If a ring of muscles forms a valve in the lower end of the esophagus from the point where it joins with the stomach, this ring of muscle is called the Lower esophageal sphincter (LES). When the food passes through the esophagus to the stomach, the LES closes instantly; if the LES does not close entirely or remains open too often, the acid from your stomach moves up to your esophagus. This issue can cause a burning sensation in the chest, named Acid Reflux disease or Heartburn. It is also known as gastroesophageal reflux disease (GERD).

Causes:

Some of the causes of Acid Reflux disease are given below:

  • Hiatal hernia (Top of the stomach bulges through an opening in the diaphragm)
  • Obesity or excessive weight
  • Taking long meals or laying down direct after meals
  • Bedtime snacking
  • Smoking
  • Pregnancy
  • Excessive use of Alcohol and Caffeine 
  • Most often, take foods like onion, garlic, Tomato, chocolates, 
  • Excessive use of citrus or spicy foods

Some medicines that also cause Acid reflux disease are the following:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Benzodiazepines
  • Calcium channel blockers
  • Certain Asthma medicines
  • Tricyclic antidepressants

Symptoms:

Some of the common symptoms of Acid Reflux disease are given below:

  • Lump sensation in the throat
  • Burning sensation in the chest
  • Regurgitation of food or sour liquids
  • Chronic cough
  • Disrupted sleep
  • Laryngitis
  • Difficulty in swallowing
  • Bloody black stools
  • Bloody vomiting
  • Nausea
  • Chest pain
  • Wheezing
  • Dysphagia
  • Burping

Diagnosis:

During the diagnosis of this problem, the doctor will ask you about your medical history and perform a physical exam for a complete check-up. He may order some of the following tests for the complete diagnosis of the disease:

  • Barium swallow (esophagram): During this test, the doctor will give you a white substance known as Barium for swallowing. When Barium is swallowed, the liquid covers all your GI tracts and appears white on the X-ray, which helps to diagnose the disease.
  • pH monitoring: In this test, the doctor will check the amount of acid present in your esophagus. During this test, the doctor will insert a device in your esophagus and leave it there for one or two days to know the amount of acid present in your esophagus.
  • Biopsy: In this test, a sample of tissues will be taken and checked in a lab under a microscope to diagnose infection or abnormality.
  • Esophageal manometry: In this test, the doctor will review the movement and functioning of the esophagus and lower sphincter.
  • Endoscopy: During Endoscopy, a thin, flexible tube with a camera will be put in your throat for the complete diagnosis of the disease and to understand the issue. The doctor may give a sedative to make you comfortable during the test.

Treatment:

There are many ways to treat Acid Reflux disease; some of them are the following:

  • Diet and lifestyle changes

Some diet and lifestyle changes are also helpful in treating acid reflux disease:

  • Quit Smoking
  • Walk for 10 to 15 minutes after a meal.
  • Use a chair for daytime naps instead of the bed.
  • Eat small meals throughout the day more frequently.
  • Control your weight
  • Avoid overeating
  • Take your meal two-three hours before going to bed.
  • Put some blocks under the head of your bed to raise it 4 to 6 inches to prevent Acid Reflux.
  • Avoid wearing tight pants and tight clothes.
  • Discuss with your doctor about the medicines causing Acid Reflux in your body and use some safe alternatives.
  • Medication

Acid Reflux disease can be easily treated with Antacids such as Alka-Seltzer, Mylanta, Riopan, Maalox, or Rolaids. These Antacids neutralize the effect of acid in your stomach, but if they are overused, they can also become the reason for constipation and Diarrhea in your body. The best valuable antacids are medicines containing aluminum hydroxide and magnesium hydroxide; when combined, they help deal with gastrointestinal side effects. If the antacids did not help treat Acid reflux, your doctor might suggest other medications such as:

  • Foaming agents like Gaviscon help coat the stomach to avoid acid reflux disease.
  • Proton pump inhibitors such as Protonix, Prilosec, Aciphex, Prevacid, and Nexium are also helpful in reducing the amount of acid in the stomach.
  • H2 blockers such as Pepcid and Tagment are beneficial in decreasing the acid production in the stomach.
  • Prokinetics such as Reglan and Urecholine help strengthen the LES, resulting in a reduction of Acid reflux.
  • Surgery

If the medication is not proven to help eliminate the Acid reflux disease, this problem severely affects your life. In that case, your doctor will recommend surgery. 

Two types of surgical treatment help reduce GERD:

  • In this procedure, a ring named LINX device is placed surgically in the patient’s lower end of the esophagus. The LINX device is made up of magnetic Titanium beads held together with Titanium wire. This device helps prevent stomach contents from backing up into the esophagus. After surgery, there is no need to take medicines; if needed, it will be in a smaller amount.
  • Fundoplication is another surgical procedure that is helpful in the prevention of Acid reflux. There are two ways to perform this surgery; an open incision incest or abdomen or a light tube with a tiny incision in the abdomen. In this process, an artificial valve is placed on the top of the stomach; this valve will help wrap the upper part of the stomach and strengthen the LES. As a result, the Acid reflux disease will be treated, and this method can also help prevent a Hiatal hernia.

Risk Factor:

Things and habits that increase the risk of Acid reflux disease are given below:

  • Taking certain medicines such as Aspirin  
  • Late-night eating or enlarged meals
  • Excessive use of beverages such as Alcohol and Caffeine
  • Excessive intake of fried and spicy food
  • Overweight or Obesity
  • Delayed stomach emptying
  • Lack of physical activity
  • Consuming chocolates and acidic juices
  • Pregnancy
  • Connective tissue disorders, such as Scleroderma
  • Bulging on the top of the stomach up into the diaphragm (Hiatal hernia)

Complications:

Chronic Inflammation in your esophagus for a more extended period can cause certain diseases:

  • Esophageal Ulcer: Stomach Acid can tear away the esophagus tissue and form an open sore in them, resulting in a stomach ulcer. A Stomach ulcer can cause bleeding, pain, and difficulty swallowing food.
  • Barrett’s esophagus: When the tissues from the lower part of the esophagus get damaged from stomach acid, this change increases the chance of esophageal cancer.
  • Esophageal stricture: The tissues damaged due to the acid of the stomach at the lower part of the esophagus can cause scar tissues to form. These scar tissues narrow the food pathway resulting in difficulty with swallowing food. 

 

References: 

  • https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=stl158005&  retrieved on April 14, 2022.
  • https://www.webmd.com/heartburn-gerd/guide/what-is-acid-reflux-disease retrieved on April 14, 2022.
  • https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940#:~:text=Acid%20reflux%20occurs%20when%20the,gastroesophageal%20reflux%20disease%20(GERD) retrieved on April 14, 2022.
  • https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.healthline.com/health/bariumswallow&ved=2ahUKEwi959Gnnpn3AhWFGewKHUquAc8QFnoECAsQBQ&usg=AOvVaw3-lgWn-2zHtNowpNjrMwA9 retrieved on April 14, 2022.
  • https://www.medicalnewstoday.com/articles/146619 retrieved on April 14, 2022.
  • https://my.clevelandclinic.org/health/diseases/8098-hiatalhernia#:~:text=A%20hiatal%20hernia%20is%20a,to%20the%20symptoms%20of%20GERD retrieved on April 14, 2022.