Q&A about GERD

Since I brought up caffeine yesterday, let me follow with a related common question I hear in the office. "What can you give me for my heartburn?" or, sadly, since the dawn of commercials telling us what we "need", "I think I need the purple pill for my GERD (Gastro-Esophageal Reflux Disease)"! And what do I say? My response is "Let me teach you what YOU can do to improve your heartburn."
There are certainly a plethora of medicines we can use to treat reflux, from over the counter antacids to expensive proton pump inhibitors, and they all work very well. However, why not address the CAUSE of the problem? Heartburn comes from stomach acid sloshing back upwards into the esophagus rather than flowing downstream. This happens when the sphincter- the band of tissue that surrounds the connection between the esophagus and the stomach- relaxes. What causes it to relax?
You already know the answer if you picture what people do after overeating, and they want to relieve their distended stomach. Tobacco, alcohol, caffeine and peppermints all relax that sphincter, letting our stomachs feel less distended, but allowing acid reflux in the process. Remember this when the waiter sets your mints down as he refills your coffee with desert.
BOTTOM LINE: If you're having heartburn on a regular basis, limit the causes of reflux- smoking, alcohol, caffeine and mints- BEFORE you head to the doctor for a quick fix.