Iliff Family Practice

Gastroesophageal Reflux Disease (GERD, “heartburn,” “hiatal hernia”)

GERD is a modern epidemic related primarily to expanding waistlines.  The stretch of the skin increases the pressure inside the abdomen, which in turn pushes stomach contents up into the esophagus.  Usually this causes “heartburn,” and sometimes cough, a hoarse voice, or no symptoms at all.  No matter what the symptoms, the esophagus is not made to handle acid and other stomach secretions.

In my medical lifetime, we have seen two great advances in treatment.  First we got H2 blockers (Tagamet, Zantac, Pepcid), then proton pump inhibitors (Prilosec, AcipHex, Protonix, Prevacid, Nexium).  These work great for symptom control by reducing acid production.  So why are we seeing more precancerous conditions (“Barrett’s esophagus”) which can lead to esophageal cancer (a bad actor--see article below)?

We don’t know.  My suspicion is that there is more danger from misplaced stomach contents than simply acid-related symptoms.  That’s why I’m going back to “barrier methods,” just like in the old days, to keep that stuff in the stomach where it belongs.

What do I want you to do?

1. Don't eat within three hours of bedtime. This gives time for the food to move down the line.
2. Chew three Gaviscon Foamtabs at bedtime, and follow with some water.  This creates a foam barrier to reflux.
3. Avoid food or drink which seem to cause you problems. I'm not going to give you a list.  It depends on your specific tolerance to different things.
4. And most important, buy a set of GI Bed Blocks, available on the Internet or by calling 800-442-5625.  Either the 4-inch or 6-inch size is fine.  This enlists the force of gravity to keep stomach contents in the stomach when you like down at night.  They cost about as much as 7 days of Nexium, and will last forever.  Unless you lose a lot of weight, that’s how long you will need them!