What is acid reflux? You may have heard about it, know someone who experienced it, or you may even be suffering from it. From the causes to the treatments, this article will provide you an overview of what and how acid reflux works.
What is Acid Reflux?
Acid reflux is the action of regurgitating digested, partially digested, or undigested food from the stomach and up to the esophagus. Normally, when we eat, certain amount of pressure holds the esophageal sphincter closed after the food passes through it. If the sphincter closes at the wrong time, opening appropriately meal, partially digested food may move back up the esophagus.
This is called a refluxate. Because this food contains enzymes and acids from the stomach, this can cause burning sensation in the middle of the chest. Since this burning feeling is commonly felt in the area near the heart, the popular term heartburn is used to describe this symptom.
Acid reflux and heartburn are commonly misused terms, but the difference lies in that acid reflux is the action, while heartburn are the associated symptoms that come along with it.
What causes Acid Reflux?
There are many factors which have been identified as causes of acid reflux. Like many other health conditions, acid reflux and heartburn occur after being triggered by primary and secondary factors. There are those factors that cause the acid reflux, and there are those that already compromise the heartburn condition.
One such factor is said to be overproduction of acid. Although acid reflux is caused by regurgitation of mostly acidic products, it is actually rare that the cause for this is overproduction of acid.
Stomach acid is very vital to health. It is required in the first major breakdown of food, which is critical to proper nutrition. Acid is especially important in the breakdown of protein, and is required for the optimal release and preparation of minerals such as calcium, magnesium and iron for absorption.
Some heartburn sufferers simply produce abnormal amounts of acid in their body, making their stomach liquid more acid concentrated and thus can inflict more damage when it comes into contact with the esophagus.
Several sources of increased acidity, other than genetic predisposition, are not having enough saliva and high acidity foods.
High acidity foods further contribute to the acidic environment of the stomach. These foods include regular cola beverages, orange juice, tomato juice, and salad dressings with vinegar. These foods can affect the nerves of the esophageal sphincter muscle, causing it to relax, and allowing food to back up into the esophagus.
Another cause lies on the opposite side of the spectrum. This is having too low stomach acid. This is the problem encountered by most acid reflux sufferers. During healthy digestion your stomach uses and acid cocktail made up of hydrochloric acid and the powerful digestive enzyme pepsin, to break down food into the vital nutrients your body needs.
Pepsin requires a highly acidic environment to do its job, and when hydrochloric acid is low, which can happen for many reasons, including age, poor diet, infection, and overusing antacids and medications, it becomes increasingly difficult for your stomach to fully process your food.
Too little stomach acid causes the same symptoms as that of too much acid. Both can cause bloating, belching, and sourness, or an acidity taste in the mouth from backing up in the esophagus.
When too little acid is produced, food tends to overstay in the stomach just to have all of it properly digested. This is a case of low supply and high demand. This lingering can cause discomfort and feeling of bloatedness. In addition to this discomfort, inadequate stomach acid reduces the absorption of essential nutrients.
In other cases, the muscle tone of the LES is weak, causing weak contractions as well. Normally, it takes a few seconds after swallowing to allow food and liquids to pass through. However, for most heartburn sufferers, the LES relaxes at random times for several minutes, allowing acid to reflux to the esophagus.
There are several reasons why the LES opens inappropriately. It could be from obesity, slow digestion, pregnancy, or even age.
What are the symptoms of Acid reflux?
The most common symptom is heartburn. This may be manifested or accompanied by other sensations such as:
- Burping, belching, a noisy stomach, or passing of gas
- Swallowing difficulty
- Swallowing pain or burning
- Nausea, vomiting, or regurgitation
- Hoarseness, Chronic cough or asthma
- Asthma and Cough
- Dyspepsia
How is acid reflux diagnosed?
To further evaluate whether or not you are suffering from acid reflux, doctors can perform any of these diagnostic tests on you:
The pH probe is the most common and standard test for acid reflux. In this test, a thin wire with an acid sensor is inserted through the nose into the lower are of the esophagus and is attached to a monitoring device worn outside the body.
After this, you are then monitored for 24-hour periods to evaluate the acidity levels of your esophagus, whether they are affected by your meals, activities, and sleep.
In an Upper GI Series, you are asked to swallow a liquid barium mixture and the radiologist uses a fluoroscope to watch the barium as it travels down your esophagus and into the stomach.
