Acid Reflux

Acid Reflux Meaning

A health condition characterized by heartburn (burning pain) around the lower chest area (usually after eating) is known as Acid Reflux. It is also referred to as indigestion or pyrosis. It is a result of stomach acid that flows back inside the food pipe or esophagus.

Acid reflux picture

When does Acid Reflux Attack Happen?

A strong hydrochloric acid inside the stomach breaks down the food and protects against pathogens like bacteria. Although lining of the stomach acts as a wall of protection, there is no protection for the esophagus.

The gastrosophageal sphincter which is a ring of muscle serves as a valve that keeps the food inside the stomach but restricts it from going back to the esophagus. In a scenario where the valve fails to do so, the food inside the stomach gets regurgitated inside the esophagus. This is when a person is said to be having a symptom for heartburn.

Facts about Acid Reflux

• A common condition and among the most common gut complaints in USA
• An estimated number of 60 million Americans report heartburn at least once every month. The figure for daily complaints is about 15 million.
• As many as 20 to 30% people in the Western countries are believed to be affected by Gastroesophageal reflux disease
• Although common, a chronic heartburn may lead to several serious health complications

Acid Reflux Causes & Other Risk Factors

Occasional Acid Reflux may happen to any person and can be a result of certain foods and drinks. However, occurrence on a regular basis can lead to Gastrosophageal Reflux Disease (GERD). Some of the possible causes include:

Hiatal hernia

Often the most common cause behind acid reflux, it occurs when the upper section of the stomach and the LES moves above the diaphragm. This results in the acid moving up to the esophagus and causing acid reflux disease.

Other Risk Factors

Some of the other Risk Factors Associated with Acid Reflux Disease are:

• Having Large Meals
• Lying down after having a meal
• Obesity
• Having snacks just before going to bed
• Consuming foods like tomato, citrus, chocolate, garlic, onions, fatty foods, mint, etc.
• Drinking alcohol, coffee, tea, or other carbonated drinks.
• Smoking (Active & Passive)
• During Pregnancy
• Regular intake of aspirin, muscle relaxers, ibuprofen, or blood pressure medicines
• Excessive intake of salt
• Low intake of dietary fiber
• Limited physical exercises
• Excessive consumption alcohol or caffeine
• Medicines for asthma, antihistamines, sedatives, antidepressants, calcium channel blockers, etc.

Acid Reflux Symptoms

Acid Reflux Symptoms – Heartburn

Heartburn

A persistent acid reflux symptom, it happens in the esophagus and is felt behind the breastbone area. It is a burning sensation felt while lying or bending down. It may last for several hours and might get worse after having meals.

The pain due to heartburn might move up towards the throat or neck area. It may also reach the throat and produce a bitter or sour taste. If this happens for two to three times a week, then a person is said to be suffering from GERD.

Symptoms of Gastrosophageal Reflux Disease

• Dry Cough
• Wheezing
• Asthma & Pneumonia
• Chronic Sore throat
• Nausea
• Vomiting
• Sourness, hoarseness or Laryngitis
• Pain while swallowing food
• Pain in the chest or abdomen
• Bad breath
• Dental Erosion

Regurgitation

As per this symptom a person complains of sour or bitter taste in the mouth or the throat.

Other Symptoms of Acid Reflux

• Bloating
• Bloody or Black Stool
• Excessive Burps
• Dysphagia
• Weight loss without any reason
• Constant hiccups
• Bloody Vomiting

Diagnosis of Acid Reflux

In order to diagnose Acid Reflux, doctors often conduct any of the following tests:

