BreAnne Gendron, NP, knows all about the effects of gastroesophageal reflux disease, or GERD. She eventually had to give up coffee because it caused a burning sensation in her throat.

As a nurse practitioner with OSF HealthCare, Gendron also treats patients who experience GERD in different ways.

“GERD probably feels a little bit different for everybody, but it definitely helps [to understand patients' experience] when you have personal experience with it,” she says. “Sometimes people with GERD have a flare-up and their stomach hurts, but they don't get that acid-up-the-throat feeling. It just causes stomach discomfort. Sometimes it changes bowel movements. Everybody has a slightly different version of it.”

Occasional heartburn or acid reflux is common. But when those symptoms happen frequently – two or more times a week – it could be a sign of GERD and worth mentioning to your health care provider.

Symptoms can include regurgitation, trouble swallowing, a feeling of a lump in your throat, a persistent cough, a sore throat or heartburn that doesn’t improve with over-the-counter medication.

Gendron says people who are 50 and older and overweight are at highest risk for GERD. Heartburn is one of the most common symptoms of GERD. But how do you know if that burning sensation in your chest is simply reflux or something more serious, such as a heart problem?

When chest pain shouldn't be ignored

Gendron says patients will sometimes go to the emergency department because they are experiencing chest pain. While some people may wonder if they are overreacting, Gendron says it’s always better to have potentially serious issues addressed.

“If it’s the first time you're having chest pain, we can't just guess, ‘Oh, that's probably acid reflux,’” she says. “You have to go in and be seen to rule out a cardiac reason, because that's what we do in health care. We rule out the scary stuff, so we can treat the treatable stuff.”

Even people with a history of GERD should pay attention when their symptoms change. For example, if chest discomfort occurs during physical activity, it could be a sign of a heart problem and should be evaluated.

“I would say any time you have activity where you're carrying in the groceries or you're going up a couple flights of stairs and that pain happens, that's not a GERD symptom,” Gendron says. “That's a cardiac symptom, and your doctor can help you figure that out. It's worth a conversation if you're having reflux feelings that are different than normal.”

If you experience new, severe or unexplained chest pain, especially with symptoms such as shortness of breath, sweating, nausea, dizziness or pain that spreads to the arm, back, neck or jaw, seek emergency medical care immediately.

Knowing your GERD triggers

Once anything serious has been ruled out, lifestyle changes can help manage GERD symptoms.

Common triggers can include spicy or fatty foods, citrus or tomato-based foods, caffeine and soda, alcohol, nicotine and heavy or late-night meals.

Gendron says there isn't one diet that works for everyone with GERD. Instead, people should pay attention to which foods trigger their symptoms and make adjustments as needed.

“Some foods will bother people,” she says. “I hear people complain to me a lot about things with tomato sauce, so pizza and spaghetti and things like that bother people with acid reflux. So, you can augment your diet. You can cut back on coffee. You can cut back on your nicotine.”

Medication can also be used to treat GERD when lifestyle changes aren't enough. But Gendron says she prefers to start with lifestyle changes if possible.

For her, that meant giving up her favorite morning beverage.

“I personally had to give up coffee because of this problem. I know if I don't drink coffee, that my whole digestive tract is happier,” she says. “So, people will figure out which foods bother them, and then you have to avoid those.”

Interview Clips

• Changed demeanor, like mood swings
   
• Frequently stepping away, like asking to go to the restroom a lot at school

“They want to go smoke because they’re addicted already. They need that time. They have to go hide,” says Thompson, a breast health navigator. “Same thing at home. They constantly go to their room or bathroom.”

• New odors coming from your child or their belongings. Williams, a radiation therapist, notes that the smell could be good, like minty.
   
• Listen for kids using new phrases. Vapes are also called hookahs, pens, tank systems and mods.

Adults should also know the changing look of vapes. Boyd says they could be in plain sight in your child’s room, and you could miss them. Vapes can look like computer flash drives, ink pens, key fobs, candy canisters and even handheld video games.

Talking to kids

First and foremost, Boyd suggests taking a loving tone when talking to kids about the dangers of vaping. Don’t start by accusing them of wrongdoing.