X-rays are performed as needed as well. This type of test provides somewhat limited information about possible acid reflux, but helps rule out other possible diagnoses such as peptic ulcers.
An endoscopy procedure involves the insertion of a small, lighted flexible tube into the mouth, through the esophagus, and to the stomach to look for abnormalities like inflammation or irritation of the lining of the esophagus.
An esophageal Monometry or Esophageal pH lets a small flexible tube pass through the nose and into the esophagus and stomach to measure pressures and function of the esophagus. The degree of acid that refluxes into the esophagus can also be measured over a 24-hour period. The results are then recorded on graph paper.
If you suffer from sore throat, cough, or hoarseness, it is often caused by inflammation of your throat or larynx, but these symptoms may also be triggered by gastric esophageal reflux disease. An ear, nose, and throat specialist will check the throat for inflammation.
However, if the diagnosis is negative, acid-suppressing treatments will be given to confirm the occurrence of acid reflux condition.
Most of those who suffer from heartburn and acid reflux have problems with digestion as well. That is why a Gastric Emptying test is aimed specifically for that type of people. This test is aimed at determining the ability of the food to pass through your stomach and out of the system.
Which Acid Reflux Treatments Are Available?
Antacids
Antacids work rapidly to relieve heartburn symptoms. They work directly in the stomach to decrease the acidity of the reflux liquid irritating the esophagus. They also help neutralize the area inside the esophagus.
When antacids and a foaming agents are combined, they produce a foam barrier in the stomach, which floats all over the content of the stomach, preventing splashing up into the esophagus.
They are best taken either just before eating or an hour after a meal. This way, the antacids will stay in the stomach longer, and their effect will increase.
H2-blockers
Also known as H2 receptor antagonists, these medications inhibit the acid secretion in the stomach. They can work in about 30 minutes and last up to 8 hours.
H2 blockers have been the traditional treatment for acid reflux because many of them can be an effective short-term therapy for resistant acid reflux symptoms. They are more effective when they are given in high doses rather than the more standard doses. They are also more effective taken twice a day rather than once a day.
Promotility Agents
These drugs are used for mild to moderate acid reflux symptoms and they are especially good at decreasing heartburn symptoms at night. They used frequently with H2 blockers to work together but act in different ways to reduce symptoms.
Promotility agents generally increase the strength of the lower esophageal sphincter muscle and quicken the emptying of the stomach contents.
Proton-pump inhibitors
These medications heal erosive esophagitis more rapidly than H2 blockers by decreasing the acidity of the stomach contents by inhibiting an enzyme necessary for acid secretion.
These provide a more potent acid suppression, to let irritated tissues get a chance to heal. They help control-stimulated acid secretion, but reflux can still happen during sleep.
Proton-pump inhibitors work by maintaining an acid level of more than 4.0 for longer periods than promotility agents. They are most effective for healing esophagitis and preventing complications. However, they may have little or no effect on regurgitation or controlling asthmatic symptoms.
Foaming Agents
Foaming agents are drugs that help cover your stomach contents with foam to prevent acid reflux. They contain a combination of aluminum hydroxide gel, magnesium trisilicate, and alginate. Foaming agents are best taken after meals and in combination with other drugs to maximize their effectiveness. If your esophagus is damaged, foaming agents are useless.
Surgery
Surgery is an alternative when no improvement has been made using medications. This is especially crucial in cases where regurgitation is chronic, cannot be treated by drugs, and result in lung infection.
Surgery can be an indication when the person is not able to take medicines over an extended period of time to control the GERD symptoms.
What are the preventive measures I can do against acid reflux?
- Eat smaller, but more frequent meals. More pressure is needed to keep the food down inside the stomach when big meals are taken in. This can lead to eventual acid reflux.
- Limit intake of acid-stimulating foods and beverages. You already know the dangers of too much or too little stomach acid.
- Don’t eat within two or three hours before bedtime. This gives your stomach time to properly digest food and prevent back-up of acid contents.
- Elevate your head a few inches before you sleep. Again, this will help you prevent regurgitation.
- Maintain a reasonable weight. Obesity plays an important factor in the development of acid reflux. Try to trim down weight.
- Don’t wear belts or clothes that are tight fitting around the waist. This is to prevent pressure from the stomach that can influence acid reflux.
Hi – I’m Stephanie Jones. Please read this website to find tips and advice on how to reduce your heartburn.
