Acid Reflux

Acid reflux is a condition that occurs when the sphincter muscle at the lower end of your oesophagus relaxes at an unusual time, resulting in the stomach acid backing up into the person's oesophagus. Usually, the lower esophageal sphincter (LES) closes as soon as food passes through it. Still, if the opening is not closed after the passage of food or if it opens more often, the acid produced by your stomach can move up to the oesophagus and cause acid reflux. If this happens more than twice a week to a person, they may have gastroesophageal reflux disease (GERD). Acid reflux is commonly known as heartburn, acid indigestion, or pyrosis. It creates a burning effect in the lower chest area.

One of the most typical causes of acid reflux is a stomach abnormality known as a hiatal hernia. This happens when the stomach's upper part and LES move above the diaphragm, a muscle that is supposed to separate your stomach from your chest. Usually, the diaphragm works to keep the acid in our stomach. But in the case of a hiatal hernia, acid can move up to your oesophagus, causing acid reflux symptoms.

Other common causes of acid reflux are below:

• Eating huge meals and laying or bending down immediately after the meal

• Eating spicy, acidic foods such as black pepper, garlic, raw onions, citrus fruits such as lemons, oranges, coffee and caffeinated drinks, alcohol and chocolates, as well as peppermint and tomatoes

• Eating close to bedtime

• Obesity

• Smoking

• Pregnancy

• Certain muscle relaxant medications may also cause acid reflux

The more common symptoms of acid reflux are: 

• Heartburn 

A burning pain or discomfort that tends to move from your stomach to your abdomen or chest, it may even be felt in your throat

• Regurgitation

A sour or even a bitter-tasting acid backing up into your throat or mouth

Other symptoms of acid reflux are below:

• Bloody or black stools vomiting

• Bloating

• Burping

• Nausea

• Weight loss for no apparent reason

• Dry coughs or chronic sore throat

• Wheezing and hoarseness

• Dysphagia- the sensation of food being stuck in your throat

• Chest pain

• Bad breath

• Dental erosion

Without proper treatment, acid reflux or GERD can lead to more severe complicated diseases, which in the long term can cause cancer. These diseases include:

• Esophagitis: The lining of the oesophagus is inflamed, causing irritation, bleeding and ulceration in some cases

• Strictures: The damage caused by the acid leads to scar development and difficulty in swallowing

• Barrett's oesophagus: A severe complication in which the repeated exposure to acid can change cells and tissues lining, which can later result in cancerous cells

Acid Reflux and heartburn is common amongst pregnant women this is because of factors such as hormonal changes and the growth of the fetus pressing against the stomach. This can easily be treated by some lifestyle changes and consultation with a doctor.

If you experience the following it is advised you consult with your doctor; Experiencing acid reflux more than twice a week. If you experience heartburn, a burning sensation in your chest, stomach and abdomen that may move up to your throat.

If you still experience severe symptoms, a doctor may recommend you to get the following tests conducted to help with diagnosis;

1. Esophageal manometry: It evaluates the function and movement of the oesophagus and the lower esophageal sphincter, which is responsible for the movement of stomach acid. 

2. Barium swallow: This can help check for ulcers around your oesophagus. It's done by swallowing a solution that helps show structures on an X-ray done after it. 

3. pH monitoring: This test can help check acidic levels in your oesophagus. The doctor inserts a device into your oesophagus, which remains for one to two days to measure the amount of acid present in your oesophagus.

4. Endoscopy: Can check for problems in your stomach or your oesophagus, which may be causing acid reflux. This test is done by inserting a long, flexible tube with a camera down your throat. The doctor might spray at the back of your throat with an anaesthetic to make you more comfortable during the test. 

5. Biopsy: During endoscopy, samples of tissues may be taken to check under a microscope for abnormalities. 

Acid reflux can also be treated by making changes in your diet and lifestyle. Keep a food diary and avoid foods and beverages that seem to be triggering acid reflux. Reduce the amount of spicy and acidic food. Reducing your daily food intake and staying within your recommended calorie intake according to your height, age and gender. Quitting smoking has also proven to help reduce acid reflux. Eating a few hours before your bedtime is also an excellent measure, ensuring you are giving your body enough time to digest the food. 

Acid reflux is also treated with the help of medications. Antacids, such as Riopan, Maalox, Mylanta and Alka-seltzer, can neutralise the amount of acid from your stomach. One side effect of them is that they may cause diarrhoea or constipation, more usual in the case of overusing them. It's better to use antacids with magnesium hydroxide and aluminium hydroxide, which can help counteract these side effects. 

Other medications for acid reflux include:

1. PPIs, including omeprazole, rabeprazole and esomeprazole. 

2. H2 blockers, like cimetidine and famotidine. 

3. Alginate drugs such as gaviscon. 

4. Proton pump inhibitors also tend to reduce the amount of acid in your stomach. 

5. Prokinetics such as reglan and urecholine can help strengthen the LES, empty your stomach quickly, and reduce acid reflux. 

PPIs and H2 blockers are for people who repeatedly experience acid reflux because these medications decrease acid production and reduce the damage caused by acid reflux to the oesophagus, abdomen or chest of a person. These medicines do have side effects and are only prescribed and cannot be taken without a doctor's prescription. The side effects include problems absorbing nutrients. This may lead to malnutrition. It is advised not to combine more than one type of antacid or other medications without your doctor's consent.

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If the acid reflux is allowed to be continued untreated, it can cause severe physical damage to the patient's oesophagus, stomach walls, throat as well as chest and abdomen. With proper treatment, acid reflux can be reduced and completely suppressed in a matter of 2 to 8 weeks with the help of lifestyle changes and medications.

Always read the patient information leaflet before starting your treatment.