Acid reflux (also known as gastroesophageal reflux disease or GERD) is a condition in which the tube that carries food from the throat to stomach i.e. the esophagus becomes weak and allows stomach acid to wash up into it. This causes heartburn and a variety of other symptoms. Most of us suffer occasional attacks of heartburn, often caused by eating a heavy meal or drinking to much coffee or alcohol- but for many people acid reflux is a chronic disease that features symptoms of almost daily discomfort and pain.
The lower part of the esophagus has a muscular sphincter that usually stays completely closed and opens only to allow food or drink to enter the stomach. Its function is to prevent the corrosive stomach acid from entering the esophagus.
In people with chronic acid reflux this sphincter mechanism does not work properly and the esophagus is exposed to acid on a regular basis. This can lead to complications like damage to the mucous lining, scarring, bleeding and ulcers and even a kind of pre-cancerous condition called Barrett’s esophagus, where cells in the esophageal lining take on an abnormal shape.
Studies show that asthma, chronic cough, and pulmonary fibrosis may also be aggravated or even caused by GERD, so it is worth it to learn to recognize the symptoms of acid reflux and get it treated if you need to.
Symptoms do vary in different individuals but usually include:
* Some form of heartburn – this may be a burning sensation behind the breastbone, tight feeling in the chest or feeling of pressure. If you have heartburn more than twice a week you may have acid reflux.
* You may not have heartburn with GERD – instead you may show symptoms of obsessive throat clearing, problems swallowing, the feeling that food is stuck in your throat, burning in the mouth, or pain in the chest.
* You may experience the harsh bitter taste of acid in your mouth (waterbrash).
* If stomach acid flows into the respiratory tubes you may have hoarseness, coughing and shortness of breath.
* Infants and children may have repeated vomiting, coughing, and respiratory problems. (Bear in mind that most babies do grow out of GERD by age one).
If your use of antacids has skyrocketed lately you need to see a doctor. Most doctors can treat GERD with drugs and suggestions on lifestyle changes. You might decide to visit an internist (who specializes in internal medicine) or a gastroenterologist (who treats diseases of the stomach and intestines). For some people surgery is the only option and is very effective in the treatment of acid reflux and its symptoms.
What Causes Acid Reflux?
Many factors contribute to GERD including certain well-known foods. As we have already mentioned individuals with acid reflux have an esophageal sphincter muscle that is weak or relaxes at the wrong time. This may happen after eating fatty or spicy foods, wearing tight clothing, smoking, certain drugs, alcohol, exercise and changing the position of the body. It is not known why some people succumb to GERD while others remain unaffected.
How is Acid Reflux Treated?
This depends on the extent and duration of your GERD but may include several lifestyle changes and medications.
o If you smoke, quit now.
o Avoid alcohol.
o Lose weight (if you need to)
o Eat smaller meals.
o Don’t wear tight clothing
o Avoid lying down for 3 hours after a meal.
o Raise the head of your bed 6 to 8 inches (put blocks of wood under the bedposts) just using extra pillows isn’t effective.
Acid Reflux Medications
Over-the-counter antacids, which you can buy without a prescription, are recommended by doctors to stop acid production or help the muscles that empty your stomach to react normally. Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids, and Riopan, are often the first drugs recommended to relieve heartburn and other mild GERD symptoms.
Most modern brands use varying combinations of three basic salts: magnesium, calcium, and aluminum – with hydroxide or bicarbonate ions to neutralize the stomach acid. However, they do have side-effects.
Magnesium salt can cause diarrhea, and aluminum salts can cause constipation problems. In many cases aluminum and magnesium salts are often combined in a single product to avoid these complaints.
Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can be a supplemental source of calcium but can also cause constipation.
* Foaming Agents
Gaviscon, for example, works by covering your stomach contents with a foam barrier to prevent acid reflux. If you don’t have any damage to the esophagus, these drugs may be helpful.
* H2 Blockers
Drugs like cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75), stop the stomach from producing excessive quantities of acid. In most cases you can obtain them in prescription strength or over the counter.
Drugs like these offer only short-term relief and should not be used for more than a few weeks at a time. They work in about 50 percent of cases but some people find that taking H2 blockers at bedtime in combination with a proton pump inhibitor works better for them.
* Proton Pump Inhibitors
Omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium), are available by prescription only. These drugs are more effective than H2 blockers and can relieve symptoms in most people who have acid reflux.
These drugs work by strengthening the sphincter muscle and making the stomach empty more quickly. Trade names are bethanechol (Urecholine) and metoclopramide (Reglan). Metoclopramide also works on muscle action in the digestive tract. Note that these drugs have frequent side effects so their usefulness is limited.
In many cases a combination of drugs can control the symptoms of acid reflux. If you get heartburn after eating you can take antacids and H2 blockers. First the antacids work to neutralize stomach acid while the H2 blockers act on acid production. When the antacid stops working, the H2 blocker will have stopped acid production. Ask your doctor for advice on how use medications in combination for your acid reflux symptoms.
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