Acid reflux is a little menace. Many experience this, and tend to feel very uncomfortable about it. Justhealthcaretips brings you the needed information on acid reflux, and all you need to handle this little menace. Just read on.
What is Acid Reflux?
Acid reflux often referred to as gastroesophageal reflux, is a common condition that features a burning pain in the lower chest area. It occurs when stomach acid flows back up into the oesophagus or food pipe.
At the entrance to your stomach, there is a valve; the lower esophageal sphincter which is a ring of muscle. Usually, the lower esophageal sphincter shuts as soon as food passes through it. However, if the Lower Esophageal Sphincter doesn’t close all the way or if it opens too often, acid made by your stomach can return up into your esophagus.
In cases where the acid refluxes occur more than twice a week, it becomes a disease called Gastroesophageal reflux disease (GERD). We’re going to take a proper look at this, but for now, let’s look at the causes of acid refluxes.
Causes of Acid Reflux
There are certain things that give rise to acid reflux. We’re going to take a look at them starting from the common ones to unknown ones.
1. Having large meals or lying down right after a meal.
The body digests food best in an upright position. So, times when we lie down, especially after heavy or large meals, the digestive process gets a bit ruffled up. The stomach is not in an upright position, thereby making digestion hard. This, in turn, causes acid reflux.
Also, too much food tends to stretch the stomach. It puts pressure on the Lower Esophageal Sphincter, the muscle ring that prevents stomach acids from going in the wrong direction.
Foods high in fat stay in your belly longer. This makes your stomach form more acid, thereby irritating your digestive system. This, in turn, affects your Lower Esophageal Sphincter with irritating stomach acids, and you’re more likely to have what’s in the stomach splash back up your throat.
2. Snacking before bedtime.
This doesn’t really affect everyone, except for individuals that suffer Gastroesophageal Reflux Disease (GERD). Furthermore, there are certain foods that could cause acid reflux when taken before bedtime. Here are such foods:
- Chocolates; most are well caffeinated. Taking foods high in caffeine is likely to cause a reflux. This is because caffeine can cause the stomach valve (LES) to relax, causing an upward flow of the stomach content into the throat.
- Acidic foods; oranges and grapefruits, garlic and onions. These increase the acid level in the stomach and increase the chances of reflux. Also, when these acidic foods are taken on an empty stomach.
- Alcohol; wines, beer or that favorite cocktail of yours can trigger heartburn. This is most likely to happen when you take them after consuming large meals.
- Fatty foods; ice-creams and other fatty foods.
- Spicy foods. Are you a fan of hot chili pepper, hot sauce, and all the ‘hot-spicy-foods’ there is? These ‘hot’ foods are likely to trigger gastroesophageal reflux. If they trigger your heartburn, it’s best you keep away from them.
- Mints. Yes, mints! I know you’re probably thinking “but they make my breath fresh.” It makes your breath fresh (if you’re going on a date). However, it also causes the sphincter muscles that are between the stomach and esophagus to relax, and give rise to reflux.
If you must snack just before bedtime, then you can take these: whole grains, vegetables, eggs (scrambled), kiwi.
Some other foods that are generally good to prevent heartburn
Don’t think every food will cause heartburn. There are a variety of foods you can eat to help prevent acid reflux. Enjoy the following meals:
The good thing about Fibrous foods is that they make you feel full. This means you’re less likely to overeat, which may lead to heartburn. So, you can comfortably eat healthy fiber from these foods:
- Whole grains like oatmeal, couscous, and brown rice.
- Root vegetables like carrots, and beets.
- Fresh Green vegetables like asparagus, broccoli, and green beans.
These are foods that fall somewhere above 7 along the pH scale. Those that have a low pH (lower than 7), are acidic and more likely to cause reflux.
