What is Acid Reflux?

Dr. Anurag Jindal

Dr. Anurag Jindal

Gastroenterologist, Manipal Patiala, 8 years of experience

November 20, 2020 Liver Section 1115 Views

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What is the meaning of Acid Reflux?

Acid reflux is a digestive disease. In this disease, the stomach acid or bile irritates the lining of the food pipe. If the condition of acid reflux occurs frequently, it is called gastroesophageal reflux disease in the medical language. Acid reflux causes heartburn or burning chest discomfort. Despite the name, heartburn has nothing to do with the heart. Acid reflux is commonly called heartburn as the esophagus lies just behind the heart and this is where the burning sensation of acid reflux is felt. 

The stomach contains hydrochloric acid, a strong acid that helps digestion by breaking down food. This acid also protects against pathogens such as bacteria. The lining of the stomach is specially adapted to protect itself against such powerful acids, but the esophagus is not protected. Nowadays, the problem of acid reflux has increased in people of all age groups, i.e., children, adults, and old age. Often, a poor lifestyle and bad eating habits such as eating untimely meals, staying empty stomach or lying down right after a meal can cause the problem of acid reflux. 

During this condition, stomach acid flows back up into the throat, and in severe cases, belching also occurs. Therefore, you need to improve your eating habits to avoid the problem of acid reflux. 

Let us tell you in detail about Acid Reflux in today’s article. 

  • What are the causes of Acid Reflux? 
  • What are the food items that trigger Acid Reflux?
  • What are the symptoms of Acid Reflux? 
  • What are diagnostic tests for Acid Reflux?
  • What are the treatments for Acid Reflux? 
  • How to prevent Acid Reflux ?
  • What are the risks and complications of  Acid Reflux? 

What are the causes of Acid Reflux? 

Acid reflux occurs when some of the acid content of the stomach flows back into the esophagus, throat, which then moves down from the mouth. 

A ring of muscle, the gastroesophageal sphincter or the lower esophageal sphincter (LES) , normally acts as a valve that allows food to pass into the stomach from the esophagus, but not back up into the esophagus. When this valve fails, and the stomach contents are regurgitated into the esophagus, symptoms of acid reflux are felt, such as heartburn. 

The common causes of Acid Reflux are as follows-

  • Hiatal hernia- Here the upper part of the stomach and the lower esophageal sphincter ( LES ) move above the diaphragm, into the chest cavity. Diaphragm usually prevents the stomach acid from rising into the food pipe. In case of hiatal hernia, acid moves up the food pipe and this can occur at age. ( Know more about- What is Hernia Surgery? )
  • Smoking– This causes acid reflux by damaging the mucus membrane of the food pipe, weakening the muscle reflexes of the throat and the LES muscle functions, increasing the acid secretions in the stomach and decreasing the saliva secretions in the mouth.
  • Pregnancy– This is due to increased levels of hormones in the body and pressure caused by the growing fetus in the womb. The symptoms of acid reflux are maximum during the third trimester and decrease after delivery.
  • Alcohol– This aggravates the risk of acid reflux and the risk becomes more when combined with smoking and tobacco. This also increases the chances of Esophageal cancer. 
  • Medications, including medicines for asthma, calcium-channel blockers, antihistamines, painkillers, sedatives and antidepressants. 
  • Poor eating habits, like taking heavy meals before sleep, lying down immediately after meals, etc can cause acid reflux. 
  • Obesity 
  • Low levels of physical exercise 

What are the food items that trigger Acid Reflux ?

Some of the food items that may cause acid reflux are-

  • Alcohol
  • Chocolate
  • Carbonated drinks like cold drinks, packed juices, etc.
  • Citrus fruits like lemons, oranges, etc.
  • Excessive consumption of Coffee or Tea
  • Excessive intake of fried and fatty foods
  • Mint containing foods
  • Spicy food items
  • Fast food items like pasta, pizza, etc
  • Food containing too much garlic in it

What are the symptoms of Acid Reflux? 

Acid Reflux has the following symptoms, but the presentation of these symptoms may vary from person to person. 

The two most common symptoms of Acid Reflux are-

  • Heartburn– This is an uncomfortable burning sensation that occurs in the esophagus and is felt behind the breastbone area. It worsens when lying down or bending over. It can last for several hours and often worsens after eating food. Heartburn pain may extend to the neck and throat. In some cases, stomach fluid can reach the back of the throat, producing a bitter or sour taste. 
  • Regurgitation– This is a condition where the acid contents of the stomach come up into the throat and mouth, leaving a sour or bitter-tasting acid taste in the mouth. 

