A Layman’s Guide to Acid Reflux

Acid reflux, also known as gastroesophageal reflux (GER), is a common digestive issue that can turn even the most enjoyable meals into a painful experience.

This common digestive disorder occurs when stomach acid creeps up into your esophagus, causing discomfort and frustration.

But there are ways to manage your condition and alleviate your symptoms.

From medications to lifestyle changes and dietary tweaks, your options are many.

In this blog post, we’ll be exploring what causes acid reflux and sharing some effective solutions for managing as well as preventing it.

What is Acid Reflux?

Acid reflux is a digestive disorder that occurs when your stomach acid or bile flows back into your food pipe (esophagus). The esophagus is the tube that connects your mouth to your stomach.

When this happens, it can cause irritation and inflammation, leading to symptoms such as heartburn and regurgitation.

What are the Symptoms of Acid Reflux?

Have you ever felt a burning sensation in your chest or throat after a big meal? Or experienced a sour taste in your mouth when you wake up in the morning? These could be symptoms of acid reflux, a condition that affects millions of people worldwide.

While the symptoms of acid reflux can differ from one person to an another, they often include uncomfortable sensations in the chest, throat and stomach.

Let’s take a closer look at the differences between two of the most common types: GER and GERD

GER

GER stands for gastroesophageal reflux, which is a condition in which your stomach acid and other contents of your stomach flow backwards into your esophagus. This can cause heartburn and regurgitation.

Symptoms of Gastroesophageal Reflux (GER)

• Heartburn: A burning sensation in the chest, usually after eating or lying down.
• Regurgitation: The sensation of acid backing up into the throat or mouth.

GERD

GERD stands for gastroesophageal reflux disease, which is a more serious condition that can lead to long-term complications if left untreated.

Symptoms of GERD are similar to those of GER but are usually more severe and longer-lasting.

In addition to the symptoms of GER, individuals with GERD may also experience difficulty swallowing, chronic cough, hoarseness and chest pain.

Over time, GERD can lead to more serious complications such as esophageal strictures and Barrett’s esophagus.

Symptoms of Gastroesophageal Reflux Disease (GERD)

• Heartburn: A burning sensation in the chest that can worsen after eating or lying down.
• Regurgitation: The sensation of acid or food coming back up into the throat or mouth.
• Chest pain: A sharp or burning pain in the chest that may be mistaken for a heart attack.
• Difficulty swallowing: A feeling of food getting stuck in the throat or chest.
• Chronic cough: A persistent cough that may be worse at night and accompanied by a sour taste in the mouth.
• Hoarseness or sore throat: A scratchy or sore feeling in the throat that can be caused by acid irritation.
• Nausea or vomiting: Feeling sick in the stomach or vomiting after eating.
• Dental problems: Tooth decay or sensitivity caused by acid erosion of the teeth.
• Asthma or respiratory problems: Wheezing, shortness of breath or other respiratory symptoms that may be triggered by acid reflux.

Causes and Risk Factors

Several factors can increase the risk of developing acid reflux. Here are some common risk factors:

• Obesity: Excess body weight puts pressure on the abdomen, increasing the likelihood of stomach acid flowing back into the esophagus.
• Hiatal hernia: A hiatal hernia occurs when the upper part of the stomach bulges through the diaphragm, which can weaken the lower esophageal sphincter (LES) and cause reflux.
• Pregnancy: Hormonal changes and increased abdominal pressure during pregnancy can lead to gastroesophageal reflux.
• Smoking: Smoking can weaken the LES and stimulate stomach acid production, making reflux more likely.
• Alcohol consumption: Alcohol can relax the LES and irritate the esophageal lining, increasing the risk of gastroesophageal reflux.
• Certain medications: Some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), calcium channel blockers, and some antidepressants, can increase the risk of gastroesophageal reflux.
• Diet: Consuming large meals, fatty or fried foods, spicy foods, acidic foods (e.g., tomatoes and citrus fruits), chocolate, and caffeinated beverages can trigger gastroesophageal reflux.
• Delayed gastric emptying: Conditions that slow down the emptying of the stomach, such as gastroparesis, can increase the risk of gastroesophageal reflux.
• Age: The risk of developing acid reflux tends to increase with age, as the LES may weaken over time.
• Genetics: A family history of acid reflux can increase your risk of developing the condition.
• Weak lower esophageal sphincter (LES): The LES is a muscle at the bottom of the esophagus that acts like a valve, opening to allow food to enter the stomach and closing to prevent acid from flowing back up. If the LES is weak, it can’t close properly, leading to acid reflux.

Genetic Connection to Acid Reflux

It appears that genetics have a significant impact on the development of GERD and associated conditions like Barrett’s esophagus and esophageal adenocarcinoma.

