Chest Pain: GERD or Heart Attack?
Most people know of someone who has landed in the emergency room with chest pains and the fear of suffering a heart attack, only to find out they were instead experiencing a panic attack. Sudden, disabling anxiety can, and often does, trigger crushing chest pain, a symptom similarly present with angina and cardiac arrest. Esophageal spasms caused by Gastroesophageal Reflux Disease (GERD) — a condition in which stomach contents flow back into the food tube connecting the stomach to the throat — can also produce sharp chest pain, making it especially difficult to tell the difference. In fact, more than half of ER visits for chest pain are due to heartburn, the most frequent GERD manifestation.
What Causes GERD?
GERD occurs when the lower esophageal sphincter (LES) — a muscle flap located at the base of the esophagus that when closed prevents the backflow of acid and stomach contents — is compromised. This can cause a burning sensation in the chest or throat and reflux of unpleasant-tasting fluid into the mouth. Difficulty or pain when swallowing, hoarseness and a chronic cough can also indicate improper function of the LES, which can weaken due to various causes including consuming spicy, fatty, carbonated and caffeinated foods and beverages, smoking and alcohol consumption, pregnancy, hiatal hernia, as a side effect of certain medications, and in conjunction with autoimmune disease. Stress may also exasperate GERD discomfort. Obesity, particularly excess weight around the mid-section that adds pressure to the stomach, precipitates most cases.
When Should You See a Doctor?
While occasional reflux is normal, severe and frequent occurrence — twice a week or more — warrants medical attention. One should see a doctor if they have difficulty or pain when swallowing and if heartburn worsens and interrupts sleep and daily activities. A specialist or gastroenterologist can best discern from a wide range of symptoms if GERD is the cause, eliminating expensive tests to rule out other conditions such as heart problems.
How Do You Treat GERD?
Treatment of GERD is long-term in order to control or reduce symptoms, heal an injured esophagus and prevent complications. Proper treatment and management can reduce the risk of GERD progressing into more serious conditions such as precancerous Barrett’s esophagus and esophageal cancer. Options include lifestyle changes, medication, surgery or a combination of those options. However, a natural, preventative approach of minor lifestyle changes that encourage a healthier digestive system can be highly effective.
GERD Can Be Prevented
Among the simplest ways to prevent GERD or reduce symptoms once it has occurred is to lose excess weight, which through intra-abdominal pressure compromises the muscle connecting the esophagus. The most effective medical therapy for GERD is the use of proton-pump inhibitors (PPIs). When using PPIs, pH is almost neutral, which allows bacteria to proliferate. This can lead to a disorder called SIBO, or small intestinal bacteria overgrowth. SIBO causes symptoms of bloating, gas and diarrhea. Clinical studies have found that taking a good probiotic supplement along with the PPI will help prevent the development of SIBO symptoms. Importantly, no adverse side effects have been noted when PPIs and probiotics are taken together.