Acid Reflux – Know details with proven treatment, symptoms, causes

Medically reviewed by Dr Itender Pal Singh

Acid reflux occurs when stomach acid flows back into the esophagus, leading to a burning sensation commonly known as heartburn. While occasional acid reflux is common, frequent episodes may indicate a more severe condition called gastroesophageal reflux disease (GERD). GERD affects about 20% of the U.S. population and about 16% of Indian population and can lead to complications if untreated. Understanding the causes, symptoms, and treatment options is crucial for managing this condition effectively.

What is Acid Reflux ?

Acid reflux, also known as gastroesophageal reflux (GER), occurs when the lower esophageal sphincter (LES), a muscular valve at the bottom of the esophagus, fails to close properly. This allows stomach acid or food to travel back up into the esophagus, leading to symptoms such as:

• Heartburn: A burning sensation in the chest or throat.
• Regurgitation: A sour or bitter taste in the mouth as stomach contents flow back up.
• Burping and nausea
• Bloating and discomfort

Types of Acid Reflux

Acid reflux can be broadly categorized into two types:

1. Gastroesophageal Reflux (GER)

GER is the most common form, often triggered by consuming certain foods or lying down soon after eating. Symptoms include heartburn, regurgitation, and burping.

2. Gastroesophageal Reflux Disease (GERD)

GERD is a chronic condition where symptoms persist and can lead to damage to the esophagus. It may include more severe symptoms like difficulty swallowing, chest pain, and chronic cough.

Causes of Acid Reflux

Acid reflux happens when the LES becomes weak or relaxes inappropriately, allowing stomach contents to rise into the esophagus. Several factors can contribute to this condition, including:

• Obesity: Excess weight increases abdominal pressure, pushing acid into the esophagus.
• Hiatal Hernia: This condition allows part of the stomach to push through the diaphragm, weakening the LES.
• Pregnancy: Hormonal changes and increased abdominal pressure can trigger acid reflux.
• Certain Medications: Some drugs, like beta-blockers, sedatives, and antidepressants, can relax the LES.

Risk Factors for Acid Reflux

Various lifestyle and health factors can increase the likelihood of developing acid reflux:

• Smoking: Both active and passive smoking weaken the LES.
• Dietary Habits: Consuming large meals, lying down soon after eating, or eating spicy, fatty, or acidic foods can trigger acid reflux.
• Low Physical Activity: Lack of exercise can contribute to obesity, a significant risk factor.
• Stress: High stress levels can exacerbate acid reflux symptoms.

Symptoms of Acid Reflux

The symptoms of acid reflux vary from person to person and may include:

• Heartburn: A burning sensation in the chest, often after eating.
• Regurgitation: A sour or bitter taste in the mouth.
• Nausea and burping
• Abdominal bloating
• Dry cough or sore throat
• Difficulty swallowing

Diagnosis of Acid Reflux

Diagnosis is often based on symptoms, but additional tests may be needed for persistent or severe cases:

• Endoscopy: A camera-tipped tube examines the esophagus and stomach.
• Esophageal pH Monitoring: Measures acid levels in the esophagus over time.
• Barium Swallow (Esophagogram): X-rays track the movement of barium through the digestive tract.
• Esophageal Manometry: Assesses the strength and coordination of esophageal muscles.

Treatment Options for Acid Reflux

Treatment typically involves lifestyle changes and medications. For occasional acid reflux, over-the-counter medications and lifestyle modifications may be sufficient. More frequent or severe cases may require prescription medications or, in extreme cases, surgery.

1. Lifestyle Changes

Adopting healthy habits can significantly reduce acid reflux symptoms:

• Avoid Trigger Foods: Stay away from spicy, fatty, and acidic foods.
• Eat Smaller Meals: Opt for smaller, frequent meals instead of large ones.
• Elevate the Bed: Raise the head of your bed to prevent nighttime reflux.
• Maintain a Healthy Weight: Reducing excess weight can alleviate pressure on the stomach.
• Quit Smoking: Smoking cessation helps strengthen the LES.

2. Medications

Various medications can help manage acid reflux:

• Antacids: Neutralize stomach acid, offering quick relief. Common brands include Gelusil, Diovol, Digene etc.
• H2-Receptor Blockers: Reduce acid production for longer-lasting relief. Examples include Aciloc (Ranitidine) , Famtac (Famotidine) etc.
• Proton Pump Inhibitors (PPIs): Block acid production more effectively. Examples include Pantop (Pantoprazole) , Rzole (Rabeprazole) etc

If medications do not control symptoms adequately, a healthcare provider may recommend stronger options or surgery, such as fundoplication, to reinforce the LES.

Preventing Acid Reflux

Preventive strategies can reduce the frequency and severity of acid reflux episodes:

• Maintain a Healthy Weight: Reducing abdominal pressure can prevent acid reflux.
• Avoid Trigger Foods: Spicy, fatty, or acidic foods should be limited.
• Wait Before Lying Down: Allow 2-3 hours after eating before lying down.
• Elevate the Bed: Raise the head of your bed by 6-8 inches.
• Quit Smoking and Limit Alcohol: Both smoking and excessive alcohol consumption can weaken the LES.

Complications of Untreated Acid Reflux

If left untreated, acid reflux can lead to severe complications, such as:

• Esophagitis: Inflammation of the esophagus, causing irritation and potential bleeding.
• Esophageal Strictures: Narrowing of the esophagus due to scar tissue, leading to swallowing difficulties.
• Barrett’s Esophagus: A condition where the esophagus lining changes, increasing the risk of esophageal cancer.

Acid reflux is a common condition that can range from mild to severe. While lifestyle changes and over-the-counter medications can manage occasional symptoms, persistent or severe acid reflux may require medical intervention. Understanding the causes, symptoms, and treatments can help you take proactive steps to manage acid reflux effectively, improving your digestive health and overall well-being.

Sources–

Harrison manual of Internal Medicine

National Digestive Diseases Information Clearinghouse (NDDIC): “Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease.” 

Cleveland Clinic: “GERD or Acid Reflux or Heartburn.” 

The American College of Gastroenterology: “Heartburn or Gastroesophageal Reflux Disease.”

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