Acid reflux is also known as Gastroesophageal Reflux Disease. It happens when the functionality of the lower esophageal sphincter is not proper. A person suffers from the problem of acid reflux when acid present inside the stomach leaks up into the gullet (oesophagus). As the stomach acid rises up into the esophagus, it becomes irritated or inflamed. It can be extremely painful and linger on and on. There are many people who suffer from this disease.
What is acid reflux?
Acid reflux happens when the tube through which food travels from the throat to stomach is not strong enough to handle the acid present inside the stomach. The digestion of food inside the stomach is done the help of an acid produced and stored by it. The walls surrounding the stomach are built strong enough to store that acid without causing damage. But when the acid flows back into the oesophagus from stomach it causes heartburn and other symptoms associated with acid reflux.
According to a 2011 Norwegian study, it has been found that in most of the industrial nations, the number of acid reflux cases has risen by more than 50% in recent times. For instance, in the US only, 25%-40% of the adult population suffers from acid reflux. Not just adults, even infants and children also suffer from this health problem.
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What causes acid reflux?
Acid reflux can happen due to a number of causes. Here are some of the common causes:
Hiatus hernia: One main reason behind the problem of acid reflux disease is a kind of stomach abnormality known as hiatus hernia. This happens when the stomach pokes through the diaphragm, thus preventing the muscle fibers of the diaphragm from closing the lower end of the oesophagus. With the oesophagus being wide open, stomach acid easily gets into the oesophagus and thus causing symptoms of acid reflux disease. This kind of stomach abnormality is very common in people above 50 years.
Overweight: When a person is overweight, the excessive fat present in the abdominal cavity increases the amount of pressure inside it. This makes the contents inside the stomach to travel up into the gullet and this causing acid reflux.
Pregnancy: During the third trimester of a pregnancy, it is very common for females to suffer from acid reflux. This happened as the uterus increases in size and the pressure from the growing fetus. This leads to high pressure inside the stomach causing acid reflux. At the same time, hormonal changes that happen during pregnancy also causes acid reflux. In most of the cases, the various symptoms of acid reflux disappear after delivery.
Smoking: When a person smokes excessively, the tobacco present in the cigarette prevents the oesophagus sphincter from functioning properly, and increases the production of stomach acid. At the same time smoking also damages mucus membranes, reduces the production of saliva that help in neutralizing the effect of acid and slows down the process of digestion.
Eating habits: People suffer from the symptoms of acid reflux where the stomach is stretched more by food. The problem can become worse after consuming fatty meals as fat delays gastric emptying. It is better to avoid large rich meals, particularly in the evening and to have four to five smaller meals throughout the day. At the same time one must avoid snacking close to bedtime or lying down right after a meal.
Certain food items: There are certain foods that can trigger the symptoms of acid reflux. Such kind of food items are alcohol, carbonated beverages, chocolate, citrus fruit juice, peppermint, coffee, fried snacks, tomato, garlic, onion, and extremely spicy food items. All these food items prevent the oesophagus sphincter from working properly.
Certain health problems: People suffering from constipation, asthma and high blood pressure can have the symptoms of acid reflux. Constipation increases the tendency to reflux by raising pressure inside the stomach cavity. The coughing and sneezing associated with asthmatic attacks can cause changes in the chest which trigger acid reflux.
Peptic ulcers and insufficient digestive enzymes: Suffering from peptic ulcers and not having enough digestive enzymes inside the stomach will slow down the process of digestion. This will ultimately cause accumulation of gastric acids that back up into the esophagus.
Certain medications: Taking aspirin, ibuprofen, certain muscle relaxants or certain blood pressure medication can also cause acid reflux. Some of the drugs that can cause acid reflux are anti-cholinergics used for treating seasickness, beta blockers used in the treatment of heart disease, bronchodilator used in the treatment of asthma and sedatives used in the treatment of anxiety.
What are the symptoms of acid reflux?
The symptoms of acid reflux can be broadly divided into two categories – common and less common.
Some of the common symptoms associated with acid reflux are:
- Regularly having a feeling that something is there in the food pipe
- Persistent heartburn or discomfort felt behind the breastbone
- As a part of the heartburn sensation having slight chest pain on regular basis
- Having the feeling of nausea or vomiting after eating a meal
- Regurgitation which means bitter acid backing up into the throat or mouth while sleeping or bending over
Some of the less common symptoms associated with acid reflux are:
- Having a bitter or sour taste inside the mouth
- Hoarseness especially during the morning time
- Dry cough
- Having difficulty in swallowing liquid as well as solid food
- Hiccups that do not let up
- Feeling of tightness inside the throat
- Weight loss for no known reason
- Upper abdominal pain and discomfort
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If the above mentioned occurs once in a while then it is not a matter of concern. But when it happens on a regular basis over a period of 2 to 3 times in a week and there is no relief even after taking medicines, then you need to see a doctor immediately.
