Is it heartburn or GERD? How to reduce symptoms during the holidays

Rich, delicious foods are irresistible during the holidays but heavy meals can leave us with that all-too-familiar burning pain that moves up to the throat. Heartburn may be a symptom of a more severe condition like gastroesophageal reflux disease (GERD).

Q. What is GERD?

A. GERD is a disorder of the digestive tract that can lead to serious complications if left untreated. GERD occurs when the lower esophageal sphincter (LES), the valve that connects the esophagus to the stomach, inappropriately relaxes and allows the digestive acids to reflux, or travel back up the esophagus.

Q. What are the worst trigger foods?

A. Unfortunately, certain foods popular during the holidays such as chocolate and peppermint, as well as fatty foods, acidic foods and alcoholic beverages, tend to exacerbate GERD.

Q. How should we manage GERD during the holidays?

A. Some tips that may help include eating smaller portions, avoid eating or drinking too late in the day (when you lie flat your stomach contents can flow into your esophagus), eliminate acidic foods (they can trigger heartburn) and limit caffeine and alcohol intake.

Q. Why does the sphincter weaken in some people?

A. A temporary weakening may be caused by the types of food you're eating. Chocolate, mints and fatty foods all relax the LES. Smoking, pregnancy, certain medications and obesity can contribute to a more consistent weakening of the sphincter.

Q. What are the best medications?

A. For infrequent heartburn, an over-the-counter remedy such as an antacid may provide relief. However, for erosive GERD and more frequent heartburn symptoms, physicians may prescribe a proton pump inhibitor or an H2 blocker.

Q. What if medications don't work? How bad does it have to be to get advanced help?

A. If lifestyle changes and medications don't help, and you're experiencing heartburn or GERD every day, you may need further testing, such as an endoscopy with biopsies (a tissue sample obtained from your esophagus). Surgery is also an option for those with severe GERD or those who can't tolerate daily medications.

• Dr. Susannah Spiess is a gastroenterologist at NorthShore University HealthSystem.