Foods with higher pH are alkaline and can help offset or reduce strong stomach acid. Alkaline foods include:
Eating foods with high moisture content (especially when if 70% of the moisture is water) can dilute and weaken stomach acid. Choose foods such as:
- Broth-based soups
- Herbal tea
3. Being overweight or obese
Yes, this can also lead to gastroesophageal reflux. This is due to excess belly fat which exerts pressure on the stomach. In some cases, it could lead to the development of a hiatal hernia that causes the backflow of acid. Ensure you keep fit, and watch your bodyweight.
Doctors say that smoking can cause gastroesophageal reflux. This happens when the lower esophageal sphincter relaxes.
The sphincter regulates the passage of food into the stomach and prevents acid from returning into the esophagus.
Nicotine can cause the sphincter to relax. This causes an increased risk of acid surging into and damaging the esophagus.
5. Being pregnant
You know pretty well that being pregnant seems to open the door to a whole lot of things. Acid reflux is one of them.
Most pregnant women have gastroesophageal reflux.
Heartburn is common during pregnancy. This is because certain hormones cause the digestive system to slow down. Also, the muscles that cause peristalsis (push food down the esophagus) also move more slowly when you are pregnant.
So, if you experience heartburn a lot during pregnancy, do not panic. However, this is what you can do:
- Skip meals and drinks that worsen it (foods mentioned above, such as citrus; spicy, fatty (especially fried or greasy) foods; caffeine; and carbonated drinks).
- Take your time when having a meal.
- Drink liquids between meals, not during meals.
- Have several small meals throughout the day.
- As much as you can, avoid eating or drinking for 3 hours before your bedtime.
- Say “NO” to that voice that tells you to lie down after a meal.
- Raise your head when you sleep.
- Make inquiries from your doctor about medicines that are safe to take for heartburn during pregnancy.
6. Taking certain drugs
There are certain medications and dietary supplements that can irritate the lining of your esophagus, and cause heartburn.
Some others can heighten the severity of gastroesophageal reflux disease (GERD).
These medications and dietary supplements can irritate your esophagus and cause heartburn:
- Antibiotics, like tetracycline and clindamycin
- Pain relievers, like ibuprofen (Advil, Motrin IB, others) and aspirin
- Potassium supplements
- Bisphosphonates are taken orally, like alendronate (Fosamax), ibandronate (Boniva) and risedronate (Actonel, Atelvia)
- Iron supplements
Medications and dietary supplements that can increase Acid reflux include:
- Tricyclic antidepressants (amitriptyline, doxepin, others)
- Theophylline (Elixophyllin, Theochron)
- Statins, angiotensin-converting enzyme (ACE) inhibitors, Calcium channel blockers and nitrates used for high blood pressure and heart disease
- Narcotics (opioids), like codeine, and those containing hydrocodone and acetaminophen (Norco, Vicodin, others)
- Anticholinergics, like oxybutynin (Ditropan XL), prescribed for overactive bladder and irritable bowel syndrome
- Sedatives including benzodiazepines like diazepam (Valium) and temazepam (Restoril)
Symptoms of Acid Reflux
- Nausea after eating
- Stomach fullness or bloating
- Pains and discomfort in the upper abdomen
- Burping, otherwise known as belching, is the expelling of gas from the stomach through the mouth.
These symptoms of acid reflux may be a sign that acid from your stomach has inflamed your esophagus. Consequently, stomach acid can lead to the damage of the lining of your esophagus and cause bleeding. After a period of time, it can lead to the change of the cells of the esophagus and cause cancer (Barrett’s esophagus).
It was initially mentioned to you that acid reflux is really common among people (mostly seems unserious), but that does not mean that the symptoms of acid reflux should be ignored.
Making subtle lifestyle changes and using over-the-counter antacids are often all you need to control acid reflux symptoms.
Remedies for Acid Reflux
- wearing loose clothing.
- standing up straight.
- elevating your upper body.
- mixing baking soda with water.
- trying ginger.
- taking licorice supplements.
- sipping apple cider vinegar.
- chewing gum to help dilute acid.
Acid Reflux Disease/Gastroesophageal Reflux Disease (GERD)
What Is Gastroesophageal Reflux Disease (GERD)?
