Overview – What is it?
Acid reflux, also referred to as Gastroesophageal reflux (GER) is a condition that occurs when stomach acid flows back into the food pipe (oesophagus). This can be caused by lifestyle factors, hiatal hernia, obesity and smoking, among other factors.
Acid reflux brings about symptoms such as heartburn, nausea and vomiting, bad breath and chest pain. Some of the tests that can be used in the diagnosis of acid reflux are endoscopy, biopsy and the oesophageal Ph test.
The treatment of acid reflux can include medication, surgery and lifestyle changes such as watching your diet by ensuring you do not eat greasy and spicy foods and watching your weight.
Not smoking, and maintaining a healthy diet and weight are some of the preventative measures for acid reflux.
Causes – What causes it?
Gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD) can be caused by:
- Weakness of the lower oesophageal sphincter causing stomach contents to go back into the oesophagus. This can happen when there is increased pressure on the abdomen due to pregnancy, overweightness or obesity,
- Certain medications that treat asthma, high blood pressure, allergies and depression including sedatives,
- Smoking or inhaling second hand smoke, and
- Hiatal hernia which occurs when the upper part of the stomach pushes up through the diaphragm into the chest cavity.
Symptoms – What do you feel?
A person who has acid reflux can experience the following symptoms:
- Nausea and vomiting
- Chest pains or pain in the upper part of the abdomen
- Breathing problems
- Bad breath
- Tooth erosion
- Pain when swallowing
- Severe acidity can lead to complications like ulcers and asthma, as well as inflammation of the lungs, oesophagus and stomach. Untreated acid reflux can lead to oesophageal cancer.
Diagnosis – How do you diagnose it?
- Upper GI series x-ray: This involves taking images of the upper gastrointestinal tract using an x-ray machine and is usually done after a person drinks barium solution which coats the inner lining of the upper GI tract, enabling the doctor to see any abnormalities such as ulcers and hiatal hernia.
- Endoscopy: This involves inserting an endoscope (a flexible tube fitted with a camera) through the mouth into the upper GI tract to check for any abnormalities inside the oesophagus.
- Biopsy: This involves getting tissue sample from the oesophagus which can be examined in a lab.
- Oesophageal Ph monitoring: This test measures the amount of acid in a person’s body when they do regular things like eating. It uses a thin tube which is inserted into the mouth or nose to the stomach and pulled to the oesophagus which then measures and records when and how much acid comes back into your oesophagus. pH monitoring can also be done using a wireless capsule that is placed on the wall of the oesophagus which then transmits information to the receiver.
- Oesophageal manometry: This test is used to measure muscle contractions in the oesophagus. A thin tube is inserted through the nose into the stomach which is then pulled slowly into the oesophagus and a computer measures and records the pressure of muscle contractions in different parts of the oesophagus.
When performing biopsy, endoscopy, oesophageal pH and manometry, local anaesthesia is administered.
Treatment – How do you treat it?
Treatment of acid reflux ranges from prescribed medication to lifestyle changes depending on the cause and severity of the condition.
- Medication: This can be prescribed by a doctor or over-the-counter medication to ease the symptoms like antacid for heartburn.
- Surgery: This can be used especially in a situation where the symptoms do not improve even after a person has taken medication and done lifestyle changes. The common surgery for treating acid reflux is fundoplication which is performed under general anaesthesia using a laparoscope (a thin flexible tube fitted with a tiny camera) which aids the surgeon in sewing the top of the stomach around the oesophagus to add pressure and reduce reflux.
- Endoscopic techniques can also be used in controlling acid reflux. An endoscope in used in this procedure that enables a surgeon to tighten the sphincter muscle using small stitches. Radiofrequency can also be used in tightening the sphincter muscles.
Lifestyle changes: Some of the things that one can do to reduce the acid reflux symptoms include:
- Not smoking,
- Avoiding second-hand smoking,
- Losing weight if the person is overweight or obese,
- Wearing loose clothes to avoid squeezing the stomach which will in turn push the acid into the oesophagus,
- Sitting upright after meals,
- Sleeping on a slight angle with the head raised
- Avoid eating foods that cause acid reflux like spicy-greasy foods and alcoholic drinks,
- Not overeating, and
- Eating 2-3 hours before going to bed.
Prevention – How do you prevent it?
- Not smoking
- Maintaining a healthy diet rich in vegetables and fruits
- Avoiding spicy foods
- Maintaining a healthy body weight
- Eating smaller meals to avoid filling up the stomach
- Avoid lying down after eating
- Avoid excessive intake of alcohol
- Avoid certain medications that can lead to acid reflux such as nonsteroidal anti-inflammatory drugs and some antibiotics