Other symptoms associated with Acid Reflux are- 

What are diagnostic tests for Acid Reflux?

If the symptoms of Acid reflux increase or they occur 2 or more times in a week, or if lifestyle changes, antacids, acid blocking medications, etc. do not resolve the symptoms of acid reflux, the the patient may be asked to do the following tests- 

  • Barium swallow ( esophagram )- This helps to look for any ulcers or narrowing of the food pipe, where the patient is asked to swallow a  solution and then an Xray is taken. 
  • Esophageal manometry- This helps to check the functioning and the movements of the esophagus.
  • pH monitoring- Here the doctor leaves a device in the esophagus for 1 to 2 days, that measures the pH of the esophagus or the amount of acid in the food pipe.
  • Endoscopy- Here a long, flexible tube with light  and camera on one end is inserted down the throat, to look for any problems associated with the food pipe. 
  • Biopsy- This helps to look for any abnormality or infection under the microscope, by taking samples of tissues during an endoscopy.  ( Know more about-What is Endoscopy? )

What are the treatments for Acid Reflux? 

The following are the treatment modalities for Acid Reflux patients-

Diet and Lifestyle Changes- One can reduce the symptoms and frequency of acid reflux attacks by bringing about the following modifications-

  • Eat small meals, over frequent intervals of time rather than heavy meals.
  • Change the types of foods you consume, i.e. reduce the intake of fried, fatty, carbonated foods. Do Not eat snacks before bed time.
  • Avoid alcohol, smoking or eating tobacco.
  • Eat meals 2-3 hours before bedtime.
  • Exercise regularly and reduce weight if obese.
  • Raise your pillow level 4-6 inches above the bed, to raise your head level to that.
  • Avoid wearing tight belts or tight clothes that may compress the stomach region.
  • Consult your doctor to find out if any medication is inducing acid reflux episodes. Change the medications only on doctor’s advice. 

Medications– The medications one may be prescribed are:

  • Antacids (  that contain both magnesium hydroxide and aluminum hydroxide ) (Know more about- What is Antacid ? )
  • Foaming agents ( that coat the stomach lining and prevent reflux )
  • H2 blockers ( these decrease the acid production in the stomach )
  • Proton pump inhibitors ( these reduce the acids that stomach makes )
  • Prokinetics ( helps to increase the strength of LES, helps to empty the stomach faster by increasing the metabolism which reduces acid reflux )

Surgery– If the medications do not resolve the symptoms of acid reflux and symptoms become severe and affect day to day life of the patients, in that case a doctor may advise the patient surgery. 

The two types of surgeries performed to treat Acid Reflux are-

  • LINX device placement surgery ( here a ring of magnetic titanium beads joined together by titanium wires, is surgically placed in the lower end of the esophagus, which prevents the stomach contents from coming back up into the food pipe )
  • Fundoplication surgery ( In this procedure, the upper part of the stomach is wrapped around the LES to strengthen it, which prevents acid reflux. This is also used to repair hiatal hernia. This surgery is done either by open method or laparoscopic method )

How to prevent Acid Reflux ?

The following measures can be taken to prevent acid reflux-

  • One should exercise daily. 
  • Avoid doing those exercises that exert pressure on the stomach. 
  • Try to have your meal 2 to 3 hours before bedtime. 
  • Wear loose fitted clothes. 
  • Avoid/reduce smoking and alcohol consumption. 
  • Do not eat spicy food. 
  • Get a yearly examination done by a doctor. 
  • Drink a small cup of cold sweet milk three times a day.
  • Eating onions with curd provides relief from acid. 
  • Try sleeping on a chair for small duration naps.

What are the risks and complications of  Acid Reflux? 

If acid reflux is left untreated for prolonged time, following complications can occur-

  • Esophagitis ( swelling, inflammation and irritation of esophagus )
  • Adult onset asthma
  • Narrowing or stricture of esophagus
  • Barrett’s esophagus ( pre-cancer changes of esophagus )
  • Acid reflux and regurgitation into lungs
  • Esophageal ulcers and bleeding
  • Sinusitis

We hope we were able to answer your questions about Acid Reflux through this article. 

If you want to get more information and treatment of Acid Reflux, contact a Gastroenterologist

We only aim to give you information through the article. We do not recommend medication or treatment in any way. Only a doctor can give you the best advice and treatment plan.

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