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Acid Reflux Tips

Gastroesophageal Reflux Disease - How Best Can You Manage It?

Dr. Sachin Wani 89% (43 ratings)
MBBS, MS - General Surgery, DNB - Gastroenterology
Gastroenterologist, Thane
Gastroesophageal Reflux Disease - How Best Can You Manage It?

GERD or gastroesophageal reflux disease is a chronic digestive disease which occurs when the stomach acid and at times the contents in your stomach flows backwards into the food pipe. The backwash or reflux irritates the esophagus's lining and hence causes GERD. Individuals may manage GERD's discomfort by changing their lifestyle and by taking over-the-counter or OTC medications. But, certain people might also require stronger medications or surgery for reducing the symptoms.

Some of the basic signs include chest pain, burning sensation in the chest, dry cough, difficulty in swallowing, sore throat, etc. If you experience such symptoms at least twice a week or if your physician notices damage in your food pipe, then you might undergo diagnosis. Though drugs are the primary GERD treatment yet, an individual can manage it by following certain tips which may give relief.

Few ways to manage GERD- self-care tips:

  1. One of the effective ways to help yourself is by consuming smaller meals. Instead of taking three big meals regularly, you may try having smaller meals frequently and avoid stuffing.
  2. Almost all individuals tend to have dinner just half an hour before sleep, but this might affect GERD patients. It is best to eat 2 hours before going to bed as by doing so your stomach will get enough time to digest the food.
  3. Due to a hectic schedule and fast paced lifestyle, people tend to eat as quickly as possible. To manage GERD, one must eat slowly and put down the spoon or fork in between each bite.
  4. Changing the daily diet by striking off the trigger foods is beneficial in managing GERD symptoms. Though the food triggers vary from one person to another yet, it includes coffee, chocolate, peppermint, alcohol, tomato, citrus juices, onions, spicy and high- fat foods, etc.
  5. Sleeping with the head end of the bed elevated by 6 inches is a very effective way of reducing night time reflux. It is also advisable to sleep on your left side . Never sleep on the right side as this position promotes reflux. Medications to reduce acid production are the mainstay of the medical treatment.
  6. One always has to ensure that they are following the various lifestyle changes along with the medication. Other medications include pro kinetic medicines which help the stomach empty. Surgery always remains the last resort in the treatment of GERD. Endoscopy is required for the diagnosis or GERD Prior to any surgery a Manometry and 24 hr ph merry test is compulsory.

If you are suffering from GERD symptoms frequently, then you may maintain a diary for figuring out which foods are giving you trouble.

When is a surgery required?
If lifestyle changing tips and other medications fail to provide any relief, then physicians recommend undergoing surgery.

  • Surgery is done for strengthening lower esophageal sphincter and also for reinforcing it. The surgery for reinforcing lower esophageal sphincter is performed by surgeons laparoscopically. The surgeon inserts instruments like a tiny camera and flexible tube by making 3-4 incisions in the abdomen. This surgery for managing GERD may be quite effective.
  • Experts state that candidates who undergo GERD surgery are those who are unwilling to take GERD drugs or are not getting relief from them. While choosing a surgeon, it is better to consider one who possesses huge experience of the particular operation which you need and also with a good track record.
  • So, you must visit a doctor if you experience frequent gastroesophageal reflux disease symptoms. It won't be a good decision to take OTC medications without your doctor's recommendation if you notice arm or jaw pain along with difficulty in breathing as these are signs of heart attack.
2124 people found this helpful

GERD - Gastroesophageal Reflux Disease!

Dr. Radhika A (Md) 92% (13 ratings)
MD - Acupuncture, Diploma In Accupuncture, Advanced Diploma In Accupuncture
Acupuncturist, Delhi
GERD - Gastroesophageal Reflux Disease!

GERD
In medical terms, Gastroesophageal Reflux Disease, commonly termed as GERD, is a prolonged recurrence of gastroesophageal reflux. It is a disorder in which the acid available in the stomach moves to the esophagus and retains there for a longer duration. Esophagus is a ring of muscle and is the part of the tube that connects the throat with the stomach. Gastroesophageal means something related to the esophagus and the stomach.

Reflux refers to flowing back or returning of some liquid or fluid from its expected place or position. So, GERD is defined as a condition in which the liquid (acid) flows back from the stomach to the esophagus and causes adverse effects. When the acid from the stomach reaches the esophagus, it may damage the vital tissues.

Most of us suffer from acidity often. In case an individual suffers from acidity for more than twice a week for a prolonged period, the condition may be associated with GERD. Normally, a valve, known as Lower Esophageal Sphincter (LES), is placed between stomach and esophagus, which relaxes only to swallow food, water and saliva.

This LES valve prevents the stomach juices and flowing back of acid to the esophagus and the throat, especially when we lay down on the bed. When this valve stops functioning as expected and relaxes unnecessarily, the acid from the stomach may reach the esophagus. GERD is a common disease. It is believed that almost every individual experience GERD at least once in the lifetime.

