Acid Reflux

Acid reflux disease, also called Gastroesophageal reflux disease (GERD) is a chronic symptom caused by stomach acid entering into the esophagus from the stomach. Stomach acid or bile can flow into your food pipe, and the backwash of acid irritates the esophagus lining causing GERD. Between 10-20% of people in the Western world are affected by acid reflux. Lifestyle changes, medications, and (rarely) surgery are used to help treat it.

Symptoms

Acid reflux is known to cause severe heartburn. Heartburn is a discomfort or burning pain that can start in your stomach and move up through your chest to your throat. Regurgitation is another symptom of acid reflux. Regurgitation causes a bitter or sour-tasting acid to back up into your mouth or throat. Other symptoms of acid reflux include bloating, burping, bloody vomiting, black or bloody stools, dysphagia (the sensation of food being stuck in your throat because your esophagus narrows), nausea, dry, wheezing cough, hiccups that don’t stop, weight loss despite eating the same, chronic sore throat, and hoarseness. Johns Hopkins Medicine has more information on acid reflux and its various symptoms.

Causes

When you eat food and swallow, the lower esophageal sphincter relaxes and allows liquid and food to move easily down into the stomach before closing up again. If the valve ends up being weakened or relaxed, it’s possible for stomach acid and bile to flow the wrong direction and back up the esophagus. This can certainly disrupt a person’s daily life by causing frequent heartburn, and the constant backwash of acid can irritate your esophagus’ lining, inflaming it. Over time, this inflammation can lead to breathing or bleeding problems as it erodes your esophagus. Other risk factors include being obese or overweight, eating large meals, bending over at the waist after eating, eating certain foods such as chocolate, citrus, garlic or onions, eating close to bedtime, drinking certain beverages like carbonated drinks, alcohol, or coffee, over the counter pain killers, and smoking.

Prevention

Luckily, acid reflux is preventable by making a few lifestyle changes. Reduce or avoid entirely the consumption of beverages and foods that contain caffeine, peppermint, chocolate, and alcohol. Decaffeinated and caffeinated coffees also increase acid secretion. If possible, avoid all carbonated drinks, and try to cut down on saturated fats. Increasing your protein intake can help strengthen muscles in your esophagus, so try choosing skim or low-fat dairy products, fish, and poultry. Make sure your diet is rich in vegetables and fruits, but try to avoid lemons, oranges, pineapple, grapefruit and tomatoes, which are all acidic. After meals, try to take a walk or remain upright for a period of time, and avoid snacking right before bedtime. When you go to sleep, try to sleep in a tilted position. This will help keep acid in your stomach through the night.

Treatment

If lifestyle changes do not cure your acid reflux, you may need medical treatment. Antacids can help neutralize stomach acid.

 Maalox, Rolaids, Mylanta and Tums can provide quick relief and are available over the counter. Your doctor may prescribe you medications to heal the esophagus and block acid production or reduce acid production. There are also medications available to help make the lower esophageal sphincter stronger. They help your stomach empty more rapidly and help tighten the valve between the esophagus and stomach. If these medications are not effective, you may need surgery. There are a variety of surgery options available, such as surgery to create a barrier preventing the backup of stomach acid, surgery to reinforce the lower esophageal sphincter, and surgery to make the lower esophageal sphincter stronger. There is also a medical procedure available that causes scar tissue to form in the esophagus to help stop the backflow of stomach acid or bile.