What is GERD and why can it occur in perimenopause and menopause
GERD stands for Gastroesophageal Reflux Disease. In the UK, it is also known as GORD.
So, what exactly is it? At the top of the stomach which is at the bottom of the oesophagus (the tube that goes down to the stomach), there's a valve. When you've eaten, this valve shuts to keep all your stomach contents where they should be.
The problem is if that valve gets a bit weaker or other situations arise in the stomach, it may not close properly. Then the stomach contents can end up refluxing or leaking back into the oesophagus, and may rise to the back of the throat.
So, GERD is what the symptoms are known as when they are more severe than just occasional acid reflux, and can last longer. Acid reflux may happen once in a blue moon if you've eaten too much or you've eaten the wrong foods, but if it’s happening daily it may be diagnosed as GERD. It's really common in menopause, purely because falling hormones weaken our digestion generally.
Also, falling hormone levels means we very often produce less stomach acid. The symptoms of acid reflux can be mistaken for over-acidity. A lot of people think, "Oh, you know, I must be producing too much acid." But if you don't produce enough stomach acid, that will give you very much the same symptoms. All that's happening is there's not enough stomach acid to break that meal down, so that meal is going to bubble, it's going to ferment, it's going to produce gases. And that is going to put a lot of pressure on that valve at the top of the stomach and the next thing you know, the valve has loosened and you're getting this gastric reflux.
It can also be caused by stress. So, again, remember that if you're under a lot of stress, particularly if you're getting things like anxiety or panic attacks, that can shut off your digestion. So, if you have just recently eaten a meal and then you're in a state of panic or stress, whatever's in your stomach is going to sit there for hours and again, it's going to bubble, it's going to cause lots of problems, and then the next thing you know, you've got this acid reflux again.
Symptoms of GERD in perimenopause and menopause
So, let's have a look at some of the symptoms of GERD:
Regular acid reflux
As I’ve said, this symptom is likely to lead to a GERD diagnosis if it is happening more and more regularly.
Unpleasant sour taste in the mouth
You can end up with a very sour bitter taste in the mouth that is not very nice.
Heartburn
Now, heartburn is feeling really uncomfortable. You might find that you're getting a lot of pressure, you can get a little bit of pain sometimes under the ribs, and a feeling of being really full. There can also be a kind of burning sensation. That's why they call it heartburn. It’s not actually your heart playing up, though, it’s your stomach.
Trouble swallowing
You might find that your throat's really dry, especially if you've been getting symptoms regularly. What can happen is that the acids from the stomach can start to irritate and burn the lining of the oesophagus, so you can end up with a sore throat, which can interfere with swallowing. You may find that you feel as if there's a lump in your throat all the time, although there's absolutely nothing there. That can interfere with your swallowing too.
A persistent cough
You can get a cough that doesn't go. So you go to the doctor, you maybe get it checked out. There's no infection. You find that cough remedies don't help, cough sweets don't help. You've no idea what's going on. What's happening in this situation is that the reflux is happening on such a regular basis that it's irritating the back of the throat, which is leading to a continual cough.
Other symptoms
You can also get hiccups regularly. It could be that you get continual bad breath. It can also have nausea, especially after eating.
What can help ease the symptoms of GERD in perimenopause and menopause
So, what can ease all these symptoms? Here are a few things I recommend to help:
Identify your food triggers: So, the first thing is it can be certain foods that are irritating the condition. So do a food diary: write down everything that you are eating and when you're eating it, and when you are getting any GERD symptoms and you may find that symptoms are worse after certain food groups.
The common food culprits are things like coffee, caffeine, fizzy drinks, tomatoes, really fatty foods, spicy foods, alcohol, and carbohydrates. If you eat a really big carb meal, very often that can start the whole fermentation process off.
Remember to eat really slowly: There is a wise saying: the stomach has no teeth. If you're eating food really quickly, if you're eating on the run, and if you're not chewing your food properly so that big lumps of undigested food are sitting in your stomach, then that's going to contribute to the problem. This little tip can be hard to do to start with, but when you sit down to eat, chew each mouthful 20 times, and that in itself can make a huge difference so it's worth persevering with.
Bitter herbs: Now, bitter herbs stimulate gastric juices. They stimulate the production of saliva in the mouth so you'll be chewing everything better, and they stimulate the production of stomach acid. So, you can either use these as herbal tinctures or as food. You can take herbal bitters in a little water before meals (such as Yarrow or Dandelion tinctures) or you can have a little starter of salad leaves, things like endive and fennel, a little bit of coriander, dandelion, and artichoke. These can all start to stimulate digestion properly.
Limit your water intake before, during and after you eat: If you think about it, if you're not producing enough stomach acid and you have a big drink whilst you're eating, you're going to dilute that stomach acid further and that's going to cause problems.
So, the rule of thumb here is don't drink within 30 minutes of eating and don’t drink whilst eating. If you do need something, then have just a small sip of plain water, and don't drink anything for at least 30 minutes after you have eaten.
Manage your stress by finding ways to relax: Address any stress, because that's going to cause ongoing digestive problems. And take time to relax.
Don’t eat large meals 3-4 hours before bedtime, & prop yourself up while sleeping: If your symptoms are happening more at night, which they very often do because if you've got pressure in the stomach and then you're lying down, that's going to put even more pressure on that stomach valve. And a lot of people do say the minute they get into bed, that's when their symptoms start.
So, with this one, have a light meal in the evening. Have your main meal during the day so you're not going to bed with your stomach full of half-undigested food.
Maybe also prop the top of your bed up a little bit so you're sleeping at an angle. And again, that's going to release the pressure on your stomach as well.
Ease your symptoms with Silicolgel: The other thing you can do if you are getting these symptoms is to try Silicolgel as this is recommended for acid reflux and stomach issues.
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When do you see the doctor?
GERD can be really serious because, if it continues, it can end up really causing problems with the oesophagus and it can cause a huge amount of damage to the actual oesophageal walls. So, if you're getting what you think is acid reflux on a daily basis, or a very regular basis, if you're getting any of these other symptoms as well, then it's really important to get this checked and diagnosed by your doctor.
Other stomach issues can cause similar symptoms, such as Helicobacter pylori. Stomach ulcers can cause these issues as well. And obviously, these need completely different treatment. So just remember, get these checked first. Once you know what it is, you can address the symptoms quite easily.
So, I hope you found this one helpful. If any of you have had GERD, what did you do to help yourself? We love to hear your stories so please share them in the comments below. And until then, I will see you next time for another edition of A.Vogel Talks Menopause.
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