As per the reports from American College of Gastroenterology, more than 15 million individuals from America experience suffer from heartburn almost every day. This count is around 20% of the America’s population. Note that the individuals of any age group may suffer from GERD. Although GERD is mainly a digestive disorder, but it is identified that individuals suffering from Asthma are more prone to suffer from it.

The reason being, since Asthma causes the LES to relax more frequently. This might allow the stomach to reflux the digestive juices along with the acid to the esophagus. Additionally, some of the asthma medicines, like theophylline, may raise the tendency of LES reflux, which could trigger GERD.

Symptoms of GERD
The various symptoms of GERD include:

- Burning sensation in the chest and throat

-  Excessive burping

- Stomach bloating

- Observing the acid taste in the mouth while burping

- Eaten food reaching to the mouth while burping

- Difficulty in swallowing food

- Constant pain in the chest for few hours after the meals

- Chest pain while swallowing the food or water

- Excessive production of saliva in the mouth

- Constant throat soaring for several days

- Hoarseness of voice

-  Inflammation in the gums

- Cavities of teeth

- Bad breath even after proper brushing of teeth

- Difficulty in breathing

- Lack of appetite

- Vomiting or nausea

- Lump feeling in the throat

- Disturbed sleep with uneasiness in the throat

- Wheezing sound while breathing

Causes of GERD
Normally, GERD is a common problem, which may occur due to numerous reasons. However, at times it occurs due to unknown reasons. The primary probable causes of this disease are mentioned below:

- Overeating

- Lying on the bed immediately after eating

- Eating too spicy food

- Weakening of esophagus due to poor muscle control or weakness in the body

- Due to certain medication comprising antihistamine, calcium channel blocker, sedative, antidepressant, and those for the treatment of asthma

- Being overweight, which induces more pressure on the stomach and abdomen causing LES to open unexpectedly

- Pregnancy also causes more pressure on the stomach and opens LES inappropriately

- Direct and passive smoking

- Overconsumption of alcohol

- Hiatal hernia, in which the diaphragm builds pressure on the stomach

Prevention of GERD
Although you may observe GERD due to multiple reasons, there are several measures that you may take to prevent it to some extent. Some of those are discussed below:

- The patients of Asthma or those who would have suffered from GERD must quit smoking.

- Elevate or raise the head side of your bed to around 6 inches than the feet side.

-  Maintain a healthy weight. Take measures to lose weight in case it is beyond the prescribed body-mass index. The excessive fat on your belly would increase the pressure on your stomach. This would forcibly open the LES on often basis, which will then allow the acid to reach at the esophagus.

- Limit the consumption of alcohol.

- Avoid heavy meals, especially in the evening. Do not go to the bed for at least three to four hours from your dinner or any other meal.

- Limit the consumption of caffeine-based products like coffee.

- Avoid consuming the theophylline drug, if possible.

- Exercise every day. However, do not work out immediately after your meals.

- Avoid eating over-spicy and junk foods.

- Consult a good dietician and eat accordingly during the pregnancy.

- Do not wear very tight clothes near to the belly. This may again increase the pressure on your stomach and open the LES, which may then allow the acid to reach at the esophagus.

- In case you are already suffering from GERD, avoid chocolates, peppermint, and tomato.

How is it diagnosed?
GERD is a common disorder that individuals often tend to ignore. Many of them assume it as a digestion disorder. The maximum that they do is to take an over the counter antacid tablet or syrup, which would ease the symptoms for a shorter duration. However, if those recur frequently or if the symptoms persist for several days, you visit your doctor.

The physician would assess the symptoms and may recommend the patient to visit the gastroenterologist for specialized treatment and investigations. One or more of the following investigations may be prescribed for the patient to confirm the occurrence of GERD:

- Esophageal pH and Impedance Monitoring: This test identifies the quantity of the acid content available in the esophagus in different states of the patient’s body, like before and after eating or sleeping.

- Upper Gastrointestinal or GI Endoscope: In this test, a camera attached with a tube is passed through the food pipe of the body. This camera captures pictures within the food pipe and the esophagus. The same process may also be used to extract a smaller piece of tissue, which would be sent to the laboratory for investigations.

- Upper Gastrointestinal or GI Series: In this test, X-ray captures pictures near to the esophagus that identify the causes of GERD.

- Esophageal Manometry: This test is based on measuring the contraction of muscles in the esophagus while swallowing food or water. It identifies the strength of the LES. In case it is found to be weaker, the individual is more likely to suffer from GERD.

- Bravo Wireless Esophageal pH Monitoring: This test involves attaching a small capsule to the esophagus for near to two days or 48 hours. This capsule measures the acidity level at the esophagus caused by the acid reflux from the stomach. In case the acidity near to the esophagus is higher continually for around two days, the individual is suffering from GERD.

Treatment of GERD
If GERD is confirmed by the doctors once after assessing the reports of the prescribed investigations, they would treat the patient based on the severity of symptoms. In normal cases, those are treated through certain course of medication. Many of these medicines focus on reducing the acid content in the stomach of the patient, which may relieve the patients from the symptoms of GERD.

