You’ve just finished a great meal and are enjoying an after dinner coffee or brandy. You’re feeling quite satisfied and then … a sudden burning sensation in your chest begins to change that glow of contentment. In fact, you are now running to the counter for your antacids.

As you sit down on the sofa chewing thoughtfully on your TUMS, that burning sensation is increasing and your chest is beginning to feel tight. And tighter. Are you having a heart attack? And, then a bit of very sour fluid rises up in your throat .. so much for a quiet, contented evening. Sound familiar?

It does to about 20 percent of the U.S. population (https://www.niddk.nih.gov/). But are these people suffering from gastroesophageal reflux disease (GERD), heartburn or acid reflux -all of which are used interchangeably, but are very different? Acid reflux is a common medical condition that can range from mild to serious. Gastroesophageal reflux disease (GERD) is the chronic, more severe form of acid reflux (healthline.com). Symptoms of GERD include bloating, nausea, chronic coughing, hoarseness and clearing your throat. If you experience these symptoms twice or more per week over three to four weeks, you just might be suffering from GERD (https://naturemed.org)

When the lower esophageal sphincter (LES), a circular band of muscle at the end of your esophagus, is working properly, it relaxes and opens when you swallow. Then it tightens and closes again. When your LES does not tighten or close properly, it allows digestive juices and other contents from your stomach (like that yummy dinner you just had) to rise up into your esophagus and acid reflux is the result. Left untreated, it can cause serious complications (https://www.niddk.nih.gov/)

If you think you may have GERD, make an appointment with your primary care physician (PCP). If your PCP says you do, he or she will often suggest you buy an over the counter proton pump inhibitor (PPI) such as Nexium, Prevacid or Prilosec, among others. Physicians can also write prescriptions for the generic versions, for instance Prilosec is omeprazole, and often these cost less (source: me). PPI’s lower stomach acid levels and reduce the acid reflux into the esophagus. The reflux results in heartburn symptoms Harvard.edu)

If your PCP is a naturopathic physician, he or she will use a variety of techniques including traditional, scientific and empirical methods that support “the body’s ability to mount a defense against the disease. Naturopathic treatment strengthens the body’s own abilities to regain and maintain health. Naturopathic medicine treats the person, not the disease. Yet it is the removal of the disease that is the main goal of naturopathic treatment.” (www.naturedoctor.com).

PCPs and naturopathic doctors both advise addressing GERD with changes in the diet. GERD patients should avoid acidic fruit, including tomatoes. Instead, look for melons, bananas, pears, apples … you get the idea. If you eat meats, be sure they are lean cuts; fried and high fat cuts are known to decrease LES pressure, which, in turn, will delay stomach emptying and increase the risk of reflux. Tofu and/or fatty fish like salmon and trout are excellent meal choices.

Veggies are your friend – but without sauces or toppings; eggs; whole grain breads, brown rice, couscous and oatmeal are healthy complex carbs that add fiber to your diet. Potatoes and other root vegetables (except for onions and garlic) are healthy carbs and digestible fiber. Use monounsaturated fats – oils such as olive, sesame, canola and sunflower; avocados; peanuts, peanut butter and many nuts and seeds; and polyunsaturated fats, which include safflower, soybean, corn and flaxseed.

Chocolate and coffee are on the avoid list, because they aggravate an already irritated esophagus.

Naturopathic doctors will also recommend fermented and cultured foods which reduce inflammation and support the immune system. Add some apple cider vinegar or lemon juice to your daily glasses of water. They will also suggest nutritional supplements including botanicals and probiotics. But remember to consult a professional before you visit your local organic store or pharmacy.

You should finish eating for the night at least two, preferably three hours before bed. Our digestive system does its thing by increasing the amount of gastric acid in the stomach – right where you want to keep it. And taking an after dinner walk really does help the process!

In some families, GERD is hereditary. Otherwise, tobacco smokers, overweight people, those with hiatal hernia, pregnancy, stress (which seems to factor into quite a lot of things) and clothes that are tight around your middle are among other culprits, as are environmental toxins and some medications that suppress the immune system.

In the long term, untreated GERD can lead to tooth enamel erosion, gum disease and other dental issues due to stomach acids; inflamation of the esophagus, narrowing or tightening of the esophagus; asthma or other breathing problems; chronic cough if you breathe stomach acid into your lungs; and Barrett’s esophagus disease, which can also lead to esophageal cancer (www.healthline.com)

If you consume alcohol, wine, beer, or other spirits, cutting down or going without may be the way to go, or not go. According to www. aboutgerd.com, alcohol is a known irritant that can weaken the LES and trigger reflux symptoms. But everyone is different: some people feel a spike in symptoms after one drink while others are able to imbibe in moderate amounts; the only way to know for sure is to experiment.

GERD is an uncomfortable, painful condition. Do not hesitate to contact a medical professional for proper diagnosis and treatment.