachea that causes a cough. If you do have a chronic cough that is not responsive to conventional therapy, you should see your doctor to address the possibility that GERD is the cause.

Question #3 - Medicine and GERD: I sometimes forget to take my acid reflux medicine an hour before a meal, as indicated. If I've already started eating, am I better off still taking it or skipping the dose? 

Answer: It is best to take most proton pump inhibitors at least 30-60 minutes before a meal. If you have already started eating, it is best to wait until prior to your next meal to take the medication.

Question #4 - Diet and GERD: I treat this daily with Prevacid, but I would be interested in knowing if this ever goes away if I change my diet. Your response would be appreciated. 

Answer: Lifestyle modifications can certainly affect GERD and alleviate the need for medication. Typical foods that worsen GERD are caffeine, chocolates and peppermints. Weight loss usually has a dramatic positive effect on GERD symptoms as well.

Question #5 - Acid Reflux Diagnosis: My tummy hurts pretty often. I am not meticulous about keeping track of what I consume to check for repeat irritants... I am wondering when to ask my doctor to check for acid reflux or something more serious. I usually don't even have time to see the doc! Thanks for any advice. 

Answer: Stomach pain is not normal and should be discussed with your doctor. There are many possible reasons for stomach pain. While most aren't serious, depending on your age and associated symptoms, your doctor will decide if you can best be treated with diet, medication, or if further diagnostic testing is necessary.