• Endoscopy: Use of a lighted flexible tube fitted with a video camera that is passed from the throat and up to esophagus. It helps to in detecting esophagitis, strictures, and Barrett’s esophagus. The test is only done when symptoms seem to be severe and persistent for a long period of time. In case it detects Barrett’s esophagus, a doctor might recommend regular endoscopy for screening cancer.
• Esophageal Manometry: Conducted to identify problems related to motility and valve pressure within the esophagus, by this study a doctor can measure the function of the LES (lower esophageal valve). It is often used for evaluating GERD and determining if surgery is needed.
• Barium X-Ray: The x-ray takes images of the esophagus, stomach and the upper duodenum. It is done after the patient is asked to swallow a chalky liquid that facilitates in producing high quality images.
• Biopsy: A small tissue is taken and microscopic analysis is done to look for abnormalities or infection.
• Impedance Monitoring: By doing this test, the observer measures the rate of fluid movement inside the esophagus.
• pH monitoring: It is a kind of test that is intended to measure the acidity levels inside the stomach. Usually a device is inserted inside the esophagus for over 1 to 2 days.

Risks from Long Term Acid Reflux and GERD

It is really important for addressing the persistent problems due to acid reflux and gastrophageal reflux. If left untreated, it might lead to serious complications where acid reflux causes cancer. Some common risks of long term GERD are:

• Esophagitis: Thin lining of the esophagus gets inflamed and causes bleeding, ulcers, or irritation around the area.
• Barrett’s esophagus: A very serious complication due to repeated cases of acid reflux, it causes changes to the cells as well as the tissue linings of the esophagus. This can often lead to development of cancer cells.
• Strictures: A damage due to stomach acids leading to scar development and difficulty while swallowing. Food can often get stock while travelling down to the esophagus.

Acid Reflux Treatment

In most of the cases, a few over the counter medicines clubbed with simple lifestyle changes is all you need to treat acid reflux. However, in case these cannot reduce the symptoms, then doctors may adopt any of the following treatments:

• Acid Reflux Medication: Doctors often prescribe antacids as these are capable of neutralizing the acid inside the stomach. However, overuse might result in constipation or diarrhea. Antacids that contain magnesium hydroxide and aluminum hydroxide can take care of the side-effects. If the symptoms persists, doctors might recommend other medications such as:
  • Gaviscon (Foaming agents)
  • Pepcid, Zantac & Tagamet (H2 Blockers)
  • Prilosec, Protonix, Nexium, Aciphex, Prevacid, and other proton pump inhibitors
  • Reglan or Urcholine (Prokinetics)

It should be mentioned that the above medicines or combining any of the above medicines without a doctor’s consultation could prove to be fatal.

• Acid Reflux Surgery: It is the only alternative if medications fail to reduce the symptoms of acid reflux. Mainly two kinds of surgical treatments are adopted, namely, fundoplication and Surgery using a LINX Device.
  • Fundoplication: This helps in preventing future acid refluxes from occurring. Here doctors create an artificial valve by wrapping the upper section of the stomach around the LES. It strengthens the area and helps in repairing hiatal hernia. Both open incision in the abdomen or the chest and lighted tube inserted via a tiny incision can be the procedure.
  • Surgery using a LINX device: It is one of the recent surgical options that is done by placing a ring called LINX device around the lower end of the esophagus. This ring comprises of magnetic titanium beads that are held using a titanium wire. This device helps in restricting the stomach from backing up inside the esophagus. However, this is not recommended for people who are allergic to metals. Moreover, once a LINX device is inserted, one should not undergo any kind of MRI test.

Acid Reflux Diet & Lifestyle Changes

Changes to the kind of diet you are following or lifestyle you have adopted can help in preventing acid reflux disease. Some recommendations include:

• Stop Smoking
• Practice sleeping on your left side
• Have a pillow of about 4 to 6 inches beneath your head
• Avoid eating at least 2 hours before you go to bed
• Take daytime naps on the chair itself
• Avoid tight belts and clothes
• Exercise and make dietary changes if you are obese
• Balance Hydrochloric Acid levels
• Avoid processed & high sugary foods
• Include digestive enzyme supplements
• Eat smaller meals spread evenly across the day.
• Drink a spoon of Raw Organic Apple Cider Vinegar with water before each meal
• Drink a solution of Baking soda & water
• Consume inner Aloe Vera gel, licorice, extract of Slippery elm, etc.