How is acid reflux disease diagnosed?
Symptoms such as regular heartburn are the key to the diagnosis of acid reflux disease. First of all you need to make some lifestyle changes, try some antacids or acid-blocking medications to reduce the symptom of heartburn. If things do not get better, you need to see a gastroenterologist who will carry out different tests to confirm a diagnosis. Some of the common tests prescribed by gastroenterologist are:
- Barium swallow test which is done to check for ulcers or a narrowing of the oesophagus. Here a patient is asked to swallow a liquid solution first and then with the help of X-ray internal images of the oesophagus are taken for further study.
- Continuous esophageal pH monitoring is also done to check for the presence of acid in the oesophagus. This test is done by inserting a device into the oesophagus for at least 24 hours. The tube monitors episodes of acid reflux over the day and while you sleep.
- Esophageal manometry test can also be prescribed by the doctor. This test is done to check the motor function of the esophagus and the function of lower esophageal sphincter. In this kind of test, a tube is passed down your throat until it reaches the esophagus. This test is often recommended for complicated cases.
- Endoscopy is also done to check for problems in oesophagus or stomach. To do this test, a long, flexible lighted tube with a camera on the end is inserted down the throat. The tube is then passed into the esophagus, stomach, and small intestine of a person. With this test, a doctor can have a clear picture of the condition of esophagus and stomach.
- A biopsy may be taken during endoscopy to check samples of tissue under a microscope for infection or other abnormalities.
It is important to remember that the above mentioned tests are only advised if symptoms are severe, or do not improve with simple treatments.
What are the treatment options for acid reflux?
The treatment options for acid reflux include lifestyle changes, over-the-counter medications, prescribed medications as well as surgery.
Diet and lifestyles changes:
Slight changes in the lifestyle and diet are the most effective way to reduce or even eliminate the various symptoms associated with acid reflux. Here are some tips to do that:
- Try to lose some weight if you are overweight as excess weight puts pressure on the abdomen.
- Control your intake of tea, caffeine and other acidic beverages.
- Stop eating foods and drinks that trigger heartburn. For instance do not eat fried foods or spicy foods as it can make your condition worse.
- It is recommended to wear loose-fitting clothes to reduce pressure on the abdomen and the lower esophageal sphincter.
- Avoid bending over for long periods soon after eating.
- Eat your dinner at least two hours before going to bed.
- Elevate the head of the bed about four to six inches.
- Totally stop smoking as smoking will not allow the lower esophageal sphincter to function properly.
- Eat smaller meals more frequently throughout the day. But avoid overeating by eating smaller meals.
- Don’t lie down right after eating at any time of day. During daytime try to sleep in a chair.
- Reduce alcohol consumption as it increases the likelihood that acid from your stomach will back up.
- Try to maintain a good posture by standing upright or sitting up straight. This will help food and acid pass through the stomach instead of backing up into the esophagus.
- Exercising is always helpful for staying healthy. So cardio exercise to get some relief from acid reflux symptoms.
Over the Counter Medications:
There are many over the counter medicines that can help in reducing the stomach acid. Some of the popular over the counter medicines are:
- Antacids such as Rolaids, Gaviscon, Mylanta, Gelusil, Maalox, Gastrocote and Tums help in neutralizing stomach acid and offer quick relief from heartburn, sour stomach, acid indigestion, and stomach upset. Antacids are available in tablet as well as liquid form. If you are using the tablets, chew them well before swallowing for faster relief. Take antacids as directed by your doctor, or according to the manufacturer’s directions. But one must not over use antacids as can cause various side effects like diarrhea, stomach cramps or constipation.
- There are certain over the counter medicines that can help in reducing acid production. Such medicines are known as H-2-receptor blockers. Some of the popular medicines in this category are Tagamet HB, Pepcid AC, Axid AR or Zantac 25, Zantac 75 and Zantac 150. The effect of these medicines is slow but they provide longer relief. These medicines should be taken about 30 minutes before a meal or bedtime. Side-effects include dizziness, diarrhea and headache.
