ACID REFLUX

  SCROLL TO THE LAST PAGE FOR SUMMARY  'POINTS TO REMEMBER'

                              WHAT IS ACID REFLUX

Gastroesophageal reflux disease (GERD), gastro-oesophageal reflux disease(GORD), gastric reflux disease, or acid reflux disease is a chronic symptom of mucosal damage caused by stomach acid coming up from the stomach into the esophagus. At the entrance to your stomach is a valve, which is a ring of muscle called the lower esophageal sphincter (LES). Normally, the LES closes as soon as food passes through it. If the LES doesn't close all the way or if it opens too often, acid produced by your stomach can move up into your esophagus. This can cause symptoms such as a burning chest pain called heartburn.

                  

                 What is the difference between acid reflux and heartburn?

Acid reflux is the action, while heartburn is the sensation. The pain is heartburn, while the movement of acid into the esophagus from the stomach is acid reflux.

                                       

                                   BARRETT'S ESOPHAGUS

GERD may lead to Barrett's esophagus, a type of intestinal metaplasia, which is in turn a precursor condition for carcinoma. The risk of progression from Barrett's to dysplasia is uncertain but is estimated at about 20% of cases. Due to the risk of chronic heartburn progressing to Barrett's, EGD every five years is recommended for patients with chronic heartburn, or who take drugs for chronic GERD

                                                       

                         WHAT ARE THE MAIN SYMPTOMS OF GERD

The main symptom of GERD in adults is frequent heartburn, also called acid indigestion—burning-type pain in the lower part of the mid-chest, behind the breast bone, and in the mid-abdomen. Most children under 12 years with GERD, and some adults, have GERD without heartburn. Instead, they may experience a dry cough, asthma symptoms, or trouble swallowing.          

                                 WHAT CAN I DO TO HELP MYSELF

GERD is largely preventable through changes in lifestyle, which are also used as treatment

• Sleep on the left side, or with your upper body raised. 

Relief is often found by raising the head of the bed to 30 degrees, raising the upper body with pillows, or sleeping sitting up. The upper body must be raised, not just the head; pillows that only raise the head do little for heartburn and put strain on the neck. Sleeping on the left side also keeps gravity working for you, keeping your stomach below your esophagus.

• Eat smaller meals. 

Eating a big meal causes excess stomach acid production, so attacks can be minimized by eating smaller meals. It is also important to avoid eating shortly before bedtime.

• Lose weight. 

Gaining even a few pounds increases your risk of heartburn. Exactly why isn't clear, but the leading theory is that more body fat puts more pressure on the stomach, which can cause highly acidic stomach contents to reflux to the lower esophageal sphincter. For the same reason, tight clothing around the abdomen can also increase the risk of heartburn.

• Avoid acidic and rich foods. 

Though less well supported by evidence, a sufferer may benefit from avoiding foods that trigger their symptoms. These commonly include acidic fruit or juices, fatty foods, coffee, tea, onions, peppermint, chocolate, especially shortly before bedtime.

• Avoid consuming acidic substances that can trigger heartburn symptoms such as caffeine, nicotine, and alcohol

                                                 

                        CAN ACID REFLUX DISEASE BE TREATED WITH MEDICATIONS?

  In many cases, lifestyle changes combined with over-the-counter medications are all you need to control the symptoms of acid reflux disease.

  Antacids, such as Alka-Seltzer, Maalox, Mylanta, Rolaids, or Riopan, can neutralize the acid from your stomach. But they may cause diarrhea or constipation, especially if you overuse them. It's best to use antacids that contain both magnesium hydroxide and aluminum hydroxide. When combined, they may help counteract these gastrointestinal side effects.

  If antacids don't help, your doctor may try other medications. Some require a prescription. Your doctor may suggest more than one type or suggest you try a combination of medications such as these:

  • Foaming agents (Gaviscon) coat your stomach to prevent reflux.
  • H2 blockers (Pepcid, Tagamet, Zantac) decrease acid production.
  • Proton pump inhibitors (Prilosec, Prevacid, Protonix, Aciphex, Nexium) also reduce the amount of acid your stomach makes.
  • Prokinetics (Reglan, Urecholine) can help strengthen the LES, empty your stomach faster, and reduce acid reflux.

  Don't combine more than one type of antacid or other medications without your doctor's guidance.

                         

                                     Points to Remember

  • Frequent heartburn, also called acid indigestion, is the most common symptom of GERD in adults. Anyone experiencing heartburn twice a week or more may have GERD.
  • You can have GERD without having heartburn. Your symptoms could include a dry cough, asthma symptoms, or trouble swallowing.
  • If you have been using antacids for more than 2 weeks, it is time to see your health care provider. Most doc-tors can treat GERD. Your health care provider may refer you to a gas-troenterologist, a doctor who treats diseases of the stomach and intestines.
  • Health care providers usually recom-mend lifestyle and dietary changes to relieve symptoms of GERD. Many people with GERD also need medica-tion. Surgery may be considered as a treatment option.
  • Most infants with GER are healthy even though they may frequently spit up or vomit. Most infants outgrow GER by their first birthday. Reflux that continues past 1 year of age may be GERD.
  • The persistence of GER along with other symptoms—arching and irritability in infants, or abdominal and chest pain in older children—is GERD. GERD is the outcome of frequent and persistent GER in infants and children and may cause repeated vomiting, coughing, and respiratory problems.