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What Is GERD or Gastroesophageal Reflux Disease?
Gastroesophageal reflux disease, or GERD as it is more commonly known, is a chronic disease of the digestive tract that causes stomach acid and bile to flow back up through the esophagus from the stomach, causing irritation to the lining of the esophagus. Eventually, the lining will become inflamed which can lead to complications such as esophageal stricture (when the esophagus narrows due to scar tissue), esophageal ulcers (open sores in the esophagus) and the development of Barrett’s esophagus (a precancerous change in the esophagus’ lining).
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What Are Esophageal Spasms and Does GERD Cause Them?
In a healthy individual, the esophagus moves food from the mouth to the stomach in one long coordinated movement. However, esophageal spasms force the esophagus to contract in an uncontrolled, irregular and usually very painful way that causes food to become lodged in the esophagus where it is unable to move down to the stomach. Individuals experiencing an esophageal spasm often feel severe chest pain that radiates outward to the back, neck, arms and/or jaw, similar to a heart attack. Generally, these attacks are not common, but in severe cases, they can begin to occur frequently enough to begin interfering with food or liquids that are trying to progress naturally through the esophagus to the stomach.
The exact cause of esophageal spasms is unknown, but individuals suffering from GERD often report them as a symptom. It is possible that the complications of GERD – irritation, inflammation, scar tissue, ulcers and precancerous changes – cause the esophagus to contract erratically and result in these spasms.
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What Are the Treatment Options for GERD Pain Spasm Management?
Through medication and lifestyle changes, managing GERD pain spasms can be accomplished quite successfully. Medical treatment for the esophageal spasms is only necessary if the spasms are interfering with normal food and liquid intake. If this is occurring, treatment for the underlying condition of GERD would be the first step. Medications for treating GERD include over-the-counter medications such as:
- Antacids (Rolaids, Tums, Mylanta, etc.)
- Acid production-reducing H-2 receptor blockers (Pepcid AC, Tagamet HB, Zantac 75, etc.)
- Proton pump inhibitors to heal the esophagus (Prevacid 24 HR, Prilosec OTC)
If over-the-counter medications are ineffective in treating GERD symptoms, a physician can prescribe the prescription-strength version of the medications listed above. Also, a physician can prescribe a medication called a prokinetic agent that empties the stomach quickly and helps strengthen the valve between the stomach and the esophagus.
If the traditional medication treatments for GERD do not ease the esophageal spasms, muscle relaxants, such as Isordil, Procardia and Cardizem, can be prescribed to help the individual relax the muscles surrounding the esophagus, thus reducing the severity of the contractions. Tricyclic antidepressants can also be used to help control the pain of the spasms. Only in the most severe cases of both GERD and esophageal spasms is surgery recommended.
Certain lifestyle changes are very effective in managing GERD pain spasms as well as esophageal spasms, such as:
- Maintaining a healthy weight – excess weight pushes acid up into the esophagus from the stomach, causing damage to the esophagus
- Stay away from foods that trigger heartburn (for GERD) or are extreme hot and/or cold temperatures (for esophageal spasms)
- Quit smoking
- Find ways to alleviate stress in day life
- Avoid tight-fitting clothing, especially around the abdominal area
- Elevate the head while lying down or sleeping (about 6-9 inches if possible)
- Wait approximately 2-3 hours after a meal before laying down
Through a combination of medications and lifestyle changes, the pain spasms associated with GERD can become manageable. Make sure to consult a physician if pain spasms worsen after beginning medication and/or the lifestyle changes do not appear to help.
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eMedicineHealth.com website, http://www.emedicinehealth.com/reflux_disease_gerd/article_em.htm#Reflux%20Disease%20%28GERD%29%20Overview
eMedicineHealth.com website, http://www.emedicinehealth.com/esophageal_spasm-health/article_em.htm
Mayo Clinic website, http://www.mayoclinic.com/health/gerd/DS00967
Mayo Clinic website, http://www.mayoclinic.com/health/esophageal-spasms/DS00763