You’ve enjoyed a nice meal and now you’re paying the price: pain or a burning in your chest, an acidy feeling in your throat, or difficulty swallowing. There’s a good chance that you’re experiencing acid reflux. Is having diabetes a cause? And most importantly, what can you do to prevent it?
What is acid reflux?
Acid reflux, sometimes called heartburn or acid indigestion, occurs when the contents of your stomach come back up into your esophagus. This happens because the valve at the end of the esophagus, called the lower esophageal sphincter, doesn’t completely close.
The “acidy” feeling that you get during acid reflux happens thanks to hydrochloric acid. The stomach releases hydrochloric acid to help break down food and kill off any harmful bacteria. When the esophageal sphincter doesn’t close, the acid content moves into the esophagus (called “reflux”), causing uncomfortable and painful symptoms.
The American College of Gastroenterology estimates that acid reflux affects about 60 million Americans at least once a month and 15 million people daily.
What are the symptoms of acid reflux?
Telltale signs that you have acid reflux include:
- Heartburn (a burning and sometimes painful feeling in your chest)
- Food that comes back into your throat or mouth
- Feeling like food is caught in your throat
- Problems swallowing
- A sore throat
You may notice that acid reflex tends to occur at night, especially when you’re sleeping (or trying to sleep). That’s because gravity no longer helps to keep stomach contents down. Plus, when you’re sleeping, you’re not swallowing as much (swallowing helps to keep stomach acid down, as well).
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Is acid reflux the same as GERD?
The occasional bout of acid reflux that occurs, say, after eating a big meal late at night is one thing; when acid reflux occurs two or more times a week, or if it’s very severe at least once a week, you may have a condition called gastroesophageal reflux disease, or GERD for short. Be sure to let your health care provider know if you have recurring acid reflux, since GERD can lead to inflammation, narrowing, ulcers, and precancerous changes in the esophagus.
How is acid reflux linked to diabetes?
Acid reflux and GERD may be more common in people who have diabetes for a few reasons:
Being overweight or obese
Excess weight puts pressure on the abdomen, squeezing the stomach and pushing acid into the esophagus.
Being overweight can cause a hiatal hernia, which is when the upper part of the stomach bulges through the diaphragm.
Constant high blood glucose (hyperglycemia) can damage the vagus nerve, which prevents muscles of the stomach and intestines from working properly to move though the digestive tract.
ACE inhibitors, calcium channel blockers, statins, and some antidepressants (medications that are often used by people with diabetes) can increase acid reflux. Even over-the-counter pain relievers, such as aspirin and ibuprofen, are culprits.
How can you manage acid reflux?
Medication is often used to help manage symptoms of acid reflux. Over-the-counter antacids, H2 blockers, and proton pump inhibitors are often recommended by doctors as the first line of treatment. Prescription-strength versions of these drugs, as well as other drugs, are prescribed if the over-the-counter versions don’t help.
While medications can indeed be helpful, they do have side effects. Changing some daily habits can be very helpful for lessening and maybe even preventing acid reflux in the first place. A study published in JAMA Internal Medicine in January 2021 looked at data from a nationwide study of women called the Nurses’ Health Study II. Here are five factors that helped:
- Reaching a healthy weight (even losing a few pounds may help provide relief).
- Not smoking (nicotine causes the esophageal sphincter to relax).
- Being physically active for 30 minutes every day (go for moderate, low-impact exercise like walking, swimming, or yoga rather than ab exercises, weight lifting, or running).
- Drinking no more than two cups of caffeinated coffee, tea, or soda daily (caffeine can relax the esophageal sphincter).
- Following a healthy diet (eating smaller meals and limiting or even avoiding alcohol, carbonated drinks, citrus fruits, tomatoes and tomato-based foods, garlic, mint, onions, and fatty foods can help).
Other steps that may help lessen or prevent acid reflux symptoms are to:
- Eat slowly — try taking smaller bites of food, chewing each bite 20 times, or putting your fork down between bites.
- Stay standing or sitting up after eating.
- Doing light activity (such as going for a walk) after eating.
- Sleeping so that your head is 6 to 8 inches higher than your feet — try putting risers on the legs at the top of your bed or using a wedge pillow.
- Avoid wearing tight clothing.
- Keeping your blood glucose within your target range.
Want to learn more about diabetes and heartburn? Read “Diabetes and GERD: Are They Linked,” “Diabetes and GERD: Diagnosis and Treatments,” and “Diabetes and GERD: The Role of Food.”