Maybe it’s the middle of the night, you wake up coughing, choking.  Or perhaps you are at work, you have a big greasy meal for lunch, and all of a sudden you feel a burning, stabbing, insistent pain in your chest.

Sound familiar?

If these scenarios do sound familiar, you could be one of the 15 million Americans who suffer from heartburn and acid reflux daily.

Many people have felt the sensation of heartburn, but what exactly is acid reflux? Acid reflux is the backward flow of stomach acid into the esophagus – the tube that connects the throat to the stomach.  This backward flow becomes possible when the sphincter muscle at the lower end of your esophagus is weak or relaxes at the wrong time.  If the valve or sphincter is open, this allows stomach acid to back up into your esophagus. This reflux can, in turn, cause heartburn – the burning sensation in your chest – along with other symptoms. When acid reflux and heart burn occurs at least twice a week, and the backwash of acid irritates the lining of your esophagus, doctors will classify this as GERD (gastroesophageal reflux disease).

Here are some common symptoms of acid reflux:

• Chest pain:  occurs because stomach acid is splashing into the esophagus, people often mistake it for a heart attack
• Regurgitation:  a sour or bitter-tasting acid backing up into your throat or mouth
• Pain after meals: if the stomach is overloaded with a big fatty meal, this can trigger acid production and reflux. 
• Choking:  sometimes acid from the stomach makes its way up to the throat and can cause choking.  If you wake up choking, this may be a sign of acid reflux
• Hoarseness:  often mistaken for an early cold symptom – this can actually be the result of stomach acid seeping into esophagus and irritating the vocal cords
• Sore throat: usually mistaken for seasonal allergies or cold symptom, a sore throat develops from the continuous irritation of acid on throat. An easy way to know to know it’s not a cold, is if you don’t develop other flu or cold- like symptoms
• Cough:  If you are experiencing a chronic cough and wheezing, this may not be a respiratory issue but rather stomach acid from reflux getting into your lungs
• Trouble swallowing:  Over time, the continuous cycle of damage and healing after acid reflux can cause scarring.  This, in turn, causes swelling in the esophageal tissue, and a narrowing of the esophagus, resulting in difficulty swallowing

Identifying that you have acid reflux can be tricky, as many of the symptoms are not obvious or can be easily mistaken for something else, like a heart attack or common cold. However, if left untreated, acid reflux can cause esophagitis, a painful irritation of the esophagus that can lead to bleeding, ulcers and scarring in the esophagus.  Chronic acid reflux has also been linked to Barrett’s esophagus, characterized by an abnormal change in the cells that line the esophagus, which is a precursor to cancer.

Ok, you have acid reflux.  Now what?

If you have acid reflux, simple lifestyle changes, like losing excess weight, eating smaller meals, and avoiding foods that seem to trigger heartburn can help.

Foods to avoid:

• Spicy foods
• Tomatoes and tomato sauce
• Garlic
• Citrus fruit
• Onion
• Peppermint
• Chocolate
• Fried foods
• Fatty/greasy foods
• Salt

Drinks to avoid:

• Coffee (including decaf)
• Alcohol
• Soda
• Citrus fruit juices

Not everyone’s reflux is triggered by the same foods or drinks.  If the items listed above don’t seem to get your acid churning, keep a food journal and note the meals that brought on reflux symptoms.  Once you have identified the food that is bringing on acid reflux, you can try to avoid it.

If you frequently suffer from acid reflux at night, you may find relief is as simple as avoiding big meals before bed and raising the head of your bed.  More prone to reflux when laying down or bending over. When we are standing, gravity lends a helping hand in keeping food down in the stomach.  When we lay down, we lose the effect of gravity and will often experience worse acid reflux.

Additionally, if you are a smoker, you may want to consider quitting. Smoking can weaken the valve in your throat, leading to acid reflux and heartburn.

Some other natural remedies to ease your heartburn and reflux are chewing gum or taking slippery elm extract.  Chewing gum helps force fluids back into the stomach and flood esophagus with alkaline saliva, neutralizing acids that cause the characteristic burning sensations of heartburn. Although there limited research, slippery elm has been used historically to soothe inflammations, reduce swelling, and heal damaged tissues.  The tree extract is said to thicken the layer of mucous lining the stomach, creating a stronger barrier against acid helping sooth acid reflux.

If these tips do not help, there is a wide array of over-the-counter medication to help ease symptoms, including:

• Antacids, such as Tums
• H-2-receptor blockers, such as cimetidine (Tagamet HB) or famotidine (Pepcid AC)
• Proton pump inhibitors, such as omeprazole (Prilosec OTC)

Stronger medications should be taken with care, as they can cause side effects.  Contact your physician if you are experiencing chronic and severe symptoms of acid reflux.