Acid reflux, also known as gastro esophageal reflux disease (GERD), is a chronic condition characterized by the seeping of the liquid contents of the stomach into the esophagus. This liquid content from the stomach mainly consists of acid and pepsin - an enzyme secreted by the stomach to digest protein. The acid damages the lining of the esophagus and causes irritation and inflammation, thus causing heartburn.
The esophagus is the food pipe that runs from the mouth to the stomach. The entrance to the stomach is regulated by a valve, which is actually a ring of muscle called the lower esophageal sphincter (LES).
In normal conditions, once the food passes through this valve, it closes. But in a person suffering from acid reflux, this mechanism becomes faulty. Either it doesn’t close properly or opens too often. That causes the acid from the stomach to rise into the esophagus.
A person suffering from this condition will have the disease for life. If there is injury to the esophagus, then this condition is also chronic. With treatment, the esophagus heals. But if the treatment is stopped, chances are that it will return in most patients after a few months. That is why treatment for acid reflux must continue indefinitely.
What are the causes of Acid Reflux?
Acid reflux occurs due to a fault in the lower esophageal sphincter (LES). Due to this, the acid from the stomach rises up into the esophagus causing discomfort. The reason why the LES becomes faulty is still unknown. But it is believed that it can be because of pressure in the stomach getting abnormally high, and which cannot be withstood by the LES.
Below is a list of some of the common causes of acid reflux:
Pregnancy:During the third trimester of pregnancy, when the baby grows in size, it presses on the wall of the stomach. Because of this, the contents of the stomach rise into the esophagus. Antacids are generally not helpful in treating acid reflux caused by pregnancy. In such circumstances, it is advisable for the person to eat smaller meals throughout the day. In most cases, the symptoms of acid reflux disappear after the baby is born.
Hiatal Hernia: This is one of the common causes of acid reflux. It happens when the upper part of the stomach and the LES rise above the diaphragm. The diaphragm is a muscle that acts a boundary between the stomach and chest. In a person suffering from a hiatal hernia, the acid from the stomach rises up into the esophagus and causes the symptoms of acid reflux.
Peptic ulcers and insufficient digestive enzymes: These slow down the digestive processes in the stomach and cause an accumulation of gastric acids that seeps back into the esophagus.
Large meals and eating habits: Acid reflux is common in people who have larger meals and lie down immediately after a meal. Usually, if the portion sizes are cut down, there is some relief from the symptoms.
Asthma: Many asthma sufferers also have acid reflux.
Smoking: Research reveals that cigarette smoking reduces the production of saliva, stimulates the production of stomach acid and also weakens the LES. So it increases the chances of acid reflux.
Alcohol: This is also among the major causes of acid reflux. Sufferers often comment that by quitting alcohol or by cutting down on their intake, the symptoms of acid reflux improve significantly.
Among other causes of acid reflux are: being overweight, eating a high fat diet, eating very spicy food, snacking before bedtime, etc.
Who can be affected by Acid Reflux/GERD?
Acid Reflux/GERD can happen to any person, irrespective of age and sex. However, people over the age of 40 are more likely to develop this condition. Statistics show that an estimated one in five people experiences at least one episode of GERD a week, and about one in ten people experience symptoms of GERD on a daily basis.
What are the common symptoms of Acid Reflux?
Following is a list of the most common symptoms:
Heartburn: This is characterized by a burning pain or discomfort that generally moves from the stomach to the chest, or may even rise up into your throat.
Regurgitation: Persons suffering from this experience a sour or bitter-tasting acid seeping into the throat or mouth.
Among other symptoms of acid reflux are:
- Bloody or black stools or bloody vomiting
- Excessive burping
- Dysphagia, which is characterized by narrowing of the esophagus, therefore creating a sensation of food being stuck in the throat
- Persistent hiccups
- A constant feeling of nausea
- Weight loss for no known reason
- Constant dry and sore throat and a feeling of soreness in the throat
How is Acid Reflux/GERD diagnosed?
If you experience any of the symptoms listed above for more than two weeks in a row, and normal gas relieving medicines are found to be ineffective, then it is advisable to seek medical help. A symptom like severe heartburn is key to the diagnosis of this disease. Your doctor may prescribe acid-blocking medication and suggest lifestyle changes to help reduce these symptoms. If these steps don’t alleviate your problem, or if your symptoms worsen, then your doctor may ask you to undergo some tests to confirm the diagnosis of acid reflux/GERD.
These are the tests you might need to undergo:
- Barium swallow (esophagram): This test is designed to check for ulcers in the esophagus and to check if there is a narrowing in the esophagus. In this test, a person has to swallow a solution that helps the internal structure of the esophagus to show up on an X-ray.
- Esophageal manometry: This test checks the function of the esophagus and if there is any fault in the lower esophageal sphincter.
- pH monitoring: This tests for acids in the esophagus. For this process a device is inserted into the esophagus and is left there for one to two days to measure the amount of acid.
- Endoscopy: This test helps to check for problems in the esophagus or stomach. A long, flexible, lighted tube is inserted down the throat. This process can be a little painful. Therefore the doctor will first spray anesthetic at the back of the throat and ask you to take a sedative to help you with the process.
- Biopsy: During an endoscopy, a sample of tissues from the esophagus may be taken to check for infection or abnormalities.
Medications to help in Acid Reflux/GERD:
- Acid suppressant – E.g. histamine2-receptor antagonists (blockers) are known to be effective, such as:
- Proton pump inhibitors – They lower the production of acid in the stomach and help with the symptoms.
- Prokinetic agents – They help in the emptying of the stomach and saving it from becoming overfull.
- Antacids – These can only be used to neutralize acids in the stomach if the symptoms are mild. They should not be used for severe cases.
Can Acid Reflux Disease be treated with Surgery?
If the symptoms are severely affecting the life of a person, then as a last resort, their doctor may recommend surgery. This surgical process is called fundoplication, and it works by creating an artificial valve using the top of the stomach. This helps strengthen the LES and prevents acid reflux.
Sometimes GERD may lead to a condition called esophagitis. In severe cases, open ulcers can occur in the esophagus which will make swallowing difficult. In even rarer cases, esophageal cancer may occur.
Diet and Lifestyle Changes to help people suffering from Acid Reflux/GERD:
By making certain dietary and lifestyle changes, one can, to a large extent, be relieved from the symptoms of this disease.
- Reduce your meal size and eat at more frequent and more regular intervals.
- If you are a smoker, it is advisable that you quit altogether.
- While sleeping, make sure your head is at least four to six inches higher than the rest of your body.
- You should take the last meal at least two to three hours before sleeping.
- If you like to take a nap during the daytime, try sleeping in a chair.
- Avoid wearing tight fitting clothes.
- If you are overweight or obese it would be helpful to lose those extra pounds and get in shape.
Foods that may cause gas and bloating and may trigger the symptoms of acid reflux should be avoided. The following are many of the items that should be avoided:
- Red chili and red chili powder
- Spicy food
- Black pepper
- Citrus fruit like pineapple, lemons, etc.
- Tomatoes, tomato sauce, etc.
- Fizzy drinks or soda
Similarly, there are certain foods that should be included in the diet, as they help in fighting the symptoms of acid reflux:
- Ginger - This has anti-inflammatory properties and hence helps with the symptoms of acid reflux when eaten in moderation
- Aloe vera
- Cantaloupe melon
- Raw honey
People generally respond well to the treatment of GERD. With lifestyle and dietary changes, a person can lead a relatively normal life.
Please refer to the Inflammation article for nutritional supplement choices. You may consider InflaGene, offered for sale on this website.
*These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.
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