Heartburn and acid reflux are something that most people will suffer from at some point in their lives. It is a common problem, and for most people, it’s just a sign of having eaten a bit too much or eat something that disagrees with them. For some people, however, acid reflux can be a recurring thing. Chronic acid reflux is known as Gastroesophageal reflux disease.1
What Is Acid Reflux?
Acid reflux is a condition that people suffer from when stomach acid escapes the stomach and reaches the esophagus. It can make people feel sick and creates a burning feeling in the esophagus. Occasional bouts of acid reflux are not dangerous, but if it is continuous and untreated, it can lead to some potentially dangerous complications.2
What Causes Acid Reflux?
Acid reflux usually happens when the ring of muscle that is located at the bottom of the esophagus weakens. A mild attack simply causes a slightly unpleasant taste at the back of the mouth, with a bit of ‘heartburn,’ but if the problem is left untreated it can get more distressing and more serious.
Who Gets Acid Reflux?
Acid reflux can affect people from all walks of life, but there are some people who are at greater risk than others.3
Those who are overweight or obese may be at greater risk because there is more pressure on the stomach, and the muscles in the esophagus can become weakened.
People who eat a lot of fatty foods may find that it takes longer for the stomach to empty of acid after digesting the meal. Large, fatty meals trigger attacks of acid reflux in some people.
Smokers and those who drink a lot of alcohol can suffer from bouts of acid reflux because these substances cause the muscles at the bottom of the esophagus to relax. In some cases, chocolate and caffeine have a similar effect.
Those who suffer from a condition known as gastroparesis often experience GERD as a condition.
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Having a hiatus hernia can cause acid reflux because a part of the stomach is pushed up through the diaphragm and is under extra pressure.
Some medications, including non-steroidal anti-inflammatory drugs and calcium-channel blockers, can cause GERD.
Pregnant women sometimes experience heartburn due to changes in their hormone balance. This usually resolves itself after the baby is born.4
Symptoms of Acid Reflux
The most noticeable symptom of acid reflux is a pain in the chest or stomach. Some people find that they regurgitate a small amount of food and also liquid that contains stomach acid. Other symptoms of acid reflux can include: 5
- The presence of a sour, acid taste while lying down
- A persistent feeling that there is food stuck in their throat
- Difficulty swallowing
- Waking up to a feeling of choking
- Noticing an acidic feeling when burping
- Bad breath
- A persistent dry cough
- Tooth decay
How Is Acid Reflux Diagnosed?
Occasional heartburn can be put down to over-indulging in rich foods, or perhaps eating a big meal and then exercising. Recurring heartburn, on the other hand, must be taken seriously and it is a good idea to seek expert medical advice if you have repeated incidents of heartburn or acid reflux. Doctors will sometimes diagnose based on just the report of regular heartburn, or a dentist may notice tooth decay and refer someone for a checkup based on that.6
There are tests that a doctor can do to rule out more serious problems and come to the conclusion of GERD.
Barium Swallow Radiograph
This is a test that allows a doctor to see if the liquid is escaping back into the esophagus. The patient drinks a chalky liquid that contains barium, and they are then x-rayed. The liquid is visible on the x-ray, so doctors can see where it is and where it flows.
Gastric Emptying Scan
This test allows doctors to see whether the patient’s stomach is emptying at a slower rate than normal. The patient is given a drink or a meal that has a tracer mixed in with it. A machine will scan the tracer to see how quickly it leaves the stomach. This test is often used because the scanning machine does not use radiation. This means that it is a viable option for people that the doctors do not want to give an x-ray too.
This test uses a very small camera to look at the esophagus, the stomach, and the small intestines. The doctor will numb the patient’s throat, and give them some anesthetic to make them comfortable while the test is performed. A small tube is slid down the throat, and into the stomach, and then the camera is fed down the tube. If necessary, the doctor will take a small piece of tissue from the stomach to perform tests on it and rule out other medical conditions.
24 Hour pH Test
This is a test that measures the pH in your esophagus and determines whether or not you have gastroesophageal reflux disease. The test can be used both for diagnosis, and to determine whether the medication that you have been given is working. The test involves feeding a tube through your nose and into the esophagus. There is a device attached to the tip of the cube that will sense acid. The tube is taped to the side of your face, and there is a device attached to the tube that will store the readings from the sensor. The test requires people to eat and drink as they normally would when they were having symptoms so that the sensor gets readings showing how their stomach responds to those foods.7
Is Acid Reflux Dangerous?
