Q:  How can I tell if I have heartburn or something worse?

A:  Gastroesophageal Reflux Disease, or GERD, is a condition in which your stomach contents come back up into your esophagus. It affects about 20% of the adult population in the United States.  If GERD goes unaddressed, serious complications can arise, particularly among the elderly. Unfortunately for seniors, the likelihood of developing this condition only increases with age.

Let’s start with some anatomy. The esophagus is a tube that carries food from your mouth to your stomach. When the muscle at the end of your esophagus does not close properly, the partially digested, acidic contents of your stomach leak back, or “reflux.”


You may feel a burning sensation in the chest or throat called heartburn. Sometimes, you can taste stomach fluid in the back of the mouth. If you have these symptoms more than twice a week, you may have GERD. You can also have GERD without experiencing heartburn. Your symptoms could include a dry cough, asthma symptoms, or trouble swallowing. Not every patient with GERD has all of these symptoms.

Seniors are at a higher risk for GERD. Many are prescribed medications for other conditions that alter the GI tract and decrease the sensitivity of the esophagus. These patients may report different symptoms, like respiratory problems, nausea, vomiting or chest pain. Ironically, the elderly patients with atypical symptoms may be at a more advanced stage of Gastroesophageal Reflux Disease. Most physicians will recommend their senior patients see a cardiologist — to rule out other diagnoses.

Lifestyle Changes

Lifestyle changes can be a first line of defense against GERD. Doctors advise losing weight, quitting smoking and may offer trial GERD medications without any testing. If a diagnosis confirms GERD, you will likely have to modify your diet and/or eat smaller meals. It is helpful to keep a food diary that notes when you have the symptoms, so that you can find your “trigger foods.” Unfortunately, the most common trigger foods can be among the hardest to cut back: coffee, chocolate, alcohol and foods that are acidic, spicy, greasy or fried top the list of things to avoid. Stop eating at least two hours before bed.

Several medications can also be prescribed to help with the symptoms of GERD. Some side effects of GERD medications (like bone depletion) can be problematic for seniors. Seniors should discuss the risks and benefits of drug therapy or other interventions with your doctor, to avoid medication interactions.

So how do you know for sure if it’s heartburn or something worse?  See your doctor!

One Senior Place is a marketplace for resources and provider of information, advice, care and on-site services for seniors and their families. Questions for this column are answered by professionals in nursing, social work, care management and in-home care. Send questions to, call 321-751-6771 or visit One Senior Place, The Experts in Aging.

Brenda Lyle is a Certified Care Manager and Certified Dementia Practitioner with One Senior Place, Greater Orlando.