Some of the common medicines used for the treatment of GERD are mentioned below:

- Proton Pump Inhibitor: These drugs are formulized to reduce the acid content in the stomach. The least acid is available in the stomach, lesser will be the chances to get it refluxed to the esophagus, which may cause GERD.

- H2 Blocker: This is another class of drugs, which would reduce the production of acid in the stomach.

- Antacid: Antacids are very common and over the counter medicines, which act by reversing the impact of acid in the stomach through multiple alkaline ingredients. Those are quite useful in the acidity and heartburn. However, those may cause multiple side effects such as constipation and diarrhea.

- Prokinetic: This medicine stimulates the digestion process of the body, which would empty the stomach faster than normal. Once the stomach is empty, the acid could not reflux to the upper side and reach the esophagus, which would avoid GERD. Since these medicines enhances digestion in the patient’s body, the individual may suffer from diarrhea. Those also cause other side effects such as anxiety and nausea.

- Erythromycin: These are the antibiotics, which treat the bacterial infection causing indigestion. Once the infection is treated, the acid formation in the stomach of the patient will be normalized, and GERD may be avoided.

In some severe cases, the patient would not be relived from the symptoms of GERD by changing the lifestyle and following the course of prescribed medication. In such cases, the gastroenterologist might recommend the patient to undergo a surgical treatment. The surgeries could be of following types:

- Fundoplication: In this process, the surgeon stitches some part of the stomach’s top near to the esophagus. This minimizes the passage between the stomach and esophagus, which reduces the chances of acid reflux. In most of the cases, this process helps in reducing the symptoms caused by GERD.

- Endoscopic Surgery: This process involves endoscopic stitching of the LES, which tightens the muscles involved in closing the valve near to the esophagus. The surgery is carried out using radiofrequencies, which produce heat for creating a burning effect for tightening of the LES muscles.

Complications of GERD
Most of the individuals suffering from heartburn take it very lightly. They often follow some home remedies or consume the over the counter medicines to get relieved from it. However, some patients of prolonged GERD may be at risk of complications. Some of such major complications are discussed below:

- Oesophageal Ulcers: This is the condition in which the acid floating from the stomach to the esophagus damages the lining of the esophagus. This further causes formation of ulcers, which may bleed and cause pain. The patients may even find it very difficult to swallow their chewed food because of the formed ulcers.

- Scarred and Narrowed Esophagus: In case a patient suffers from GERD for a long duration, the continual impairment of the esophagus caused by the refluxed acid may narrow it. This will further make very difficult for the patient to swallow anything. In such a case, a small balloon looking device is used for the widening of esophagus to ease the condition.

- Barrett's Esophagus: In case GERD is repeated frequently and not treated well, the cells in the LES lining are impacted. There is a little risk that the patient’s suffering from this condition or Barrett's Esophagus may suffer from oesophageal cancer due to the impaired cells. Around 10% of the GERD patients attain the Barrett's Esophagus condition. Further, 5 – 10% of the Barrett's Esophagus patients may suffer from the oesophageal cancer.

Myths of GERD
Myth #1:
The only cause of GERD is eating spicy food.

There are lots of reasons causing GERD. Eating spicy food may be one of those.

Myth #2: Heartburn is a normal condition, which would heal either by its own or consuming the antacids.

Heartburn could be a symptom of GERD. If not treated on time, it may cause complications to the patient suffering from it.

Myth #3: Acidity is always caused by indigestion.

Acidity or heartburn could be caused by multiple reasons other than indigestion. It could also be a symptom of GERD, which must be treated by the doctor on time.

Myth #4: GERD may only affect kids and aged people

GERD can impact people of any age.

Myth #5: GERD is more likely to take place in the winters.

The patients may suffer from the symptoms of GERD in any season or month.

Myth #6: Healthy people with a robust immune system could not suffer from GERD.

Healthy immune system is not an important criterion for preventing the development of GERD in the body. However, those individuals whose esophagus muscles are weaker, are more prone to develop this disease.

3 people found this helpful

Acid Reflux - Why Should You Limit Your Food Intake To Control It?

Dr. Rohith P A 92% (56 ratings)
MBBS
General Physician, Chennai
Acid Reflux - Why Should You Limit Your Food Intake To Control It?

Feeling acidic after eating a heavy meal can often make you regret those last few morsels. This acidic sensation is known as acid reflux or Gastroesophageal reflux disease, better known as GERD. GERD occurs when the functioning of the lower oesophagus muscles is restricted. This makes the undigested food in the stomach and stomach acids leak back into the oesophagus.

Thankfully, this is not something you have to live with and a few simple lifestyle changes can help resolve the situation.

