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Smoking aggravates acid reflux disease

Health advice

POSTED: September 27, 2007 5:03 a.m.
Just about everyone knows smoking is a significant risk factor for many health problems including cardiovascular disease, diabetes and cancer, but most don’t realize smoking can cause your esophageal sphincter to relax and stimulate stomach acid resulting in gastroesophageal reflux disease.
GERD occurs when the lower esophageal sphincter does not close properly and stomach contents leak back (or reflux) into the esophagus. The lower esophageal sphincter is a ring of muscle at the bottom of the esophagus that acts like a valve. The esophagus carries food from the mouth to the stomach and when this valve is functioning properly, food and liquids pass into the stomach but the sphincter prevents them from coming back up.
When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat commonly called “heartburn.” It is called “acid indigestion” when the fluid is tasted in the back of the mouth. Heartburn every now and then is common and having it occasionally does not necessarily mean you have GERD. Heartburn that occurs more than twice a week, however, may be considered GERD, and this can eventually lead to more serious health problems.
Persistent heartburn is the most frequent symptom of GERD. Most Americans don’t associate heartburn with GERD because it is so common. Most people know that heartburn and pain are symptoms of GERD but don’t realize that there are lots of other symptoms that can occur when GERD is present. Symptoms can include hoarseness, chronic cough, asthma, laryngitis, recurrent pneumonia and ENT infections, nocturnal choking, sleep apnea, loss of dental enamel and bad breath.
A chronic disease, GERD requires treatment on a long-term basis, sometimes even after symptoms have been brought under control. Issues of daily living and compliance with long-term use of medication often need to be addressed. Various methods to effectively treat GERD range from lifestyle measures to the use of medication or surgical procedures. It is essential for individuals who suffer persistent heartburn or other chronic and recurrent symptoms of GERD to work with their physician, and to receive the most effective treatment available.
Certain foods promote or worsen symptoms of acid reflux. Some, such as citrus, tomato and coffee, directly irritate the esophagus lining. Overeating as well as going to bed within 2-3 hours of supper should be avoided since gastric distention promotes reflux. GERD suffers should also avoid late night snacks. Foods that can be associated with reflux include; citrus fruits, chocolate, drinks with caffeine, fatty and fried foods, garlic and onions, mint flavorings, spicy foods and tomato-based foods.
Weight gain, pregnancy, smoking and alcohol have also been implicated as risk factors for GERD. Reflux symptoms may often be reduced simply by elevating the head end of the bed or by using a wedge under the upper body. Other lifestyle changes include:
If you smoke, stop.
Do not drink alcohol.
Lose weight if needed.
Eat small meals.
Wear loose-fitting clothes.
Avoid lying down for three hours after a meal.
GERD is primarily treated with changes in lifestyle as well as acid suppression.

Ratcliffe works for the Coastal Health District.
 

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