Northern Virginia Health & Life Magazine: November 2009
"The Fire Inside"

If the holiday treats headed your way are decidedly decadent, you may be more likely to indulge. But you also may find yourself paying a hefty price if you suffer from the sting of acid reflux.

Acid reflux—or gastroesophageal reflux disease (GERD), in its ongoing form—occurs when stomach acid backs up into the esophagus, causing a host of symptoms that range from a sour taste in one’s mouth to pain or burning in the chest (as in heartburn). Some sufferers find themselves awake at night due to pain or chronic coughing.

The regurgitation that often accompanies reflux is unpleasant, sure—but it could also be doing long-term harm to your esophagus, which in turn may make you more susceptible to esophageal cancer. And if acid is rising into your mouth, your oral health is being compromised. “Acid reflux is a gastrointestinal problem, but if you’re regurgitating and bringing acidic matter into your mouth, you could adversely affect your gums and teeth if you don’t remove that acid,” explains Dental Associates of Northern Virginia periodontist Leo J. Sushner, DDS, of Falls Church. “The acid can lead to additional tooth decay, and that—if not removed properly—can lead to periodontal disease.”

In fact, those with chronic acid reflux face many of the same oral-health concerns as bulimics, who binge on food and then purge their stomach contents, explains Beverly Fink, RDH director of dental hygiene for Dental Associates and the president and founder of PerioAdvocates. In bulimic patientes, the acids from the stomach actually etch and begin to break down the enamel of the tooth which is the hardest thing in the body, harder than bone. If any root surfaces are exposed in the mouth due to recession of the gums big problems can develop. Roots are very soft and vulnerable to destruction. Once roots are weakened by the acids, actual tooth loss may follow. It is a serious problem.

The factors that contribute to acid reflux are as varied as the condition’s symptoms. One common culprit is a stomach abnormality called hiatal hernia, in which the upper part of the stomach moves above the diaphragm, allowing acid to move up the esophagus. Other causes are related more to lifestyle habits and diet options. People who are overweight are more likely to experience acid reflux regularly, but even eating just one overly large meal (or eating and then lying down or bending over) can cause problems; fatty or fried items are particularly unfriendly foods. Medications, including aspirin, ibuprofen, or blood-pressure regulators, also can contribute to reflux. And pregnant women and smokers are more likely to suffer from it, too.

For the occasional bout of acid reflux, over-the-counter remedies usually are enough to cure what ails you. But if symptoms persist or you’re experiencing acid reflux two or more times a week, it’s time to see your doctor. He or she may order an endoscopy, in which a long, flexible, lighted tube is inserted down your throat to check for problems in your esophagus or stomach. (The doctor may also use an endoscopy as an opportunity to do a biopsy, checking cells for infection or other abnormalities that may be indicative of cancer.) A standard endoscopy can be combined with newer technologies, too, like a wireless capsule that is hooked on to the esophagus to provide a 48-hour reading of any changes in esophageal pH, sending readings to a remote recorder. As you eat and swallow over the course of a few days, the capsule loosens, drops down into the stomach, and passes easily through the digestive tract.

If your physician confirms that you have acute reflux, prescription medications are a common line of defense; in the most severe cases, surgery may be in order. But for most people, simple lifestyle changes can provide the comfort they seek. Avoid alcohol and tobacco, and don’t lie down after meals. Shedding even a few pounds can help, as can sleeping with the head of your bed slightly elevated. Also, take medication with plenty of water, and steer clear of common foods known to cause problems. These include citrus juices, raw onion, ground beef, ice cream and milkshakes, doughnuts, potato chips, and tomato products.
Now, when the hors d’oeuvres and party platters start circulating at your next holiday get-together, you’ll know what to steer clear of for a more comfortable celebration.