 

 

  1. Do not lie down after eating: When your body is in a horizontal position, there are higher chances of food being regurgitated into the oesophagus. To avoid this, finish your meals at least 3 hours before going to bed. Sit upright while eating and do not lie down or slouch immediately after eating. This gives the food time to be digested and move out of the stomach.
  2. Limit your food intake: Overeating is one of the most common triggers of GERD. Cutting down your portion sizes can instantly reduce the number of GERD occurrences. Instead of eating large, heavy meals, shorten the duration between meals and have more frequent small meals.
  3. Avoid foods that trigger acidityWith time, you will soon realise which types of foods trigger an acidic reaction. Some common triggers are onions, peppermint, caffeine, citrus fruits etc. Keeping a diary can help identify such foods and ease your problem.
  4. Quit smokingNicotine not only harms your lungs, but can affect your digestive system as well. It is responsible for weakening the muscles that control the opening between the stomach and oesophagus. This allows stomach acids and food from the stomach to re-enter the oesophagus. Alcohol can also worsen GERD symptoms and hence it is better to avoid alcohol is you suffer from frequent bouts of acid reflux.
  5. Lose weight: Overeating, obesity and acid reflux go hand in hand. Being overweight can put extra pressure on your stomach and abdomen, thus pushing food and gastric juices into the oesophagus. Losing this extra weight should effectively resolve your acid reflux problem if you are overweight.
  6. Look at your medications: Some types of medication too can cause acid reflux by interfering with the digestive system and irritating the oesophagus. These types of medication include blood pressure medication, asthma medication, Non-steroidal anti-inflammatory drugs, bisphosphonates, sedatives and painkillers. Do not simply stop taking these medications, but talk to your doctor about replacing them with something else.
5080 people found this helpful

Gastroesophageal Reflux Disease - How Can It Be Managed?

Dr. Srishail Chiniwalar 89% (90 ratings)
DNB ( Surgical Gastroenterology), Membership of The Royal College of Surgeons (MRCS), MBBS, MS - General Surgery
Gastroenterologist, Hubli-Dharwad
Gastroesophageal Reflux Disease - How Can It Be Managed?

GERD or gastroesophageal reflux disease is a chronic digestive disease which occurs when the stomach acid and at times the contents in your stomach flows backwards into the food pipe. The backwash or reflux irritates the esophagus's lining and hence causes GERD. Individuals may manage GERD's discomfort by changing their lifestyle and by taking over-the-counter or OTC medications. But, certain people might also require stronger medications or surgery for reducing the symptoms.

Some of the basic signs include chest pain, burning sensation in the chest, dry cough, difficulty in swallowing, sore throat, etc. If you experience such symptoms at least twice a week or if your physician notices damage in your food pipe, then you might undergo diagnosis. Though drugs are the primary GERD treatment yet, an individual can manage it by following certain tips which may give relief.

Few ways to manage GERD- self-care tips:

  1. One of the effective ways to help yourself is by consuming smaller meals. Instead of taking three big meals regularly, you may try having smaller meals frequently and avoid stuffing.
  2. Almost all individuals tend to have dinner just half an hour before sleep, but this might affect GERD patients. It is best to eat 2 hours before going to bed as by doing so your stomach will get enough time to digest the food.
  3. Due to a hectic schedule and fast paced lifestyle, people tend to eat as quickly as possible. To manage GERD, one must eat slowly and put down the spoon or fork in between each bite.
  4. Changing the daily diet by striking off the trigger foods is beneficial in managing GERD symptoms. Though the food triggers vary from one person to another yet, it includes coffee, chocolate, peppermint, alcohol, tomato, citrus juices, onions, spicy and high- fat foods, etc.
  5. Sleeping with the head end of the bed elevated by 6 inches is a very effective way of reducing night time reflux. It is also advisable to sleep on your left side . Never sleep on the right side as this position promotes reflux. Medications to reduce acid production are the mainstay of the medical treatment.
  6. One always has to ensure that they are following the various lifestyle changes along with the medication. Other medications include pro kinetic medicines which help the stomach empty. Surgery always remains the last resort in the treatment of GERD. Endoscopy is required for the diagnosis or GERD Prior to any surgery a Manometry and 24 hr ph merry test is compulsory.

If you are suffering from GERD symptoms frequently, then you may maintain a diary for figuring out which foods are giving you trouble.

When is a surgery required?
If lifestyle changing tips and other medications fail to provide any relief, then physicians recommend undergoing surgery.

  • Surgery is done for strengthening lower esophageal sphincter and also for reinforcing it. The surgery for reinforcing lower esophageal sphincter is performed by surgeons laparoscopically. The surgeon inserts instruments like a tiny camera and flexible tube by making 3-4 incisions in the abdomen. This surgery for managing GERD may be quite effective.
  • Experts state that candidates who undergo GERD surgery are those who are unwilling to take GERD drugs or are not getting relief from them. While choosing a surgeon, it is better to consider one who possesses huge experience of the particular operation which you need and also with a good track record.
  • So, you must visit a doctor if you experience frequent gastroesophageal reflux disease symptoms. It won't be a good decision to take OTC medications without your doctor's recommendation if you notice arm or jaw pain along with difficulty in breathing as these are signs of heart attack.

In case you have a concern or query you can always consult an expert & get answers to your questions!

1984 people found this helpful

Amazing Benefits That You Must Know About Cranberries!

