Diabetes And GERD: What You Need To Know

There’s a bad taste in your mouth, and it’s not because you had orange juice after brushing your teeth. Or maybe you’re experiencing a burning sensation in your chest, but it’s just a little heartburn, right? Heartburn is quite common in the United States, but for those with diabetes, it’s important to know when “just a little heartburn” could be something more serious.

More than 60 million adults in the United States deal with heartburn at least once a month. What they experience may be referred to as heartburn or acid reflux, and while often used interchangeably, there is a slight difference between the terms.

Photo: AdobeStock/kanachaifoto
Photo: AdobeStock/kanachaifoto

Heartburn specifically refers to the burning sensation in your chest, neck, or throat resulting from stomach acid coming into contact with the lining of your esophagus. Heartburn is a symptom of acid reflux. Acid reflux refers to having stomach acid back up (or reflux) into your esophagus. This can progress to a more serious condition called gastroesophageal reflux disease, or GERD.

While the symptoms GERD causes are not always associated with diabetes, GERD is a common complication of diabetes, and could eventually cause serious conditions if left unchecked. Let’s break it down piece by piece.

The symptoms of GERD are similar to those of your garden-variety acid reflux:

  • Heartburn
  • Acid in the esophagus
  • Tightness of the throat
  • Hoarseness
  • Shortness of breath
  • Bitter taste in the mouth

Unmanaged, GERD may lead to:

  • Severe chest pain
  • Damage to the esophagus (narrowing, obstruction, and/or bleeding)
  • Increased risk of esophageal cancer
  • Dysphagia (difficulty swallowing)

The most obvious difference between GERD and simple acid reflux is frequency. If you have symptoms of acid reflux twice a week or more, you may have GERD. The disease is caused by the relaxing of the lower esophageal sphincter (LES), which is the sphincter that allows food into your stomach, but shouldn’t allow anything back up into your esophagus. When the LES relaxes, acid that belongs in your stomach can reflux into your esophagus, causing discomfort.

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Photo: AdobeStock/kanachaifoto
Photo: AdobeStock/kanachaifoto

Nerve damage from diabetic neuropathy may also mean the muscles in your esophagus are less able to clear acid, and this combination of increased acid contact and delayed clearing can cause irritation in the esophagus lining. Gastroparesis, another common complication of diabetes, may further exacerbate matters. In gastroparesis, the stomach doesn’t empty as quickly as it should which increases pressure in the stomach and makes it harder for the LES to stay closed and keep stomach acid in check.

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