This is a more severe than the case of acid reflux. It’s more like the disease that is when acid reflux occurs more than normal.
Gastroesophageal reflux disease (GERD) is a condition where the esophagus becomes irritated or inflamed because of acid backing up from the stomach.
The acid that comes up from the stomach is the hydrochloric acid. This acid aids the digestion of a meal after consumption.
The inner lining of the stomach fights corrosion by this acid. Protective mucus is secreted in large amounts by the cells lining the stomach.
However, the lining of the esophagus does not have these resistant (protective mucus) features and stomach acid can damage it.
The esophagus positions itself just behind the heart, that’s why the term “heartburn” was coined to describe the sensation of acid burning the food pipe near where the heart is located.
At the lower end of the esophagus, lies a valve. this valve called the lower esophageal sphincter prevents reflux of acid.
This sphincter relaxes or opens up during swallowing to allow food to pass. It then tightens or closes up to prevent the flow of food in the opposite direction.
With GERD, however, this sphincter relaxes between swallows. This allows stomach contents (gastric reflux) and corrosive acid to well up and damage the lining of the esophagus.
What Facts Should I Know GERD?
GERD is a condition in which acid goes up from the stomach into the esophagus and sometimes, the throat, irritating their lining tissues.
It can be worsened by many different things, including medication, lifestyle, diet, weight gain, pregnancy, and some medical conditions.
Symptoms of acid reflux include regurgitation of bitter acid into the throat, heartburn, bitter taste in mouth, chest pain, dry cough, feeling of tightness in the throat, hoarseness, and wheezing.
There are some home remedies for acid reflux like changes in lifestyle, diet, and habits. These remedies are discussed extensively below.
Regarding treatment, the use of over-the-counter (OTC) medications like antacids and H2-blockers; prescription medications like coating agents, proton pump inhibitors, and promotility agents; and in severe cases, surgery. You’ll see more ways GERD can be treated as you read on.
Acid reflux can be prevented though. In some cases, just by making changes in the habits that cause reflux, like avoiding alcohol, smoking, limiting fatty foods, food triggers, maintaining healthy body weight.
The prognosis for GERD is when it is mild or moderate. In chronic cases, the prescription of drugs is used. In very severe cases, you may require surgery to avoid serious complications.
Symptoms of Acid Reflux (GERD)
The symptom of GERD that everyone knows is persistent heartburn.
Heartburn is a burning pain felt in the center of the chest, just behind the breastbone. This burning pain often starts in the upper abdomen and spreads up into the neck or throat. It can last as long as 2 hours. Also, it is usually worse after eating.
Lying down or bending over could make it worse. The pain, sometimes, does not start or get worse with physical activity. Heartburn is sometimes called acid indigestion. Not everyone with Gastroesophageal Reflux Disease has heartburn.
Other symptoms of GERD include:
- Regurgitation of acid up into the throat while bending over or sleeping
- Persistent dry cough
- Post-meal pain in the abdomen
- The feeling of tightness in the throat
- Trouble swallowing
- Sore throat
- Bitter taste in the mouth
- Hoarseness (mostly in the morning)
In children and infants, the most common symptoms are repeated, coughing, vomiting, and other respiratory problems.
Causes Of Gastroesophageal Reflux Disease (GERD)
There are many factors that influence the symptoms of GERD or cause GERD. Here are some contributing factors that weaken or relax the lower esophageal sphincter, making gastric reflux worse:
Eating habits: Eating large meals, eating quickly or just before bedtime
Lifestyle: Frequent use of alcohol or cigarettes, poor posture (slouching), obesity
Medications: Calcium channel blockers, nitrates, antihistamines, theophylline (Tedral, Hydrophed, Marax, Bronchial, Quibron)
Diet: Fatty and fried foods, drinks with caffeine, acidic foods such as citrus fruits and tomatoes, spicy foods, mint flavorings, chocolate, garlic and onions
Other medical conditions: Hiatal hernia, diabetes, rapid weight gain, pregnancy
Hiatal hernia is a condition where the upper part of the stomach protrudes through the opening in the diaphragm. This happens where the esophagus passes through to its connection with the stomach.