Dt. Sangeetha Natarajan 87% (13 ratings)
Mphil Nutrition & Dietetics, MBA Human Resource Management
Dietitian/Nutritionist, Chennai
Amazing Benefits That You Must Know About Cranberries!

Cranberries are the most useful fruits for you, if you suffer from repeated UTIs, stomach ulcers and GI distress, have a problem with your heart or liver, have been diagnosed with cancer, have gum disease or bad skin. The list can go on and on to prove cranberries are indeed nature’s wonder fruits.

A cup of cranberries contains the following:

  • Calories - 46
  • Manganese - 18 %
  • Vitamin C - 18 %
  • Vitamin E
  • Fibre
  • Copper
  • Vitamin K
  • Glycemic index – Low

Cranberries have thousands of benefits for our health. 

What makes cranberries so awesome?

  1. Fight UTI: Cranberries are strongly acidic and they contain a chemical compound that gives them their bacteria fighting punch. This compound is called proanthocyanidins (PACs). It helps prevent UTIs as the special structure of PACs acts as a barrier to bacteria, which latch on the walls of your urinary bladder, causing UTIs.
  2. Prevent stomach cancer: The PAC prevents bacteria, which cause stomach cancer called Helicobacter pylori to latch on to the walls of your stomach and large intestine.
  3. Protect your heart: Cranberries contain Anthocyanin. This phytonutrient gives cranberries their amazing red colour and is linked to their unique antioxidant and anti-inflammatory properties, which protect your cardiovascular system and liver. To reap the complete benefits of all five cranberry phytonutrients, it’s best to consume the whole berry rather than have it in the form of an extract or juice.
  4. Contain anti-cancer properties: Cranberries possess solid cancer-preventive benefits. They can prevent cancers of the breast, colon, lung, and prostate. None of the cancer-related benefits of cranberries should be surprising, since cranberry is loaded with antioxidant and anti-inflammatory phytonutrients like anthocyanins which provide antioxidant, anti-inflammatory, and anti-cancer properties. Antioxidants are essential for improving health by helping combat the free radicals that can damage cellular structures as well as DNA, thereby preventing cancers.
  5. Oral health: Apart from boosting immunity, making our skin lush and youthful, cranberries can also prevent periodontal disease.
  6. Good for diabetic patients: Since, cranberries are a low GI fruit, diabetics can have them too and benefit from their health benefits.
  7. Good for your heart: The fruit has also been proven to lower LDL and raise HDL or good cholesterol, as well as help in recovery from stroke.
  8. Promote weight loss: The fruit is loaded with fibre, which keeps you full for a longer time and aids in weight loss. Because of high antioxidant and anti-inflammatory content, cranberries help improve memory.

This food is no less than a superfood, sent straight from heaven for our well-being.

2194 people found this helpful

Lymphoma - Can Age Increase Your Risk?

Dr. Varun Goel 84% (10 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Medicine, DNB - Medical Oncology, MRCP - Medical Oncology, ECMO - Medical Oncology
Oncologist, Delhi
Lymphoma - Can Age Increase Your Risk?

Non Hodgkin Lymphoma is when the cells in your lymphatic system become cancerous. The lymphatic system is responsible for fighting off diseases which may attack your body. Initially, tumors develop from the lymphocytes in your body. Non-Hodgkin lymphoma is much more common than the other type of lymphoma which is Hodgkin lymphoma. There are various types of Non-Hodgkin lymphoma; the most common of which are diffuse large B-cell lymphoma and follicular lymphoma. Here is everything you need to know about Non-Hodgkin lymphoma.

Symptoms
1. Swollen lymph nodes
A swollen lymph node in the neck, underarm and armpit which comes about without any pain is a very common symptom of non-Hodgkin lymphoma.
2. Fever
When you have a sudden unexplained fever, it may be due to Non-Hodgkin lymphoma.
3. Night sweats
Night sweats are simply when you sweat excessively in the night.
4. Fatigue
Feeling extremely tired can be due to Non-Hodgkin lymphoma.
5. Weight loss
A sudden unexplained loss of weight is a very common symptom of non-Hodgkin lymphoma.

6. Itchiness
An itchy skin is a rather serious indicator of Non-Hodgkin lymphoma.

Causes
Just like other forms of cancer, it is not known what causes Non-Hodgkin lymphoma but there are factors which put you more at risk compared to others.

Risk factors
1. Immunosuppressive drugs
You are more likely to develop Non-Hodgkin lymphoma especially after taking immunosuppressive drugs after a major organ transplant.
2. Bacteria and viruses
Certain bacterial and viral infections cause Non-Hodgkin lymphoma including the HIV and Epstein-Barr virus as well as the Helicobacter pylori bacteria.
3. Pesticides
Research suggests that overexposure to the pesticides which kill weeds increases your likelihood of developing Non-Hodgkin lymphoma.
4. Age
Elder people are also more likely to suffer from Non-Hodgkin lymphoma.

