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

There are few things more embarrassing than halitosis – better known as bad breath. Whether it’s that disturbing look on your significant other’s face when you give them a smooch, or that unpleasant odor coming from that stranger chatting you up at a party, bad breath can cause a little anxiety for everyone involved.

“Bad breath can be a totally benign thing, and you just need to brush more, or it could be a sign that something more serious is going on,” says Breanne Gendron, a nurse practitioner for OSF HealthCare. “If you are someone who has bad breath despite regular like twice daily brushing and flossing, then it would be important for you to see your dentist to make sure everything's healthy on the inside of your mouth.”

Gendron says bad breath is common. One in four adults have had bad breath at some point in their lives. It can also be chronic. And some people, Gendron adds, don’t even know they have bad breath due to a condition called Olfactory fatigue, which is when people lose their sensitivity to odors.

Bad breath can be caused by many things, but it all starts with good dental hygiene. In addition to brushing twice a day, flossing is also extremely important. While some people tend to blow off brushing their teeth before bedtime, Gendron says that’s the most important time of the day. That’s when cavities can form the easiest and we don't make as much saliva when we sleep. When your mouth is dry you wake up with the always dreaded “morning breath.”

Gendron says the first call to make is to your dentist. Ongoing bad breath can be a sign of gum disease, which can be caused by genetics, plaque, or both. If your dentist doesn’t find any problems such as cavities or gum disease — then your primary care physician can determine if another condition is causing the bad breath.

“We need to check the inside of the mouth first, if the dentist says everything looks good, you need to see your doctor to talk about other reasons for those issues,” says Gendron.  Some more serious conditions that can cause bad breath are oral or throat cancer or tonsillitis. People who are diabetic are prone to gingivitis and gum infections.

The most obvious symptom of bad breath is, well, bad breath. But other problems include a white coating on the tongue, a dry mouth, or excess mucus in the back of the throat usually from nasal irritation, allergies, or a bacterial infection.

There are other reasons, of course, for bad breath. Smoking is one. But it’s also the foods we eat.

“When I'm thinking bad breath, I think garlic, onions, spicy food, those types of things. If you have an important afternoon meeting, those are the foods you want to avoid at lunch,” says Gendron, who adds coffee breath isn’t usually a problem. “I think that most of the public drinks coffee for breakfast, and I think that drinking coffee is fine.” 

For many of us who experience bad breath from time to time the old standby is to pop a mint or a piece of gum in your mouth. While that may help rid yourself of the smell, Gendron says that’s just hiding a potential problem.

“I think using gum or mints when you're in a situation where you're going to be talking to somebody in close range, and you want to make sure your breath is good, it's fine, but it isn't something you should use on a regular basis to mask symptoms,” she says.  

So the next time someone tells you that your breath isn't up to snuff, take heed. It just might be the hint you need to get to the root of what's really causing that undesirable odor. 

Interview Clips