All About Acid Reflux

Symptoms

Some common signs and symptoms of acid reflux are:

• Pain in the upper abdomen or chest

• Heartburn, i.e., a burning sensation or discomfort in your chest, particularly after eating. This can get worse at night or while lying down.

• Feeling a lump in your throat, known as Globus Sensation

• Having difficulty swallowing

• Inflammation of vocal cords

• Sour taste in the mouth (regurgitation)

• Nausea or vomiting

• Chronic cough

• Hoarse voice

Causes

Acid reflux occurs when the acid from your stomach flows backwards into your oesophagus and throat, causing heartburn. Some common causes are:

• Weak Lower Oesophageal Sphincter (LES):

LES is a circular muscle at the bottom of the oesophagus that acts as a valve between the stomach and the oesophagus. It prevents the stomach acid from going backwards. If the LES weakens, the acid can flow back to the oesophagus, causing acid reflux.

• Triggers:

Certain foods and beverages, such as spicy and greasy foods, tomatoes, citrus fruits, chocolates, mint, carbonated beverages, alcohol, etc., can trigger acid reflux.

• Obesity:

Excess weight, particularly around the abdomen, can put pressure on the stomach and weaken the LES.

• Pregnancy:

The LES can weaken due to hormonal changes during pregnancy, leading to acid reflux.

• Overeating:

Eating large meals or overeating can put pressure on the stomach, contributing to acid reflux.

Lying down immediately after eating or having food just before bedtime can also increase the risk of acid reflux.

Risk Factors

Factors which can increase a person’s risk of developing acid reflux are:

• Overweight or obesity

• Pregnancy

• Gastroparesis or delayed stomach emptying, i.e., the food stays in the stomach for a longer time, causing the stomach to make more acid

• Hiatal hernia, i.e., a condition in which part of your abdomen moves above your diaphragm toward your chest

• People with connective tissue disorders like scleroderma

• Certain medications, such as anti-inflammatory drugs or antidepressants

• Eating heavy meals late at night or just before bedtime

• Beverages like coffee or alcohol

Diagnosis

Your doctor will first conduct a physical examination based on your symptoms. If the symptoms are severe, you will be asked to undergo certain tests to diagnose acid reflux. Some tests include Upper Endoscopy, Ambulatory Acid (pH) Probe Test, Oesophagram, Oesophageal pH monitoring, and Oesophageal Manometry.

Treatment

Acid reflux can be treated with medications and lifestyle modifications. If symptoms don’t improve, doctors may recommend surgery.

Lifestyle changes:

• Eat smaller meals throughout the day.

• Avoid heavy meals in the evening.

• Eat at least 2-3 hours before going to bed.

• Maintain a healthy body weight. If you are overweight, reducing weight with diet and exercise is advisable.

• Sleep with your head slightly elevated.

• Quit smoking.

• Avoid foods that trigger acid reflux, such as spicy and greasy foods, caffeine, chocolate, peppermint, alcohol, etc.

Medications:

If lifestyle changes don’t help, your doctor will prescribe medications, which include antacids, H2 blockers, and proton pump inhibitors.

Surgery:

This is the last option if symptoms don’t improve with both lifestyle changes and medications. Some surgical procedures are bariatric surgery, endoscopic procedures, and fundoplication.

Prevention

Here are some tips to help prevent acid reflux:

• Don’t lie down immediately after eating; wait for at least 2-3 hours

• Eat small meals frequently instead of heavy or large meals

• Ensure your last meal of the day is 2–3 hours before going to bed

• Avoid or quit smoking

• Avoid strenuous activities after eating

• Consider losing weight with diet and physical activity if you are overweight

• Maintain a healthy weight

• Avoid wearing tight clothes around the abdomen

• When you sleep, keep your head slightly elevated