You just drank your nighttime protein shake and you’re trying to get to sleep and you keep having a burning sensation in your throat, almost as though you might vomit. You sit up, take over the counter acid reducers, but night after night it happens, no matter which protein shake you use.
Sometimes it happens after taking your vitamins. The burning sensation won’t stop in spite of drinking volumes of water.
It can happen in the gym during a workout. It starts midway through your training and sometimes can be so severe that it stops you from training.
This is an extremely common problem, but especially common with athletes; its called GERD.
Gastroesophageal reflux disorder is a common malady with many causes. The symptoms range from a feeling of a burning sensation in the throat, chest pain or tightness (sometimes to the extent that it may mimic a heart attack), sour taste, burping, as well as stomach pain. The pain or other symptoms stem from too much stomach acid and its drift upward out of the stomach back into the lower aspect of the esophagus (the tube connecting the mouth to the stomach). The cells which line the stomach are designed to withstand the high acidity needed in the stomach in order to digest food. The cells lining the esophagus, however, are not. When subjected to acid, the esophagus causes the previously described symptoms. If this goes on for a long enough period of time, the cells of the esophagus can change to accommodate the acid, however, this change can lead to a pre-cancerous condition called Barrett’s esophagus. This condition is very serious and difficult to treat.
What causes acid from the stomach to reflux back up into the esophagus? There is no valve separating the esophagus from the stomach. Food and fluids move downward with the assistance of gravity. The esophagus travels through an opening in the diaphragm (the muscular wall which separates the contents of the chest from those of the abdomen). The pressure of the muscular wall against the sides of the esophagus creates a “functional valve” and helps stomach contents to remain where they should. There can be a loosening of pressure of the diaphragm called a “hiatal hernia” which can allow food to reflux back into the esophagus. Sometimes this is responsible for heartburn symptoms which are worse at night. When you lie down, the gravity assist to the diaphragm relaxes, and it is easier for reflux to occur. Food eaten up to three hours before bed may cause symptoms to occur. Some foods can cause hyper-acidity, like caffeine or other stimulants, spicy foods, alcohol, carbonated beverages and others. Medications can cause this, including aspirin, NSAIDs (non-steroidal anti-inflammatories) like Motrin and Naprosyn. There are some medications which can irritate the esophagus itself before ever reaching the stomach, a condition called “pill esophagitis” which feels just like GERD. It’s the most common reason why this happens to athletes taking a lot of supplements. There is also a bacteria called Helicobactor pylori which can live within the wall of the stomach, undetected in some cases except by special tests, and it can cause GERD.
The stomach also undergoes pathologic changes when hyper-secretion of acid occurs. The stomach can begin to “digest itself”; this is how ulcers form. The irritation within the wall may be significant enough to cause a bleed to occur, and many times patients are completely unaware of this. A bleed in the upper digestive tract, like the stomach, will allow blood to move into the intestine where some digestion of the blood occurs. There is no evidence of bright red blood in the bowel movement since digestion changes its appearance. The stool takes on a dark, tarry appearance bearing no resemblance to blood. It is often a hidden cause of anemia (low red blood cell count).
The most important step you can take is to undergo an examination and talk with me about the things that may have brought about this condition so that you can be diagnosed correctly. There is treatment available, but the treatments vary dependant on which one of the many causes are responsible for your symptoms.
If you have any of these symptoms, you need to have the cause diagnosed correctly so that the proper treatment can begin. Contact me through my website at www.DrMarilynLajoie.com. There is a Telemedicine for Athletes page for alternatives to an office visit.
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