Research involving twins and families has demonstrated that the heritability of this disorder is approximately 31%.

However, genetics is not the sole determinant of GERD risk, as environmental and lifestyle factors also play a significant role. These factors include diet, obesity, smoking and certain medications, among others.

It is likely that a combination of genetic predisposition and environmental factors contribute to the development and severity of GERD in people.

Diagnosis

Diagnosing acid reflux, or gastroesophageal reflux disease (GERD), typically begins with a thorough evaluation of your symptoms and medical history.

However, in some cases, additional tests may be necessary to confirm the diagnosis or assess the severity of the condition.

Some common diagnostic methods include:

• Upper gastrointestinal (GI) endoscopy: Also known as an esophagogastroduodenoscopy (EGD), this procedure involves using a flexible tube with a camera and light (endoscope) to examine the esophagus, stomach and the first part of the small intestine (duodenum) for signs of inflammation, ulcers or other abnormalities.
• Esophageal pH monitoring: This test measures the acidity levels in the esophagus over a 24-hour period to determine the presence and severity of gastroesophageal reflux. A small probe is either inserted through the nose into the esophagus or placed temporarily during an endoscopy.
• Barium swallow (esophagram): This is an X-ray examination of the upper digestive system. The patient drinks a liquid containing barium, which coats the esophagus, stomach and small intestine, making it easier to visualise any structural issues or abnormalities on the X-ray.
• Esophageal manometry: This test measures the pressure and coordination of the esophageal muscles as well as the function of the lower esophageal sphincter (LES). A thin tube is passed through the nose into the esophagus to record the muscle contractions.
• Impedance monitoring: This test helps to identify non-acid reflux episodes in the esophagus. A small probe is inserted through the nose into the esophagus to measure changes in electrical impedance, which can indicate the presence of reflux.

These diagnostic methods can help your doctor determine the presence, severity and potential complications of gastroesophageal reflux.

Waste no time in reaching out to your doctor, if you’re already experiencing these symptoms.

Treatment

Acid reflux can be a frustrating and uncomfortable condition to manage. However, with the right treatment, it’s possible to alleviate symptoms and prevent future episodes.

Treatment options range from medications to lifestyle changes and natural remedies.

• Medications: Antacids, proton pump inhibitors (PPIs), H2 blockers and prokinetics are some of the medications that can be used to treat the condition. 
• Lifestyle changes: Making changes to your lifestyle can help manage your acid reflux symptoms. Some changes you can possibly make include avoiding trigger foods, eating smaller meals, not lying down immediately after eating, losing weight if you are overweight and quitting smoking.
• Surgery: In severe cases, surgery may be recommended. The most common surgery for acid reflux is fundoplication, which involves wrapping the upper part of the stomach around the lower esophageal sphincter (LES) to strengthen it.
• Natural remedies: There are several natural remedies that can help alleviate the symptoms. These include drinking ginger tea, chewing gum to stimulate saliva production and elevating head of your bed by 6 to 8 inches while sleeping.

Diet for Acid Reflux

A healthy diet can also help you prevent or manage your acid reflux. Some foods that may help reduce the risk of acid reflux include:

• Non-citrus fruits, such as bananas, melons and apples.
• Vegetables, such as leafy greens, broccoli, cauliflower and sweet potatoes.
• Whole grains, such as oatmeal, brown rice and whole-grain bread.
• Lean proteins, such as chicken, fish and beans.
• Low-fat dairy products, such as yogurt and skim milk.

On the other hand, some foods that can trigger your acid reflux should be avoided, such as:

• Fatty or fried foods.
• Spicy foods.
• Chocolate.
• Caffeine.
• Alcohol.
• Acidic foods, such as citrus and tomatoes.

Lifestyle Changes

Aside from dietary changes, lifestyle changes can also immensely help alleviate your symptoms of acid reflux. These include:

• Losing weight if you’re overweight or obese.
• Not wearing tight clothing around your waist.
• Not smoking or using tobacco products.
• Managing your stress through relaxation techniques.
• Sleeping in an elevated position by raising the head of your bed by 6 to 8 inches.
• Avoiding eating 2-3 hours before bedtime.
• Restricting or reducing alcohol consumption.

Summary

Acid reflux can be a challenging condition to manage, but with the right treatment and lifestyle changes, it can be managed.

It’s important to seek medical attention if your symptoms persist or worsen.

Making healthy choices in diet and lifestyle can also help you prevent the onset of acid reflux.

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Sources: Mayo Clinic (1, 2), WebMD, Medical News Today (1, 2), HHP, Healthline (1, 2), Cleveland Clinic, NHS, Johns Hopkins, NIH, PMC (1, 2).