In this case, the upper part of the stomach is up above the diaphragm (the firm muscle that keeps off the organs of the chest from those of the abdomen).
- The cause of Hiatal hernias is certain yet. However, it is possible that it can occur because of persistent vomiting, coughing, straining, or sudden physical exertion. Obesity and pregnancy often make this condition worse.
- A hiatal hernia makes it easier for the acid to reflux.
- This condition is very common in people that are older than 50 years of age. Often, it is not associated with GERD.
- Hiatal hernia usually does not require any treatment. In rare cases when the hernia is very large or becomes really twisted, surgery may be needed.
What Does GERD Feel Like?
Acid reflux usually feels like a hurting or burning sensation in your stomach, upper abdomen behind the breastbone, esophagus, and even up into your throat. There’s a feeling of a hot, acidic, or sour tasting fluid at the back of the throat or a sore throat.
It may feel like it’s difficult to swallow or feel a tightness in the throat when you have heartburn, and it may feel as if food is stuck in your throat or esophagus.
You’re likely to feel chest pain when lying down, bending over, or after eating. (See your doctor for any undiagnosed chest pain – do not assume you are experiencing heartburn until a doctor diagnoses it)
Doctors That Treat GERD And When To See One
Notwithstanding the fact that many people can relieve their reflux disease symptoms by changes in their habits, diet, and lifestyle, others need to consult their health-care professional.
You can start with your family or general practitioner (primary care provider). You may be referred to a gastroenterologist, a specialist in disorders of the gastrointestinal (GI) tract. If the symptoms you experience are severe and require surgery, you will be referred to a general surgeon. Most of the diagnostic tests for GERD are done by a radiologist.
- Call your health-care professional when symptoms of GERD occur frequently, disrupt your sleep, interfere with work or other activities, are associated with respiratory problems, or are not relieved by self-care measures alone.
- Make your health-care professional aware that you are using self-care measures or over-the-counter medications so that they can monitor how well they work and how often you need to use them.
If you have any of the following, go immediately to the emergency department where you will be seen by an emergency medical specialist:
- Acute chest pain or pressure, especially if it radiates to your arm, neck, or back
- Vomiting followed by severe chest pain
- Vomiting blood
- Dark, tarry stools
- Difficulty swallowing
- Shortness of breath
Diagnosis of GERD
Doctors have a way of diagnosing reflux disease from the symptoms you report.
- Lifestyle changes may be recommended first (which includes diet), and maybe an over-the-counter antacid.
- If symptoms continue more than 4 weeks despite this therapy the person may be referred to a gastroenterologist, which is a doctor who specializes in the gastrointestinal (GI) tract.
The gastroenterologist may perform an upper GI series.
- This is a series of X-rays of the esophagus, stomach, and upper part of the intestine.
- You will have to take a contrast liquid (before the x-ray) that makes certain features show up better on the X-rays.
- This series is sometimes called a barium swallow for one type of contrast liquid that is used and when the examination is limited to the esophagus.
- This test gives less information than an upper GI endoscopy but is ordered to rule out other conditions such as ulcers or blockage of the esophagus. The upper GI series is sometimes skipped altogether.
The gastroenterologist may perform an upper GI endoscopy, also called esophagogastroduodenoscopy or EGD, a procedure that can be done as an outpatient.
- You receive sedation then a flexible probe with a tiny camera on the end is passed down your throat. The camera allows the doctor to see damage to the esophagus, how severe the GERD is, and to rule out serious complications of GERD or unexpected diseases.
- If you have mild GERD, your esophagus may appear normal.
- the specialist to make diagnoses, assess damage, take biopsies if necessary, and even treat certain conditions on the spot from this procedure.
