Severe Acid Reflux: When to Seek Medical Help and Lifestyle Tips

If your gastroesophageal reflux disease (GERD) symptoms have worsened recently, it is advisable to seek medical attention?

Health condition: 18 years old, 157 cm, 44 kg (not on a diet but recently lost another 2 kg).
In the past few weeks, my gastroesophageal reflux has worsened significantly; I can burp thirty to forty times in one night, some even bringing up food remnants (like vegetable scraps).
I also seem to be experiencing a feeling of tightness and pain in my chest.
My mother suggested practicing "Qigong" to improve my condition, saying that seeing a doctor hasn't been very helpful (which sounds like an outdated belief?).
However, practicing Qigong only helps me release some gas (which is just through burping), and I often find myself in a situation where the gas is only partially released, which is very distressing.
Is this a folk remedy or a credible method? Should I continue doing it? Or should I go for a morning run? Could morning running or yoga stretching potentially improve my condition? I enjoy making a fruit juice (without added sugar, with fresh milk) around 5:30 PM when I get home and have no tutoring.
Could this be one of the reasons for worsening my gastroesophageal reflux? My mother keeps telling me that I should eat fresh-cut fruit instead of drinking fruit juice because saliva helps in digesting fruit, but isn't saliva primarily for breaking down starch? Additionally, my tutoring on Saturdays is from 8:40 AM to 2:00 PM.
Should I eat something around noon to settle my stomach, or can I wait until after tutoring to eat? If I eat after tutoring, should I have dinner around 5:00 PM since I have another tutoring session starting at 5:30 PM? Or should I skip a meal altogether? I’ve noticed that having dinner often makes me feel worse! Should I reduce my intake of certain types of food in the evening, such as meat or starch? Thank you for taking the time to help me with my questions!

A Yu, 10~19 year old female. Ask Date: 2021/03/02

Dr. Chen Shidian reply Gastroenterology and Hepatology

The principle is to eat at regular intervals and in appropriate portions (small, frequent meals are acceptable), with limited intake of sweets, acidic foods, coffee, and tea.
Take a short walk after meals and avoid prolonged sitting.
If necessary, medication can be taken for management, and it's important to avoid excessive psychological stress!

Reply Date: 2021/03/02

More Info

Severe acid reflux, also known as gastroesophageal reflux disease (GERD), can be a distressing condition, especially when it leads to symptoms such as frequent burping, chest discomfort, and the sensation of food remnants in the throat. Given your age and weight, it’s important to address these symptoms seriously, as they can significantly impact your quality of life.

When to Seek Medical Help
You should seek medical attention if you experience any of the following:
1. Severe or persistent symptoms: If your acid reflux symptoms are worsening, as you described, it’s crucial to consult a healthcare provider. Frequent burping, especially with food remnants, can indicate a more serious underlying issue.

2. Chest pain: While it may be related to reflux, chest pain can also signify heart problems. It’s essential to rule out any cardiac issues, especially if the pain is severe or accompanied by other symptoms like shortness of breath.

3. Weight loss: Losing weight unintentionally, as you mentioned, can be concerning. It may indicate that you are avoiding food due to discomfort, which can lead to nutritional deficiencies.

4. Difficulty swallowing: If you find it hard to swallow or feel like food is getting stuck, this warrants immediate medical evaluation.

5. Persistent nausea or vomiting: If you experience these symptoms, it’s important to see a doctor.

Lifestyle Tips for Managing Acid Reflux
1. Dietary Changes:
- Avoid trigger foods: Common culprits include spicy foods, citrus fruits, tomatoes, chocolate, caffeine, and fatty foods. Since you enjoy fruit juice, consider switching to whole fruits, as they are less likely to trigger reflux compared to juices.

- Meal timing: Eating smaller meals more frequently can help. If you have a busy schedule, try to eat a light snack around noon before your classes, rather than waiting until after. This can help prevent excessive hunger and reduce the likelihood of overeating later.

- Avoid late-night eating: Since you mentioned feeling worse after dinner, try to have your last meal at least 2-3 hours before lying down or going to bed.

2. Physical Activity:
- Exercise: Engaging in regular physical activity, such as jogging or yoga, can help improve digestion and reduce symptoms. However, avoid vigorous exercise immediately after eating, as this can exacerbate reflux.

- Posture: Maintain an upright position during and after meals. If you experience reflux symptoms, try to sit up straight for at least 30 minutes after eating.

3. Home Remedies:
- While your mother suggested practicing "qigong," which may help with relaxation and stress management, it’s essential to combine this with dietary and lifestyle changes for effective management of reflux.

- Hydration: Drink water throughout the day, but avoid large amounts during meals to prevent overfilling your stomach.

4. Medication: If lifestyle changes do not alleviate your symptoms, consider discussing over-the-counter antacids or proton pump inhibitors with a healthcare provider. These can help reduce stomach acid and provide relief.

Conclusion
In summary, while lifestyle modifications can significantly help manage acid reflux, it’s crucial to consult a healthcare professional to evaluate your symptoms thoroughly. Given your weight loss and worsening symptoms, a medical evaluation is warranted to rule out any serious conditions and to discuss appropriate treatment options. Remember, managing acid reflux often requires a combination of dietary changes, lifestyle adjustments, and possibly medication to achieve the best results.

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