- Type I: Sliding.
- Type II: Paraesophageal ("rolling").
- Type III: Combined I & II.
- Weak esophageal muscles which can result from aging, cancer, injury, certain surgeries, or an inherited flaw in formation of the diaphragm. It is often associated with gastroesophageal reflux (GERD) in infants.
- Increased abdominal pressure that occurs during bending, straining, coughing, extreme physical exertion, or wearing tight clothing that can cause the stomach and esophagus to push into the chest.
- Increased abdominal fluid accumulation, pregnancy, and obesity can also contribute.
- Repetitive straining to have a bowel movement or to urinate.
- Chronic coughing.
- Heavy lifting with poor body mechanics.
- Smoking history.
- Heartburn 1-4 hours after eating which increases with lying down.
- Swallowing difficulty.
- Abdominal pressure.
- Possible vomiting.
- Epigastric pain.
- Chest pain.
- Postprandial fullness.
- Abdominal bloating.
- Respiratory symptoms.
- Antacids that neutralize stomach acid: Over-the-counter antacids, such as Maalox, Mylanta, Gelusil, Rolaids and Tums, may provide quick relief. But antacids alone would not heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects, such as diarrhea or constipation.
- Medications to reduce acid production: These medications include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac 75). H2-receptor blockers do not act as quickly as antacids, but they provide longer relief. Stronger versions of these medications are available in prescription form.
- Medications that block acid production and heal the esophagus: Proton pump inhibitors block acid production and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24HR) and omeprazole (Prilosec OTC). Stronger versions of these medications are available in prescription form.
- Avoiding large or heavy meals.
- Not lying down or bending over immediately after a meal.
- Reducing weight and not smoking.
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