“Gather information. Encourage them to open up. Make it a safe place,” Boyd says. “If they don’t feel comfortable talking to mom or dad, maybe try somebody at church, an older sibling, a school counselor or a teacher. Find those accountability people.”

If your child has a hard time opening up, talk to their pediatrician so they can broach the subject at the next appointment. During the appointment, offer to step out of the room so the child isn’t nervous to talk about their habits.

Thompson adds to keep kids active. If you’re playing backyard baseball with them, you know they’re not vaping.

“We want you to be healthy and live a long life,” she adds, suggesting words to use with your child. Not to mention the money you’ll save.

What about smoking?

How does smoking a traditional cigarette or cigar play into all this?

Boyd says some people see vaping as a way to quit smoking. She says that’s a bad idea. Talk to your health care provider instead about medication and other options.

At OSF Moeller Cancer Center, Boyd, Thompson and Williams offer a smoking cessation program. Providers can refer patients to the program, or they can self-refer by calling (618) 474-6791. OSF then connects the person with resources to quit and provides regular check-ins. Schools, businesses and community groups can also call to see how they can benefit from the program.

“Working on oncology, we see the back end. We see patients who have been 30-year smokers. They have a CT scan, and they find an abnormal mass,” Thompson recalls. “So we try to catch them early. We have younger patients who are seeing their primary care provider. Their provider says they’ve been smoking for five years, and they put the referral in. Well, we just saved them 25 years of smoking if we can get them to stop now.”

“Don’t see it as a failure,” if you can’t quit right away or if you relapse and smoke a few, Boyd adds. “Try again. We’re not all made the same. Quitting looks different for everyone”

Interview clips - Karen Boyd

Interview clips - Heather Thompson

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Christina Reifsteck knows the statistics all too well.

Law enforcement officers may not live as long as people in other professions. The job requires you to be in a constant state of hypervigilance for up to a 12-hour shift. The resulting stress may lead to serious heart issues.

But Reifsteck, a sergeant with the Rantoul, Illinois, police department, her colleagues and OSF HealthCare are trying to change that.

Rantoul police have partnered with OSF HealthCare Occupational Health and OSF HealthCare Cardiovascular Institute to have OSF provide heart screenings and the necessary follow-up appointments for officers.

“We wanted to make sure our officers have a better knowledge of what is going on inside their body,” Reifsteck says. “Sometimes you can’t see the problems.”

For Reifsteck, that need for knowledge played out on a gray February morning at OSF HealthCare Heart of Mary Medical Center in Urbana, Illinois. With monitors attached to her body, she walked, then ran on a treadmill while OSF Mission Partners (employees) observed her heart rate on a screen. It’s known as a stress test.

“The treadmill started out slow, and every couple minutes it got faster, and the incline raised higher,” Reifsteck recalls. “You did feel like at the end you were getting a workout. But it felt fine.”

“With the stress test, we try to identify someone’s functional capacity and if they demonstrate any evidence of impairment of blood flow to the heart,” says Alaa Ujayli, MD, an interventional cardiologist at OSF HealthCare Cardiovascular Institute in Urbana.

Down the hall, Reifsteck got pictures taken of her heart.

“We look at calcification of the coronary arteries, which is the beginning of plaque disease,” Dr. Ujayli says.

Reifsteck got reassuring news that her test results looked good. But a follow-up appointment with a cardiology provider was on her calendar for two days later.

“See where we are and if I need to make some lifestyle changes,” Reifsteck says. “First responders function better when they’re healthy.”

Dr. Ujayli agrees.

“Cardiovascular disease is a preventable illness,” he says. “If we establish preventive measures, we have a significant impact on the progression of the disease.”

Those measures include medication, talking with a dietitian to change eating habits, consistent exercise, better sleep habits and avoiding smoking and alcohol. Mental health care like meditation and visiting a counselor are also helpful for everyone, but especially first responders. More serious heart issues may require a procedure in the hospital.

Learn more about heart care on the OSF HealthCare website.

Interview clips - Sgt. Christina Reifsteck

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