Occasional attacks of acid reflux can be dismissed as having a clear cause (such as eating too much in one sitting), but recurring attacks should be cause for concern. If left untreated, acid reflux can scar your esophagus, which leads to a condition called Barrett’s esophagus. People who have this condition are at a much greater risk of developing esophageal cancer.8 Around 10 to 15 percent of people who have GERD develop Barrett’s Esophagus and most cases of adenocarcinoma-type esophageal cancers develop in Barrett’s tissues.9
Medication for Acid Reflux
Occasional bouts of acid reflux can be managed through over-the-counter medication. If you develop serious acid reflux then your doctor will likely recommend lifestyle changes, although you may still end up using medications as well to manage attacks.
Acid reflux bouts can be controlled through the use of antacids such as Alka-Seltzer, which can neutralize the acid in your stomach. The issue with antacids is that they can have some gastrointestinal side-effects.
Other potential treatments include foaming agents which will coat the stomach to prevent acid escaping, as well as H2 blockers or proton pump inhibitors that reduce the amount of acid produced by the stomach. In addition to these, there are prokinetics that can strengthen the lower esophageal sphincter, and therefore reduce acid reflux.
There have been some alarming studies relating to the treatments that are used for acid reflux. One study highlighted that there could be a potential link between proton pump inhibitors and an increased risk of stomach cancer.10
The study is not conclusive—some people are prescribed PPIs to treat other illnesses that have their own associated increased cancer risk. In addition, the patient group used in the study has a higher stomach cancer risk as a population, so there are several confounding factors. The study does, however, raise questions as to whether using drugs to manage acid reflux is a good idea when there are other non-medication options out there.
Complementary and Alternative Therapies for Acid Reflux
If you are struggling with acid reflux, and want to try some alternative therapies, then there are many options out there.
Acupuncture is something that has a long history in traditional Chinese medicine. The theory, as the Chinese put it, is that the needles rebalance the flow of energy in the body. Modern medicine takes a different view, working on the idea that the needles can stimulate nerve endings to reduce the feeling of pain. Recent studies suggest that using a newer treatment known as electroacupuncture can increase lower esophageal sphincter pressure, thereby reducing the symptoms of acid reflux.11 If electroacupuncture is not available in your area, then there are still benefits to traditional acupuncture if you can find a clinic that is highly regarded and that follows best practices (including using a fresh set of disposable needles for each patient, to ensure that there is no risk of infection). Talk to your doctor if you are interested in trying acupuncture as a potential complementary therapy.
Melatonin is typically used as a sleep aid, but more and more people are experimenting with it as a treatment for acid reflux because it can reduce pain, and also reduce the pH of your stomach. Studies show that taking melatonin alongside the common GERD medication omeprazole can help to reduce the side effects of the medication, and can also reduce the duration of attacks.12
Hypnotherapy is often used to manage anxiety, but it can be useful for other conditions as well. At the moment, studies into hypnotherapy and gastric health are limited, but there is some evidence to show that it can help people to get over their fear of pain and that in people who suffer from increased sensitivity to a normal level of esophageal stimulation (something that is common in GERD sufferers), the relaxation help can be beneficial.13 Hypnotherapy is something that a lot of people are cynical about, and it is true that someone who is resistant to the idea of hypnosis may not respond to it at all. However, since it is a non-invasive treatment, and one that does not tend to have side-effects, it is worth trying if other treatments have failed.
Essential Oils and Acid Reflux
Herbal remedies, including treatments with essential oils and aromatherapy, are something that a lot of people have found to help ease their pain. There is evidence to show that ginger and chamomile can be useful for reducing gastric distress.14, 15 The calming properties of ginger and chamomile can help people manage their acid reflux, and the pain and discomfort that comes with it.16
One popular home remedy that people use to manage attacks of acid reflux is to use baking soda as a makeshift antacid. Adults and teenagers can neutralize the stomach acid by taking 1/2 a teaspoon of baking soda in a 4oz glass of water. It is not recommended to try this treatment to help children with acid reflux without first discussing doses with a doctor.
Lifestyle Changes to Prevent Acid Reflux
While there are many home remedies that can help people to cope with acid reflux, most doctors would recommend finding ways to avoid attacks in the first place rather than looking to neutralize stomach acid or use drugs to improve the function of the lower esophageal sphincter.
There are several things that a person can do to proactively stop acid reflux from being a further issue.
Studies show that smokers have poorer lower esophageal sphincter function than non-smokers and the link between smoking and GERD has been known since the 1970s.17,18 Stopping smoking is not just a way to reduce your risk of acid reflux attacks, it will also cut your risk of numerous other potentially life-threatening conditions.
