Acid Reflux: Causes, Symptoms and Treatment

February 1, 2017

Acid Reflux

Acid reflux, also known as Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents leak back, or reflux, into the esophagus. The LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach. The esophagus carries food from the mouth to the stomach. Reflux is a normal process that occurs in healthy infants, children, and adults. Most episodes are brief and do not cause bothersome symptoms or complications.

Acid reflux is a common condition in which stomach acid flows backward up the esophagus (the tube carries food from the mouth to the stomach), causing acid refulx symptoms such as a burning feeling in the chest (heartburn) and a bitter or sour taste in the mouth. These acid reflux symptoms usually last a few hours after a meal and then go away. Most people experience acid reflux from time to time, usually after eating certain foods. Acid reflux that occurs more than twice a week is called gastroesophageal reflux disease (GERD). This is a more serious condition that, left untreated, can lead to problems such as inflammation of the esophagus (esophagitis) and a precancerous condition called Barrett’s esophagus. GERD can also worsen asthma, chronic cough, insomnia, and pulmonary fibrosis.

Acid reflux is considered very common, and diseases resulting from acid reflux are the most common gut complaint seen by US hospital departments. Studies suggest that over 60 million Americans experience heartburn at least once a month, and at least 15 million as often as daily.

Causes

Gastroesophageal reflux disease is seen in people of all ages, sometimes for unknown reasons (idiopathic). Often the cause is attributable to a lifestyle factor, but it can also be due to causes that cannot always be prevented.

The main cause of acid reflux disease is a problem with the lower esophageal sphincter (LES) muscle. This muscle, which is the “valve” between the stomach and the esophagus, normally closes tightly after food has passed through to the stomach.

The LES does not stay closed in people with acid reflux disease. When this happens, acid and stomach contents may back up (reflux) into the esophagus. This acid backup can sometimes cause the painful, burning sensation known as heartburn or other symptoms.

Other risk factors are more easily controlled and often directly linked to modifiable lifestyle or dietary issues, including –

  • Obesity
  • Smoking (active or passive)
  • High intake of table salt
  • Low dietary fibre intake
  • Low levels of hysical exercise
  • Medications, including drugs for asthma, calcium-channel blockers, antihistamines, painkillers, sedatives, and antidepressants.

Symptoms

  • Stomach pain (pain in the upper abdomen)
  • Non-burning chest pain
  • Difficulty swallowing (called dysphagia), or food getting stuck
  • Painful swallowing (called odynophagia)
  • Persistent laryngitis/hoarseness
  • Persistent sore throat
  • Chronic cough, new onset asthma, or asthma only at night
  • Regurgitation of foods/fluids; taste of acid in the throat
  • Sense of a lump in the throat
  • Worsening dental disease
  • Recurrent pneumonia
  • Chronic sinusitis
  • Waking up with a choking sensation

The following signs and symptoms may indicate a more serious problem, and should be reported to a healthcare provider immediately –

  • Difficulty or pain with swallowing (feeling that food gets “stuck”)
  • Unexplained weight loss
  • Chest pain
  • Choking
  • Bleeding (vomiting blood or dark-colored stools)

Complications

Ulcers – Ulcers can form in the esophagus as a result of burning from stomach acid.

Lung and throat problems – Some people reflux acid into the throat, causing inflammation of the vocal cords, a sore throat, or a hoarse voice.

Stricture – Damage from acid can cause the esophagus to scar and narrow, causing a blockage (stricture) that can cause food or pills to get stuck in the esophagus.

Barrett’s esophagus – Barrett’s esophagus occurs when the normal cells that line the lower esophagus (squamous cells) are replaced by a different cell type (intestinal cells).

Esophageal cancer – There are two main types of esophageal cancer: adenocarcinoma and squamous cell carcinoma.

Treatment

Antacids – These OTC drugs (Alka-Seltzer, Maalox, Mylanta, Rolaids, Tums) use different combinations of either magnesium, calcium, or aluminum and hydroxide or bicarbonate ions to help neutralize stomach acid and temporarily relieve symptoms. Depending on their ingredients, they may also cause diarrhea or constipation.

H2 Blockers – Available both OTC and by prescription, these drugs (Tagamet, Pepcid, Zantac, Axid) provide short-term relief of GERD by preventing production of stomach acid.

Proton Pump Inhibitors (PPIs) – Available by prescription, PPIs (Prilosec, Prevacid, Protonix, Nexium) block stomach acid production more effectively than H2 blockers. However, they can cause “rebound” reflux: If the patient uses them, then stops taking them, the stomach acid may return worse than before.

Surgery is an option when medicine and lifestyle changes do not work. Surgery may also be a reasonable alternative to a lifetime of drugs and discomfort. Fundoplication, usually a specific variation called Nissen fundoplication, is the standard surgical treatment for GERD. The upper part of the stomach is wrapped around the LES to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia.

Alternative Treatment

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.

Omega-3 fatty acids, such as fish oil, may help decrease inflammation. Omega-3 fatty acids may increase the risk of bleeding.

Probiotic or “friendly” bacteria may help maintain a balance in the digestive system between good and harmful bacteria.

Melatonin is usually thought of as the sleep hormone.

Glutamine is the one that is naturally appearing within the body. Glutamine is found in several dietary sources including milk, fish, parsley, spinach, eggs, and more. Glutamine is yet another thing that many people have had helped their acid reflux.

Herbal licorice can help to coat your belly with a protective layer of gel. Removing the distress from acid reflux disease can be achieved without costly over-the-counter drugs.

Cranberry (Vaccinium macrocarpon) – Preliminary research suggests cranberry may inhibit H. pylori growth in the stomach. Cranberry may increase the length of time that medications, including warfarin (Coumadin), may stay in your body.

Mastic is a traditional treatment for peptic ulcers.

Hypnosis, massage, and other relaxation techniques may help reduce symptoms of GERD. Stress often makes GERD symptoms worse.

 

Reference –

http://www.drweil.com/drw/u/ART02882/acid-reflux.html

https://my.clevelandclinic.org/health/diseases_conditions/hic_gastroesophogeal_reflux_disease_GERD/dd_overview

http://www.besthealthmag.ca/best-you/a-z-index/acid-reflux-gastroesophageal-reflux-disease-heartburn

https://www.tums.com/heartburn-information/acid-reflux-gerd/

http://www.healthline.com/health/gerd/acid-reflux-symptoms

http://patient.info/health/Acid-Reflux-and-Oesophagitis

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