Acid Reflux

All of us have some days when we feel lots of discomfort because something we ate did not agree with our system. This leads to heartburn and then we reach for antacid tablets or syrups for some relief. In India, acidity-related diseases are very common. Some researchers have attributed this prevalence to spicy food, and non-vegetarian dietary factors.

An occasional acidity issue is not a cause to worry at all. But, when it becomes a regular issue, and almost every meal troubles us, there could be chances of GERD or gastroesophageal reflux disease. It is a disease wherein stomach acid can enter the oesophagus and cause heartburn and discomfort. Having acidity-related symptoms more than twice a week could be an indicator of this disease.

Causes

Typical reasons or risk factors for GERD are

• Eating heavy meals, and laying down after a meal.
• Obesity, bending over after a large meal, snacking just before sleeping.
• Eating acidic or citrus fruits/spicy or fatty foods/junk foods.
• Smoking, Alcohol consumption, drinking carbonated drinks or coffee.
• Stress, certain medications, stomach abnormalities like hiatal hernia.

There is a ring of muscle at the entrance of the stomach called the lower oesophageal sphincter (LES). Usually, this closes after food passes through, but when it does not or opens up often, stomach acid passes back into oesophagus, causing reflux. This is more likely to happen in people who have hiatal hernia. In a hiatal hernia, part of the stomach pushes into the chest cavity. It enters via an opening where the food tube (oesophagus) passes on its way to the stomach.

Symptoms

Common symptoms are heartburn, bloating, acid coming into the throat or mouth (regurgitation), burping, hiccups, weight loss, dry cough, wheezing, chronic sore throat, etc. Symptoms could be heavy or mild depending on the disease’s progress. Also, some may experience only one or two symptoms. In some excessive cases, bloody vomiting or bloody stool are also seen. When one or more of the above symptoms do not let up, it is time to meet the doctor rather than consume antacids. Chronic use of antacids can cause constipation and other side effects. A timely diagnosis can help in improving the situation.

Diagnosis

Mild symptoms are treated by the doctor with lifestyle and dietary changes and acid-blocking medications. However, if these don’t help, then various tests may be conducted.

Radiography (Barium swallow test)- The patient is given a solution of Barium after which an upper GI tract X-ray is taken to detect any constrictions.

Endoscopy-The doctor inserts a tube with a camera into the oesophagus through the mouth to check for any abnormalities.

Oesophagus biopsy- A tissue sample is taken for biopsy.

Oesophagus manometry- To check the motility of the oesophagus, a small tube is inserted through the nose, and the sensors on the tube record the oesophageal contraction.

pH monitoring- A small tube with a pH sensor is inserted through the nose into the oesophagus and left there for 24 hours to record acidity levels and compare them to normal levels.

Treatment

When usual antacids don’t work, doctors prescribe acid-reducing medications such as H2 blockers, Proton Pump Inhibitors (PPI), foaming agents, or prokinetics. None of these should be taken without a proper doctor’s prescription and should be taken only in prescribed doses. In some worst-case scenarios, surgery is advised.

Prevention

It is indeed better than a cure. Hence follow some simple lifestyle changes to ensure to keep GERD at bay or under control.

• Eat smaller & more frequent meals, watch out for food triggers, and avoid.
• Quit smoking, avoid alcohol, and get adequate sleep.
• Do not lie down immediately after eating, and watch your weight.
• Keep head at a slightly raised level while sleeping.
• Eat 2 to 3 hours before bedtime.
• Avoid tight clothes.

In the end, the bottom line to counter acid reflux disease is a healthy diet and lifestyle that can keep it under control.

Waiting for your views on this blog.

Anil Malik

Mumbai, India

25^th August 2022.