Digestive Disorders: Heartburn, Acid Reflux, and GERD
Digestive disorders affect millions of individuals and cover a variety of diseases ranging from mild to severe. These conditions involve the digestive tract, also known as the gastrointestinal or GI tract. The digestive disorders of heartburn, acid reflux, and gastroesophageal reflux disease/GERD are related and have similar symptoms but are different. Accurately diagnosing digestive disorders involves a thorough medical history, imaging and lab tests, and physical examination to develop the proper treatment plan.
The gastrointestinal tract includes the esophagus, liver, gallbladder, stomach, pancreas, and large and small intestines.
Heartburn has nothing to do with the heart but describes a burning sensation in the chest. Individuals experience heartburn when stomach acid flows back into the esophagus. Occasional heartburn after eating spicy foods or foods an individual is not used to is common and is no cause for alarm. Most can manage the discomfort symptoms with lifestyle adjustments and over-the-counter medications. Chronic heartburn that interferes with daily/nightly routines could indicate a more serious condition requiring medical care. Symptoms include:
- The burning discomfort sensations in the stomach and chest regions are usually worse after eating a meal, bending down, at night, and when lying down.
- A bitter or acidic taste.
The esophagus comprises mainly smooth muscle that extends from the throat down through the chest cavity and past the abdomen, where it connects with the stomach. When swallowing, the esophagus opens and squeezes food down to the bottom, where a valve (lower esophageal sphincter LES) separates it from the stomach. The valve is normally closed. When swallowing, it opens so that food can pass through and then closes up. Acid reflux is a disorder that causes the valve to open when it’s not supposed to. This allows stomach contents like acid, digestive juices, enzymes, and food to flow backward from the stomach into the esophagus, causing heartburn symptoms. This usually happens when the lower esophageal sphincter is under added pressure, weakened, or malfunctioning. Symptoms can be caused by:
- Eating spicy or acidic foods that can trigger symptoms.
- Eating right before going to bed.
- Over alcohol consumption.
- Exercising after eating.
Acid reflux and heartburn affect everyone, but most can handle the discomfort by taking antacids and avoiding the foods that brought it on. Occasional acid reflux can be treated with over-the-counter medication, including:
- H-2-receptor blockers.
- If signs and symptoms worsen, or nausea, vomiting, or difficulty swallowing occurs, consult a doctor.
- Prescription medications could be recommended.
Acid reflux can potentially progress to gastroesophageal reflux disease, a more serious form of acid reflux that lasts longer. GERD is frequent heartburn that happens two or more times a week. Other signs and symptoms can include:
- Regurgitation of food or sour liquid.
- Difficulty swallowing.
- Inflammation of vocal cords.
- A sensation of a lump in the throat.
- Coughing to clear throat constantly.
- Asthma-like symptoms.
- Chest pain, especially when lying down at night.
Various factors can cause GERD, that include lifestyle and physiological. It can develop as a result of the following:
- Delayed stomach emptying.
- Being overweight or obese.
- Hiatal hernias.
- Connective tissue disorders like scleroderma.
Some individuals with digestive disorders may need more extensive diagnostic evaluations, including GI endoscopy, laboratory tests, and imaging.
Body misalignments, unhealthy posture, and restrictive positions can contribute to digestive disorders that put pressure on the stomach and chest, triggering symptoms. A chiropractor can realign the body and take the stress off the joints and spine, relieving the pressure on the nerves. They can also strengthen the muscles through adjustments that help alleviate pressure on the stomach. A chiropractor designs a treatment plan that suits the individual’s needs, including stretches and exercises, nutrition, and health coaching to achieve and manage a healthy weight.
Carvalho de Miranda Chaves, Renata, et al. “Respiratory physiotherapy can increase lower esophageal sphincter pressure in GERD patients.” Respiratory medicine vol. 106,12 (2012): 1794-9. doi:10.1016/j.rmed.2012.08.023
Harding, Susan M. “Acid reflux and asthma.” Current opinion in pulmonary medicine vol. 9,1 (2003): 42-5. doi:10.1097/00063198-200301000-00007
Kahrilas, Peter J. “Regurgitation in patients with gastroesophageal reflux disease.” Gastroenterology & hepatology vol. 9,1 (2013): 37-9.
Pope, C E 2nd. “Acid-reflux disorders.” The New England journal of medicine vol. 331,10 (1994): 656-60. doi:10.1056/NEJM199409083311007
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