By Health Square desk 
What is Acid Reflux?
Acid reflux results from flow back of stomach content to into the oesophagus. It is also called oesophageal reflux or acid regurgitation.
Acid reflux causes extreme discomfort and burning pain known as heartburn in the lower chest area. Chronic heartburn can lead to health complications. If a person suffers from heartburn more often, then you may be suffering from gastroesophageal reflux disease.
Causes of Acid Reflux
A ring of muscles called gastroesophageal ring is present at the end of oesophagus and opening of the stomach. The sphincter works by relaxing when you swallow the food and let it enter the stomach. Afterwards closes and tightens so that the food does not flow back to the gullet.
When sphincter does not close completely, backflow of food results in acid regurgitation, unlike stomach, the oesophageal lining is not adapted to protect against gastric acid and juices. Therefore, it causes an extreme burning sensation in the chest.
Symptoms
Heartburn becomes worse when a person is in a lying position. It can last from minutes to several hours and becomes worse when going to bed at once after eating late. The heartburn is felt in the upper throat. The stomach fluid reaches the throat causing a bitter or sour taste. Other Symptoms of GERD are
- Dry cough
- Wheezing
- Asthma
- Nausea
- Vomiting
- Pain in swallowing
- Dental erosion
- Bad breath
Risk factors aggravating GERD
The lifestyle, some health conditions and eating habits can potentialize the risk of GERD. Some of these factors are
- Obesity
- Hiatal hernia
- Connective tissue disorder
- Pregnancy
- Smoking
- Caffeine
- A diet low in dietary fibre
- Eating plentiful and fatty meals
- Going to bed at once after eating
- Alcohol or soda-based beverages
- Spicy food
- Prolong use of NSAIDs drugs
- Other drugs (antihistamines, a calcium-channel blocker, antidepressants)
If you have any of these factors in your routine, steps should be taken to change these and prevent yourself from heartburn and GERD.
Diagnosis
The pain in acid reflux and heartburn is common and is easy to diagnose. However, people can be confused while having these symptoms and usually associate their heartburn to problems like
- Chest pain
- Heart attack
- Pneumonia
- Pulmonary embolus
If there is no improvement in heartburn, despite changing lifestyle and medication, then an investigation for GERD is needed.
- A gastroenterologist performs the following test to examine
- Endoscopy: the image of the gastric tract by using a small camera
- Biopsy: taking a tissue sample by inserting a small tube mounted camera in the oesophagus
- Barium X-Ray: taking X-Ray images of the digestive tract after drinking a barium solution
- Oesophageal manometry: measurement of oesophageal pressure
- Impedance monitoring: Oesophageal tissues strength is measured by inserting a flexible tube
- pH monitoring: acidity testing
Complications of GERD
GERD does not cause any severe complications in most of the people. But it can lead to life-threatening complications if left untreated. Some of them are
- Oesophagitis: inflammation of the oesophagus
- Oesophageal stricture: narrowing of the oesophagus
- Barrett’s oesophagus disorder: change in the lining of the oesophagus
- Asthma: if you breathe stomach into the lungs, it can develop into chronic cough or breathing problems. Tooth decay, enamel erosion, gum problems
These complications can be prevented by alleviating the symptoms of GERD.
Diet to avoid in GERD
Certain types of foods and drinks can aggravate the symptoms of GERD in some people. Some of them are
- High-fat foods
- Spicy foods
- Chocolate
- Citrus fruits
- Caffeine
- Tomato
- Onions
- Garlic
- Alcohol
- Tea
- Soda-based beverages
- Food triggers are different in different people. You can get rid of heartburn by avoiding specific foods that act as a triggering factor for you.
Home Remedies for GERD
You can adopt some simple remedies to diminish the symptoms of heartburn and GERD. It needs a few changes in your lifestyle and eating patterns. Lifestyle measures that can make a change include
- Eating healthy food
- Avoid triggering food
- Eating smaller meals
- Avoid going to bed after eating.
- Eating late at night.
- Quit smoking
- Drinking apple cider vinegar mixed with water
- Wearing loose clothes
- Doing regular exercise
- Some herbal medications can also give relief from symptoms, but it varies from person to person.
Treatment
The most often used medicines to treat acid reflux are
Proton pump inhibitors-Omeprazole, Lansoprazole, Esomeprazole etc
H2 receptor antagonists-Cimetidine, Ranitidine etc
These medicines decrease the production of gastrointestinal acid and reduce the damage caused by acid reflux. H2 blockers are safe but can cause a few side effects in some patients.
Over the counter medicines
Many people experience heartburn or indigestion infrequently at night after eating a heavy or fatty meal. Over the counter, medicines are the best remedy to reduce the acidity in these people.
There are dozens of brands available for these formulations called antacids. The one which suits you better and relieves symptom can be discussed with a doctor.
Antacids supply prompt relief by reducing the acidity of stomach content rapidly. These have chemical components
- Calcium carbonate
- Sodium bicarbonate
- Aluminium
- Magnesium hydroxide
Some other treatment options include
- Sucralfate acid suppressants
- Potassium blockers
- TLESR -Transient lower oesophageal sphincter relaxation reducers
- GABA receptor agonist
- antidepressants
- Selective serotonin reuptake inhibitors (SSRIs)
- Theophylline
Surgery
The lifestyle changes and medicines are not adequately responding to alleviate the disease in some people. In such cases, the doctors opt for surgical procedures as a last resort. Multiple surgical procedures are available for the treatment of GERD.
GERD in Pregnancy
The chances of acid reflux increase in pregnant women. Even those women can also suffer who don’t have symptoms of heartburn before pregnancy.
Acid regurgitation in pregnancy results from hormonal changes. The muscles of the oesophagus relax more often due to hormonal changes. The pressure on the stomach is also increased due to growing foetus and can cause the back-flow of gastric fluid into the oesophagus.
Many OTC medicines are safe to use during pregnancy for GERD. However, it is better to consult your doctor.
GERD in Infants
It is common in babies to spit milk or even do vomit sometimes. But if the baby is spitting up milk or food often, then a check-up is important-the baby may have GERD. Other common symptoms in infants include
- Refusal to eating
- Swallowing problems
- Choking
- Wet burps
- Weight loss
- Poor growth
- Frequent coughing or pneumonia
- Difficulty in sleeping
If these symptoms are persistently appearing in the baby, then an appointment with the doctor is necessary.
Does GERD cause Palpitations?
Heart palpitations are feelings of skipping a heartbeat or fluttering sensation. The person also feels that the heart is beating very fast or pumping harder.
It is unlikely that GERD causes palpitations. A person may feel a tight chest, but these are not palpitations.
In the case of continuous palpitations, call the emergency help service.
Anxiety-related GERD
In many anxiety and depression patients, the symptoms of GERD can become worse. Researchers suggest that prolonged anxiety and depression causes increased muscle tension. If the long-lasting stress affects abdominal muscles, then it can cause a reflux of acidic content. It is important to consult the doctor for advice.
Despite, consulting doctor specific lifestyle changes are a must to cope with the depression and anxiety-related stress.
Once the anxiety is reduced, the GERD symptoms usually alleviate after that.
Is there any difference between GERD and Heartburn?
Heartburn is a common symptom of acid reflux. It is not a chronic medical problem and alleviates after some time.
However, if a person is suffering from acid reflux for more than twice a week, then one must consult the doctor for GERD diagnosis.
The complications of GERD can be chronic if left untreated.