GERD (gastroesophageal reflux disease)--caused by acid reflux--is one example. Gerd is more than just frequent "heartburn". It's even possible to have damage from GERD without frequent heartburn, since the amount of heartburn can depend on what kind of foods you eat, degree of overweight and other factors. Other common symptoms-- usually occurring at night--include coughing, snoring, swelling of sinus tissues producing cold-like symptoms, mucus drainage and throat clearing. Chest pain is another GERD symptom that prompts many a midnight trip to the emergency room. It should be noted, however, that even though chest pain is commonly related to GERD, it is not safe to assume GERD is the cause. You should seek emergency care anytime you experience sudden chest pain that persists

GERD happens when stomach acid flows back into your esophagus--the "tube" through which food enters your stomach. This happens more often when you bend over, or when you're lying down at night. While you're sleeping, GERD may be bathing your esophagus in stomach acid, causing burning and scarring. Over time, the scar tissue can narrow your esophagus, cause difficulty swallowing and even trouble breathing. Asthma-like wheezing, chronic laryngitis, and--infrequently--cancer of the esophagus can result if left uncorrected. Since the cause of these problems may not be immediately apparent--especially if you're not experiencing frequent bouts of heartburn--they often go undetected until substantial damage has been done.

When you swallow, the band of muscle around the lower part of your esophagus (called the esophageal sphincter) relaxes long enough for the food or liquid to pass through the esophagus to your stomach, then tightens again--keeping stomach acid where it belongs, in your stomach. If you are overweight, excess abdominal weight can crowd your stomach and diaphragm (the big band of muscle between your stomach and chest that helps you breathe), pushing your diaphragm against the bottom of your esophagus. The added pressure forces the esophogeal sphincter open, allowing stomach acid to flow backward into your esophagus.

One of the lesser-known side effects of diabetes is gastroparesis, which simply means your stomach takes longer than normal to empty. Food that stays in your stomach too long can sour and regurgitate, sending the acid-drenched contents into your esophagus and causing heartburn or GERD.

Over-the-counter antacids like Maalox ®, Tums ® or Rolaids ® may control your heartburn by neutralizing stomach acid. Some prescription drugs reduce the amount of acid in your stomach rather than neutralizing it--like Pepcid ® or Zantac ®. These are sold in weaker versions over the counter, and may be more effective than simple antacids against GERD. But if your esophagus is already damaged, you may need prescription-strength medicine to prevent acid reflux and heal the damage. Prilosec ® is one such drug, though its full-strength version is now sold over the counter. To be effective, Prilosec ® and similar drugs need to be taken at least half an hour before eating.

Apart from medications, there are things you can do to prevent the acid reflux that causes GERD:

&bull Lose weight

&bull Eat smaller meals

&bull Elevate the head of your bed 6-9 inches by inserting a foam wedge under your pillow or putting cement blocks under the front legs of the bedframe.

&bull Quit smoking and avoid alcohol

&bull Eliminate "triggers" from your diet--fried or fatty foods, onions, garlic, chocolate and coffee are frequent culprits.

&bull Avoid bending over.

&bull Don't lie down right after eating. Wait 3-4 hours after eating before going to bed.