Treatment
1. Chemotherapy
Chemotherapy comprises of administering drugs to kill the cancerous cells, either through injection or orally which kill cancer.
2. Radiation therapy
Radiation therapy deals with radiation which is directed at the parts of your body affected by cancer.
3. Medications to enhance the immune system
There are many medications which fight off cancer by boosting the immune system.

4 people found this helpful

Acid Reflux And Oesophagitis Heartburn

Dr. Vijan Sharan 92% (20 ratings)
MBBS, Doctor of Medicine, Member of the Royal College of Physicians, UK (MRCP UK)
General Physician, Patna
Acid Reflux And Oesophagitis Heartburn

Acid Reflux and Oesophagitis Heartburn

Acid Reflux and heartburn are a very common problem faced by many of us. And so I decided to discuss in a very simplified way.

Let us understand the oesophagus and stomach first

When we eat, food passes down the gullet (oesophagus) into the stomach. Cells in the lining of the stomach make acid and other chemicals which help to digest food. Stomach cells also make mucus which protects them from damage from the acid. The cells lining the oesophagus are different and have little protection from acid.
There is a circular band of muscle (a sphincter) at the junction between the oesophagus and stomach. This relaxes to allow food down but then normally tightens up and stops food and acid leaking up (refluxing) into the oesophagus. In effect, the sphincter acts like a valve.

What are Acid reflux and oesophagitis?

Acid reflux means that some acid leaks up (refluxes) into the gullet (oesophagus).

Oesophagitis means inflammation of the lining of the oesophagus. Most cases of oesophagitis are due to reflux of stomach acid which irritates the inside lining of the oesophagus.

The lining of the oesophagus can cope with a certain amount of acid. However, it is more sensitive to acid in some people. Therefore, some people develop symptoms with only a small amount of reflux. However, some people have a lot of reflux without developing oesophagitis or symptoms.

What is Gastro-oesophageal reflux disease (GORD)

This is a general term which describes the range of situations - acid reflux, with or without oesophagitis and symptoms.

What are the symptoms of acid reflux and oesophagitis?

Heartburn: this is the main symptom. This is a burning feeling which rises from the upper tummy (abdomen) or lower chest up towards the neck. (It is confusing, as it has nothing to do with the heart!)
Other common symptoms: these include pain in the upper abdomen and chest, feeling sick, an acid taste in the mouth, bloating, belching, indigestion and a burning pain when we swallow hot drinks. Like heartburn, these symptoms tend to come and go and tend to be worse after a meal.
Some other uncommon symptoms: these may occur and if they do, can make the diagnosis difficult, as these symptoms can mimic other conditions. For example A persistent cough, particularly at night, sometimes occurs. This is due to the refluxed acid irritating the windpipe (trachea). Asthma symptoms of cough and wheeze can sometimes be due to acid leaking up (reflux).
Other mouth and throat symptoms sometimes occur, such as gum problems, bad breath, sore throat, hoarseness and a feeling of a lump in the throat.
Severe chest pain develops in some cases (and may be mistaken for a heart attack).

What causes acid reflux and whom does it affect?

The circular band of muscle (sphincter) at the bottom of the gullet (oesophagus) normally prevents acid leaking up (refux). Problems occur if the sphincter does not work very well. This is common but in most cases it is not known why it does not work so well. In some cases, the pressure in the stomach rises higher than the sphincter can withstand - for example, during pregnancy, after a large meal, or when bending forward.

What are the causes of  Heartburn and what are the  Treatment options
Most people have heartburn at some time, perhaps after a large meal. However, about 1 adult in 3 has some heartburn every few days, and nearly 1 adult in 10 has heartburn at least once a day. In many cases it is mild and soon passes. However, it is quite common for symptoms to be frequent or severe enough to affect the quality of life. Regular heartburn is more common in smokers, pregnant women, heavy drinkers, those who are overweight and those aged between 35 and 64 years.

What tests can be done to arrive at the diagnosis?

Tests are not usually necessary if you have typical symptoms. Many people experiencing acid leaking up (refluxing) into the gullet (oesophagus) are diagnosed with 'presumed acid reflux'. In this situation, they have typical symptoms and the symptoms are eased by treatment. Tests may be advised if symptoms are severe, or do not improve with treatment, or are not typical of GORD.
Gastroscopy (endoscopy) is the common test. A thin, flexible telescope is passed down the oesophagus into the stomach. This allows a doctor to look inside. With inflammation of the lining of the oesophagus (oesophagitis), the lower part of the oesophagus looks red and inflamed. However, if it looks normal it does not rule out acid reflux. Some people are very sensitive to small amounts of acid and can have symptoms with little or no inflammation to see. Two terms that are often used after an endoscopy are:

Oesophagitis. This term is used when the oesophagus can be seen to be inflamed.

Endoscopy-negative reflux disease. This term is used when someone has typical symptoms of reflux but endoscopy is normal.A test to check the acidity inside the oesophagus may be done if the diagnosis is not clear. Other tests such as heart tracings, chest X-ray, etc, may be done to rule out other conditions if the symptoms are not typical.

What can be done to relieve with symptoms?

