Gastroesophageal Reflux Disease (GERD) and the Holidays

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Gastroesophageal reflux disease (GERD), often referred to as acid reflux, is the passage of gastric contents into the esophagus. The stomach contents are very acidic, and when they pass into the esophagus, result in a burning sensation in the esophagus, or food tube. Acid reflux is caused by some level of dysfunction of the muscular valve that is at the junction of the esophagus and the stomach.

Reflux symptoms are often exacerbated by dietary and lifestyle choices, the environment, and particular medical conditions — all of which can be triggered around the holidays.

In an interview conducted with Anthony Starpoli, M.D., a gastroenterologist in New York, we gained some insight on managing GERD in the holiday season.

Understanding the common and less-common signs of acid reflux

The most common and classic symptoms of GERD are heartburn, or a burning sensation moving up the chest to the neck, and acid regurgitation where patients experience reflux of gastric contents or acid in their throat or mouth. This is not to be confused with vomiting, when stomach contents violently is forced backwards from the stomach out the mouth.

Some atypical symptoms suggestive of GERD are constant throat clearing, nausea, chest pain, excessive salivation, constant coughing, wheezing or bronchospasm, hoarseness of the voice, belching, neck or throat pain, and globus sensation in the throat.

Culprits for causing/worsening reflux

Everyone’s reflux is triggered by different foods and drink. The more common foods that trigger reflux in many include acidic foods, coffee or caffeinated products, fatty foods, milk and cheese products (these have a very high acid content), spicy foods, tomato products, vinegar products (salad dressings), citrus fruit, carbonated beverages, alcohol, and large meals in general.

Why does reflux get worse during holidays or special occasions?

According to Dr. Anthony Starpoli, “It’s a case of the perfect storm. You have excessive quantities of food taken in short periods of time that tend to have all the trigger components. And, in concert, they make more reflux apparent at this time of year.”

Most often during the holidays, we tend to eat larger meals containing foods high in fat and other trigger components, as well as drink more alcoholic beverages.

Is it possible to prevent breakthrough or worsening reflux during the holidays?

Absolutely. Starpoli noted, “The key is moderation." It is important to avoid trigger foods, continue to eat normal size or small portions, avoid large amounts of alcohol consumption. Should you experience reflux symptoms, however, it is best to remedy the symptoms with over-the-counter medications, such as antacids.

What should you do if you have reflux episodes over the holidays in the short-term until you can reach your doctor?

If you experience new reflux symptoms or worsening symptoms over the holidays, it is important to reflect back on what you ate and avoid these foods moving forward. Given that most cases of reflux from holiday meals are temporary, using an over-the-counter antacid, such as tums or other chewable antacids, is appropriate and should work in the short-term.

Damage as a result of 'significant' uncontrolled refluxDr. Starpoli explained that** chronic GERD is considered significant wheou experience GERD symptoms two or more times during the week**. This type of chronic GERD can result in long-term complications.

The lining of the esophagus can wear away resulting in an ulcer or open wound, which can be very painful, cause bleeding, or food to get stuck in the area of the ulcer. According to Dr. Starpoli, “This can also be a higher risk factor for esophageal cancer in the most extreme form."

You can also get a scar tissue formation, or a stricture, that can cause difficulty swallowing or sensation of food getting stuck. Inflammation or irritation of the esophagus called esophagitis is more common and can be quite uncomfortable, even painful.

Can people take acid-blocker medications long-term without concern for any negative effects, such as kidney injury, infection, dementia, etc?

The proton-pump inhibitor (PPI) medications, which are the strongest of the acid blockers have been implicated in causing other medical problems, such as dementia, kidney failure, vitamin/mineral deficiencies, and more recently stroke. However, all of these studies are purely observational and have no proof of cause and effect. PPI’s have never been shown to cause any of these adverse events. These studies only have shown an association of PPI use and the listed medical problems. They are safe to use long-term, but as with any medication, it is best to use them under the care of a physician to monitor for any potential adverse effects.

Dr. Starpoli mentioned, “Acid reflux affects 7-10 percent of the population having heartburn on a daily basis." He added, “It should not be ignored.”

For people interested in learning more about acid reflux, a good resource is gerdhelp.com or just ask your physician!