Maintain a Healthy Weight
Being overweight or obese can put extra pressure on your stomach, and this can increase your risk of suffering from GERD. There is a wealth of evidence relating to the link between the conditions, and associated conditions such as esophageal adenocarcinoma.19, 20 Those who are overweight or obese may benefit from losing as little as 5% of their body weight. As an added bonus, many people find that when they revisit their eating habits as a part of their weight loss efforts, they learn about food triggers and find that their acid reflux is reduced simply by changing what they eat.
Change What You Wear
Aso obvious as it might sound, wearing tight-fitting clothing can put pressure on your stomach, just like carrying extra weight can. If you know that you suffer from acid reflux, then try wearing loose-fitting clothing that does not compress your waistband.
Sleep With Your Head Elevated
Another thing that can help you to avoid getting woken up by attacks of acid reflux is elevating your head when sleeping. If you can raise the head of your bed by just 6 to 9 inches with some wooden blocks, then that will be enough to keep your head raised and to encourage the contents of your stomach to flow downwards.
Avoid Eating Before Bed
Another way to reduce GERD is to avoid eating before bed. Give yourself some time to sit and digest your meals before you attempt to go to sleep.
Avoid Eating Before Exercise
Eating before performing vigorous exercise is a sure-fire way of ending up with heartburn for many people, even those who are otherwise generally healthy. Try to eat about an hour (or even longer) before exercise. If you do want to snack before exercise, keep it to something light and simple such as a banana, rather than a rich meal.
Keep a Food Diary
Most people can eliminate GERD without having to eliminate specific foods, although there are some foods such as chocolate and carbonated drinks that do aggravate the condition in some people. Keep a food diary to help yourself identify is that there are triggers in your case.
Common triggers include spicy foods, citrus, vinegar, tomato sauces, and fried or fatty foods. The good news is that there are plenty of other foods that are rarely triggered for GERD, including lean meat, fish, whole grains, non-citrus fruits, legumes, and vegetables. Roasting foods produces a nice flavor without making the food as overly fatty, and fresh herbs are less concentrated than powdered spices, so can add flavor without being as potentially irritating to the stomach.21
Consider Surgical Treatments
In extreme cases, doctors may recommend surgery to treat chronic GERD. Surgery is a serious matter and it is not something that would be done for the occasional bout of heartburn. However, if lifestyle changes have not had an impact on the condition and the patient is not responding to traditional medications then surgery could be an option. The most commonly performed procedure for acid reflux is called Fundoplication, and it takes that name from the name of the surgeon who pioneered the procedure in the 1950s.22 The surgery involves winding the top part of the stomach around so that it constricts the end of the esophagus, effectively reinforcing the lower esophageal sphincter, to turn it into a one-way valve. This stops the acid escaping. If the patient has a hiatal hernia, then the surgeon will fix that at the same time as performing the rest of the surgery. Usually, the surgery is done using just one long incision at the upper part of the abdomen, but it is sometimes done with several smaller incisions.
If several smaller incisions are used, then this is known as laparoscopic surgery. This surgery tends to heal faster and offers a better cosmetic result (less scarring). People can return to work more quickly after it and will spend less time in a hospital. Not everyone with GERD is a good candidate for this kind of surgery, and it is something that should be done only as a last resort. There are risks with any form of surgery, including the risk associated with the anesthetic, and the potential for infection of the surgical site. Usually, a doctor would ask that a smoker quit smoking before they go for such surgery and that someone who is overweight loses some weight first of all as well. These things both reduce the risk of the surgery and could potentially help to resolve the acid reflux issue, negating the need for the procedure.
Do Not Ignore GERD
Acid reflux is a condition that is incredibly common. So common that there are advertisements on TV talking about over the counter medications that will treat it. Because the condition is so widespread and ‘socially accepted,’ people tend to not take it seriously, but it is a very serious condition.
In the UK, there were 9,211 cases of esophageal cancer in 2015. It accounted for three percent of the total cancer cases in the country that year. In 2016, there were more than 8,000 deaths from esophageal cancer, and it accounted for five percent of total cancer deaths.23 It is considered a silent killer, and while not all cases of esophageal cancer are related to Barrett’s esophagus, many cases are, and those cases could be prevented if the damage to the esophagus was not allowed to happen.
GERD is a common problem in America, too. Thirty to forty million people in the USA suffer from it.24 It is a condition that is often overlooked, but it can be incredibly serious. It can cause problems with sleep and make it difficult to enjoy food, and it can even damage your throat so much that it is hard to swallow food. If you are suffering from GERD that is persistent and serious, do not try to manage it yourself with antacids. You should consider professional help.
To manage pain that comes from acid reflux, there are a wide variety of remedies available. MONQ’s Relieve Blend can be coupled with an option to aid in a better, pain-free life that doesn’t let acid reflux always be in mind.
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