The following are commonly advised. However, there has been little research to prove how well these lifestyle changes help to ease reflux:

Smoking. The chemicals from cigarettes relax the circular band of muscle (sphincter) at the bottom of the gullet (oesophagus) and make acid leaking up (refluxing) more likely. Symptoms may ease if you are a smoker and stop smoking.Some foods and drinks may make reflux worse in some people. It is thought that some foods may relax the sphincter and allow more acid to rfleux. It is difcult to be certain how much foods contribute. Let common sense be your guide. If it seems that a food is causing symptoms then try avoiding it for a while to see if symptoms improve. Foods and drinks that have been suspected of making symptoms worse in some people include peppermint, tomatoes, chocolates, hot drinks, coffee and alcoholic drinks. Also, avoiding large-volume meals may help.

There are some medicines which can make symptoms worse. They may irritate the oesophagus or relax the sphincter muscle and make acid reflux more likely. The most common culprits are anti-inflammatory painkillers (such as ibuprofen or aspirin). Others include diazepam, theophylline, calcium-channel blockers (such as nifedipine) and nitrates. But this is not a complete list. 

Weight. If you are overweight it puts extra pressure on the stomach and encourages acid reflux. Losing some weight may ease the symptoms.

Posture. Lying down or bending forward a lot during the day encourages reflux. Sitting hunched or wearing tight belts may put extra pressure on the stomach, which may make any reflux worse.

Bedtime. If symptoms recur most nights, the following may help: Go to bed with an empty, dry stomach. To do this, don't eat in the last three hours before bedtime and don't drink in the last two hours before bedtime.

If you are able, try raising the head of the bed by 10-20 cm (for example, putting two normal sized pillows under your head. This helps gravity to keep acid from refluxing into the oesophagus. 

What are the treatments for acid reflux and oesophagitis?

Antacids
Antacids are alkaline liquids or tablets that reduce the amount of acid. A dose usually gives quick relief. There are many brands which you can buy. You can also obtain some on prescription. You can use antacids 'as required' for mild or infrequent bouts of heartburn.

Acid-suppressing medicines

If you have symptoms frequently then see a doctor. An acid-suppressing medicine will usually be advised. Two groups of acid-suppressing medicines are available - proton pump inhibitors (PPIs) and histamine receptor blockers (H2 blockers). They work in different ways but both reduce (suppress) the amount of acid that the stomach makes. PPIs include omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole. H2 blockers include cimetidine, famotidine, nizatidine and ranitidine.
In general, a PPI is used first, as these medicines tend to work better than H2 blockers. A common initial plan is to take a full-dose course of a PPI for a month or so. This often settles symptoms down and allows any inflammation in the gullet (oesophagus) to clear. After this, all that you may need is to go back to antacids 'as required' or to take a short course of an acid-suppressing medicine 'as required.
However, some people need long-term daily acid-suppressing treatment. Without medication, their symptoms return quickly. Long-term treatment with an acid-suppressing medicine is thought to be safe and side-effects are uncommon. The aim is to take a full-dose course for a month or so to settle symptoms. After this, it is common to 'step down' the dose to the lowest dose that prevents symptoms. However, the maximum full dose taken each day is needed by some people.

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6 people found this helpful

Pre & Post Workout Meal - Why Is It Important?

Dt. Riyaz Khan 93% (3340 ratings)
Diploma In Diet & Nutrition
Dietitian/Nutritionist, Hyderabad
Pre & Post Workout Meal - Why Is It Important?

Eating the right food at the right time is essential to in order to complete your fitness goal. While there exist many theories on the importance of workout meal, there are some simple rules which when followed can fetch great results. The right amount of nutrition pre and post workout can go a long way in ensuring that the body responds well to the stress.

Why is nutrient timing an important component of the exercise regime?
Consider your body as a machine, it is imperative that a well-maintained machine with the right fuel at the right time will have more longevity compared to others. The same holds true for the body as well. To maximize the output of the gym, it is necessary to consume the right nutrients for the body. A right meal just before the gym session can result in a great workout session. This, in turn, means an inch closer to the fitness goal. Similarly, the post workout meal ensures that muscles are adequately refueled and the blood sugar level is well maintained. Another advantage of the right pre and post workout meal is the fact that it helps the body to work out for a longer duration.

Know the carbohydrate
Instead of blindly choosing an energy drink, it makes sense to choose the right carbohydrate. There are 2 types of carbohydrate- simple and complex. Eventually, all carbohydrates are broken down into simple carbohydrates. Both have their own role to play. As per various studies, it has been proved that the best time to consume complex carbohydrate such as brown rice, oats and brown grains is before a couple of hours of the workout session. It ensures that the body is provided with a gradual supply of energy throughout the session. After a workout session, much of the glycogen gets depleted from the muscles. It is, therefore, essential to consume simple carbohydrate after a gym session. It readily supplies instant energy and carb to the muscles. Some good source of simple carbohydrate includes sugar, candy bar, sweet bread, fruits etc.