Esophageal manometry is a test that measures the functionality of the lower esophageal sphincter and the motor function of the esophagus. There is a passing of a tube until it reaches the esophagus. Usually, it is performed along with 24-hour pH probe study.
In a 24-hour pH probe study, a thin tube is placed down into your esophagus for 24 hours. The tube observes and records episodes of acid reflux over the day and while you sleep.
Home Remedies To Treat and Soothe Acid Reflux (GERD)
For certain people, acid reflux symptoms may be relieved by changing diets, habits, and lifestyle. The following steps may help reduce reflux.
- Don’t eat within 3 hours of bedtime. During this time your stomach empties and acid production decreases.
- Avoid lying down right after eating at any time of day.
- Raise the head of your bed 6 inches with blocks. This is because gravity helps prevent reflux.
- Don’t eat large meals. When you eat a lot of food at one time, the amount of acid needed to digest it increases. Rather, have smaller, more periodic meals throughout the day.
- Keep away from fatty or greasy foods, chocolate, caffeine, mints or mint-flavored foods, spicy foods, citrus, and tomato-based foods. The competence of the lower esophageal sphincter is decreased by these foods.
- Avoid drinking alcohol. The likelihood that acid from your stomach will back up increases when you take alcohol.
- Stop smoking. The lower esophageal sphincter and increases reflux when you smoke.
- Lose excess weight. When you’re of a healthy weight, you stand a better chance than obese and overweight individuals.
- Stand upright, sit up straight, and maintain good posture. This aids food and acid pass through the stomach instead of returning up into the esophagus.
- Talk to your health-care professional about taking over-the-counter pain relievers like aspirin, ibuprofen (Advil, Motrin), or medicines for osteoporosis. These can aggravate reflux in some people.
Is There a Diet for GERD?
For GERD, the proper diet is just one of elimination (removing from diet foods that aggravate it). The following foods that may aggravate acid reflux, and should be avoided:
- fatty or greasy foods,
- onions and garlic,
- mints or mint-flavored foods,
- spicy foods,
- citrus, and tomato-based foods, or
- any foods that aggravate the symptoms.
In addition, being overweight can aggravate symptoms of acid reflux. Losing even 5 or 10 pounds may help relieve some of your GERD symptoms. Talk to your doctor about a diet plan to help you lose weight.
Foods That Aggravate GERD
Certain foods may stimulate the production of stomach acid and may irritate the esophagus. Common foods that may cause heartburn include:
- Onions and garlic
- Fatty foods
- Coffee (caffeinated and decaffeinated), tea, cola, energy drinks
- Spicy foods
- Tomato and citrus juices
Different people have different triggers. Doctors often suggest you keep a food journal to find out what aggravates your acid reflux symptoms.
Can Nonprescription (Over-the-Counter) Medications Treat GERD?
Over-the-counter medications also may help relieve your symptoms. However, be sure to check with your health-care professional before trying any of these.
Antacids like Gaviscon, Maalox, Mylanta, and Tums: These take effect when taken 1 hour after meals and at bedtime because they neutralize acid already present.
Some are combined with a foaming agent. This is because foam in the stomach aids prevent acid from returning up into the esophagus.
These agents are safe to use every day over a few weeks, but if taken over a longer period can cause side effects:
- Impaired metabolism of calcium in the body
- Build-up of magnesium in the body, which can damage the kidneys
If you use these daily for more than 3 weeks, inform your health-care professional.
Histamine-2 receptor blockers (H2-blockers) prevent acid production.
- H2-blockers are effective only if taken at least 1 hour before meals because they don’t affect acid that is already present.
- Common H2-blockers are cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac), and nizatidine (Axid).
If self-care and treatment with nonprescription medication does not work, your health-care professional likely will prescribe one of a class of stronger antacids. This therapy may be needed only for a short time or over a longer period while you make gradual changes in your lifestyle.
What Prescription Medications Treat GERD?
The drugs that come from prescription employ different mechanisms to reduce reflux.
