GERD (gastroesophageal reflux), which is also commonly known as heartburn of acid reflux, may seem like a relatively trivial condition, but it is one of the most discomforting issues to impact seniors today. While GERD is common, it can be extremely uncomfortable and is characterized by a deep burning sensation in the stomach, throat and chest area. Simply put, this sensation occurs when the stomach's contents travel back up to the esophagus. It is estimated that every day, millions of Americans deal with GERD.
Unfortunately for seniors, the likelihood of developing this condition only increases with age. Some of this has to do with natural changes in the body that occur throughout the years. It can also have to do with the fact that many seniors are prescribed medications for other conditions that also alter the GI tract. No matter what the reason, more and more seniors today are dealing with GERD, and it has become an increasingly underdiagnosed problem among the senior community. Many seniors are unable to communicate their pain or discomfort with GERD, leaving this condition to go un-diagnosed and untreated.
The good news is, when caught, most cases of GERD can be treated with over-the-counter medications. In some situations, when the condition persists at a frequent rate (often more than 3-4 times per week) or if the symptoms are not getting better, a primary care provider may need to step in and prescribe a more aggressive form of treatment to get these symptoms under control.
Diagnosing GERD in Seniors
The first step to helping any senior get the acid reflux relief that they need is to diagnose the issue at hand. In most cases, seniors will be able to express their pain or discomfort associated with GERD. However, in some cases, home care providers may need to step in and look for signs of pain and discomfort in seniors, particularly while or after they are eating. Common symptoms include:
- Chest pain or discomfort when lying down
- Chest pain or discomfort when waking up in the morning
- Bitter taste in the mouth
- Regurgitating food in the mouth after eating
- Complaints of pain while swallowing
- Frequent issues of food getting stuck in the throat while swallowing
- Unexplained wheezing hoarseness or sore throats
- Chronic coughing or throat clearing
- Excess mucus production
- Choking fits
While some people may be able to live with the symptoms of GERD, if left untreated, it can lead to a number of more serious issues, particularly in seniors. If seniors, or their care providers notice any of these signs and symptoms, they should contact their primary healthcare provider as soon as possible.
These more serious signs and symptoms include:
- Extreme, or unintentional weight loss
- Black, tarry stools
- Rectal bleeding
- Unexplained vomiting
- Blood in vomit
- Vomiting up coffee-ground looking materials
- Severe chest pain
These symptoms can be life-threatening or even be an indication of a more serious problem that may be developing. Many seniors who have GERD also suffer from heart disease, so an accurate diagnosis is important to rule out a more serious problem.
When it comes to getting an accurate diagnosis, typically, most doctors will take a medical history, look at the senior's symptoms and begin by prescribing or suggesting an antacid. Many times, this medication can help ease the symptoms. However, if the symptoms don't ease or subside, the doctor may conduct an x-ray of the GI tract, or try an anendoscopyis, which is a procedure that sends a small scope through the mouth and through the esophagus, stomach and small intestine.
Some doctors may do a fecal exam to test pH levels. A tube can also be placed through the nose to determine how the esophagus and the sphincter is working to ensure more permanent internal damage hasn't occurred inside the body. These tests can help determine if there is a more serious issue such as esophageal cancer forming, or if a more serious medication needs to be prescribed to remedy this condition.
The Causes of GERD
In basic terms, GERD occurs when the tube, also known as the esophageal tube, that connects the mouth and the stomach is damaged. When this happens, it prevents the bottom of the esophagus, also known as the esophageal sphincter from keeping all of the items inside the stomach where they are supposed to be. When this happens, these stomach contents can harm the lining of the esophagus and result in a burning sensation.
Certain people are more prone to GERD than others. Age is a factor as is asthma and diabetes. Those who have had hiatal hernias, peptic ulcers and issues such as scleroderma are also more prone to GERD than others. Other risk factors include:
- Certain foods including acidic, spicy, greasy or fried foods
- Eating chocolates or mints
- Caffeine and alcohol
- Eating large meals or eating a lot of food quickly
- Wearing compressed clothing, particularly over the stomach
- Eating and lying down right away
- Taking calcium channel blockers
- Asthma medications
Seniors who engage in the aforementioned activities may be much more likely to develop GERD and should be aware that these factors put them at risk for developing this condition.
Treating and Managing GERD in Seniors
In addition to over-the-counter medications such as antacids, many seniors can start making little lifestyle changes in order to improve their GERD-related symptoms. This includes:
- Avoiding trigger foods that make burning worse
- Quitting smoking
- Drinking plenty of water
- Refraining from eating large meals at once
- Wearing loose-fitting clothing that doesn't place pressures on the stomach
- Staying upright and not laying down in the hours following a meal
- Sleeping with the head elevated
- Sucking on lozenges or chewing gum to increase saliva production
When changes like this do not prevent the onset of GERD symptoms or fail to help with the frequency of GERD, it may be time for the senior to see a doctor about a more serious remedy.