The next meal after workout
Post workout, the simple carbohydrate gets absorbed by the body way too fast. It is, therefore, necessary to have a good meal couple of hours after the workout session. Some good to consume food include green veggies, fruit salad etc. It helps in suppressing the appetite and make a person feel full.

What should be the protein count?
While there are many recommendations out there, a good way to determine the protein count is to consume 1.1 gm to 1.2 gm per kilogram of body weight. However, there is no magic number. 25-35 grams of protein needs to be consumed in every meal. Ideally, protein intake should happen a couple of hours before the workout and couple of hours after the workout session.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2330 people found this helpful

Can Autoimmune Disorders Be The Cause Behind Achalasia?

Dr. Arulprakash S 90% (54 ratings)
DNB- Gastroenterology, DM - Gastroenterology, DNB, MD, MBBS
Gastroenterologist, Chennai
Can Autoimmune Disorders Be The Cause Behind Achalasia?

The tube that carries food to your stomach from your throat is called the oesophagus. When the muscular valve (lower oesophagus sphincter) in the oesophagus fails to relax and carry the food to the stomach, the condition is termed as achalasia.

Achalasia has a variety of causes, and can be difficult for your doctor to diagnose the exact cause. Some common causes of achalasia include:

  1. Hereditary predispositions
  2. Autoimmune disorders (The immune system erroneously destroys healthy cells in the body)
  3. Nerve degeneration in the oesophagus

There other medical conditions that often lead to symptoms identical to achalasia, such as oesophageal cancer and Chagas’ disease (an infectious disease caused by a parasite).

Other symptoms of achalasia include:

The most prominent symptom of achalasia is dysphagia, which is characterised by swallowing difficulties or sensations of food stuck in the oesophagus. Dysphagia often triggers coughing and shortness of breath or choking on food.

  1. Discomfort or pain in the chest
  2. Weight loss
  3. Heartburn
  4. Intense discomfort or pain after eating

Some of the treatments include:

Most of the methods to treat achalasia focus on the lower oesophageal sphincter (LES). The treatments used can either permanently alter the sphincter’s function, or reduce symptoms.

  1. Oral medications such as calcium channel blockers or nitrates are prescribed, which can relax the LES to let food pass through with more ease. Your doctor may also treat the LES with Botox.
  2. For a more permanent treatment, the sphincter can be dilated or altered. In dilation, a balloon is inserted into the oesophagus and it is inflated. This will stretch out your oesophagus to improve function.
  3. To alter the oesophagus, oesophagomyotomy is performed. It is a kind of surgery where minimal incisions are made to gain access to the LES, and then it is carefully altered to improve flow of food to the stomach.

Unlike dilation, which can cause complications such as tears in the oesophagus, oesophagomyotomy has a greater success rate. However, certain complications may still arise, such as:

  1. Acid reflux
  2. Respiratory conditions that are caused by food entering your windpipe

In case you have a concern or query you can always consult an expert & get answers to your questions!

2685 people found this helpful

Abdominal Problem: Few Ways to Deal With It

Dr. Rajeev Kumar Bansal 91% (21 ratings)
DNB(Gastroenterology), Gujarat University
Gastroenterologist, Ahmedabad
Abdominal Problem: Few Ways to Deal With It

Undigested food that lurks around in the digestive tract produces a host of disorders due to intestinal distress. These disorders range from acidity to gastro-oesophageal reflux and even colon diseases like cancer, irritable bowel syndrome, constipation, gallstones, ulcers and Crohn's disease. Cramps, nausea, vomiting, loose motions, gas, and acidity are some of the most common symptoms that visit the patient as a result of such ailments. There are many ways of dealing with such intestinal distress, as follows :-

  1. Diet: Introduce plenty of fibre into your diet to aid the digestion process. This can cut the risk of many such ailments and also aid in the treatment of the same. Intestinal distress is largely caused by food that is still lurking around in the digestive tract, so it is important to clean out the digestive system with plenty of fibre and water.
  2. Nutrition for better Digestive System Health: Food that is rich in minerals, vitamins, antioxidants and iron will help in creating a stronger system that cleanses the digestive tract and helps in reducing the production of excess acid in the stomach. A balanced diet with plenty of nutrition aids digestion and makes the immunity stronger.
  3. Study your Triggers: Watch out for foods that can trigger reflux action and other acidity related issues on the intake. These can include fatty food, fried and oily food as well as extremely spicy food. Stress is also a major trigger of intestinal distress, so it would be a good idea to avoid stressful situations or take medical help to deal with them in a better manner.
  4. Medication: Antacids and other medication to prevent the onset and growth of such distress can be sought out after due consultation with a medical practitioner. Medication will help in dealing with and altering the acid level production in the stomach.
  5. Surgery: In very extreme cases like ulcers and large size gallstones, surgery may be helpful so that you avoid rupturing the stomach's lining which can lead to a serious infection or even internal bleeding.

Knowing your triggers and getting into a better routine as far as your diet goes is as important as seeing a doctor about the severity of your case when it comes to intestinal distress.

In case you have a concern or query you can always consult an expert & get answers to your questions!

1714 people found this helpful
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