Proton Pump Inhibitors (PPIs)
- PPIs include the following omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), rabeprazole (Aciphex), and pantoprazole (Protonix). You can get or find many of these medications over-the-counter in certain doses, without a prescription.
- They inhibit the production of an enzyme needed to produce stomach acid.
- These PPIs stop acid production more completely than H2-blockers does.
Sucralfate (Carafate) provides an additional protective barrier against stomach acid by coating mucous membranes and sores.
- Promotility agents include the following metoclopramide (Reglan, Clopra, Maxolon) and bethanechol (Duvoid, Urabeth, Urecholine).
- They aid tighten the lower esophageal sphincter and make the stomach empty faster.
- Because they have fairly significant side effects, health-care professionals often are reluctant to prescribe these medications.
- PPIs work better for most people than promotility agents do.
- Because of safety concerns related to drug interactions that could cause lethal cardiac conditions, one of these agents, cisapride (Propulsid), has been removed from the U.S. market.
To get the best of results, follow the advice of your health-care professional gives concerning medication and lifestyle.
Always tell or give your doctor feedback on what you are doing about your reflux disease and how well it is working.
Don’t fail on follow-up appointments. As the case may be, your doctor may have to adjust your treatment at preset intervals of time. This is to decide to refer you to a specialist if initial therapy fails.
Can Surgery Treat Acid Reflux (GERD)?
When it comes to the treatment of GERD, surgery is never the first option. A change in lifestyle, diet, and habits, nonprescription antacids, and prescription medications are the first things to try before resorting to surgery. In a case where all these fail, then you can resort to surgery.
Lifestyle changes and medications work well in most people. This makes surgery to be done on only a small number of people.
Fundoplication is the operation that is mostly used for GERD.
- It works by increasing pressure in the lower esophagus. This is to keep acid from backing up.
- To provide more of a one-way valve effect, the surgeon wraps a part of your stomach around your esophagus like a collar and tacks it down.
- Now, this procedure can be done laparoscopically. Very small cuts in your belly by the surgeon, through which the surgeon inserts long narrow instruments and a fiberoptic camera (laparoscope) through the slits. The scarring from this method is little. It also brings about fast recovery.
- A newer procedure, the LINX procedure, works by placing a ring around the lower esophageal sphincter and is less invasive than a fundoplication.
- It is common to all surgical operations, and fundoplication is so; it does not always work and can have complications.
Can I Prevent Acid Reflux Disease (GERD)?
To change the things that cause reflux is the best and safest way to prevent reflux disease from occurring.
- Maintain a healthy body weight.
- Keep away from large meals and eating within 3 hours of bedtime.
- Reduce the intake of fatty or greasy foods, chocolate, caffeine, and other irritating foods.
- Avoid alcohol.
- Stop smoking.
- Maintain good posture, especially while seated.
- Working out, bending, or stooping on a full stomach should be avoided.
What Is the Prognosis for Someone With GERD?
GERD is treatable, relapses are common though, especially if there is no change in your lifestyle.
- People whose cases are mild-to-moderate disease (GERD), home care and H2-blockers are generally effective to them.
- Severe esophagitis usually requires PPI therapy.
- In cases of relapse, long-term therapy or surgery will be necessary to avoid complications.
Complications of acid reflux can include any of the following. Most of these are rare, but GERD can be the first step toward any of them. The best treatment for any of these is prevention.
- Esophageal ulcers and esophagitis: Inflammation, irritation of the lining of the esophagus
- Laryngopharyngeal reflux: This occurs when acid from the stomach gets into the throat, the voice becomes hoarse.
- Bleeding: This comes from the ulcers in the damaged esophageal lining
- Strictures: Chronic scarring from the narrowing of the esophagus
- Swallowing problems: Due to strictures
- Respiratory problems like asthma: This occurs when acid from the stomach gets into the breathing tracts
- Barrett’s esophagus: Changes in the cells lining the esophagus, a precancerous condition
- Cancer of the esophagus: Has a very low incidence rate.
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