- There are also over the counter medicines that help in blocking acid production and healing the esophagus. Such medicines are known as proton pump inhibitors. Some of the popular medicines in this category are Prevacid 24 HR, Prilosec OTC and Zegerid. Take these drugs according to the directions on the package or as advised by your doctor.
All these medicines can give you quick relied buy if you do not get relief from the symptoms of acid reflux after two weeks; you need to see a doctor.
To treat the problem of acid reflux, doctors may also suggest other stong medications, such as:
- There are some stong H-2-receptor blockers that can help a lot. Some of the popular medicines in this category are Tagamet, Pepcid, Axid and Zantac. It is better to take H2 blockers half an hour before meals. They can also be taken at bedtime to reduce the production of acid during night. Side effects include abdominal pain, headache, nausea, runny nose, gas and sore throat.
- There are some stong proton pump inhibitors also to treat the various symptoms of acid reflux. Some of the popular medicines in this category are Nexium, Prevacid, Prilosec, Protonix, Aciphex and Dexilant. It is recommended to take these medicines an hour before meals. Side effects of these medicines are constipation, nausea, headache, abdominal pain, and gas.
- Medications known as Prokinetics are also used to strengthen the lower esophageal sphincter. These medications help in tightening the valve located between the stomach and the esophagus. Some of the popular medicines are domperidone and metoclopramide. However these medications have certain side effects like fatigue, anxiety and depression.
One major side effect of these medications is that it may lead to bone loss and increase the risk of a bone fracture. This is why it is very essential to take a calcium supplement along with these medicines to reduce these risks.
Even after trying different types of over the counter medicines as well as prescribed medications, if there is no relief from the symptoms of acid reflux disease then surgery is the last hope.
- A surgery to ‘tighten’ the lower esophageal sphincter can be done to prevent acid to leak up from the stomach. This surgery is perfect for people whose quality of life remains significantly affected by the various symptoms of acid reflux. This type of surgery can be both open and laparoscopic. In open surgery, a long incision in the abdomen is made by the surgeon. In laparoscopic surgery, three or four small incisions in the abdomen are made through which instruments are inserted.
- A surgery can also be done to create a barrier preventing the backup of stomach acid. A device known as Esophyx is inserted inside the stomach via the mouth. Esophyx folds the tissue at the base of the stomach near the sphincter valve, to stop the stomach acid from entering the esophagus.
- Another kind of surgery to form scar tissue in the esophagus can also be done. Here electrode energy is used to heat the esophageal tissue. The heat creates scar tissue and damages the nerves responsible for responding to refluxed acid. This procedure is done only as a last resort for treatment of acid reflux disease when other forms of treatment are not successful.
To know more about the treatment options for acid reflux, visit www.ncbi.nlm.nih.gov
Home Remedies for Acid Reflux:
If you are having the symptoms of acid reflux disease then you must try some of home remedies. The best part about home remedies is that you need to use easily available ingredients from your kitchen. You can get relief from the symptoms and that too without worrying about the side effects.
For instance you can try Aloe vera. The juice of aloe vera aids in digestion and can give you relief from acid reflux symptoms. Mix one part of aloe vera juice with two part of water and drink it as soon you start having the acid reflux symptoms.
Another simple and easy home remedy is to use apple cider vinegar. Add one teaspoon of this vinegar to half cup of water and sip it while eating your food. At the same time ginger root can also be used to soothe stomach ailments for quite some time now. This herb absorbs stomach acid.
Chewing gum is another quick remedy for acid reflux. It increases saliva which is a natural antacid. Saliva production can settle the stomach and reduce the amount of acid being produced.
Those suffering from acid reflux, must also include fruits like banana, apple, pineapple and papaya along with vegetables like carrots and cabbage in their diet plan. All these fruits and vegetable have certain elements that can help in controlling the symptoms of acid reflux.
Complications from acid reflux
If acid reflux is not treated properly, it can give rise to various other health complications, such as:
- It can cause stricture which means scarring and narrowing (a stricture) of the lower oesophagus. This complication is uncommon but can happen in case of severe and long-standing inflammation.
- It can also cause Barrett’s oesophagus in which the cells that line the lower oesophagus become changed. The changed cells can even become cancerous.
- It can also cause cancer. Those suffering from acid reflux for a long time are at a higher risk of developing cancer of the oesophagus.
Although acid reflux is a very common health problem and rarely serious, you must not ignore the symptoms of acid reflux. If not treated on time, acid reflux can even cause other severe health complications.