Acid reflux is a common condition, experienced by many. Knowing the causes of acid reflux can help in identifying the triggers. In this article, we also look at some of the most effective diet and lifestyle tips to overcome acid reflux.
What Causes Acid Reflux?
In the stomach, gastric juice is produced, which helps in digesting the food. It contains an acid hydrochloric acid and salts such as sodium chloride and potassium chloride. Gastric juice is secreted by endothelium cells of the stomach. This acid helps in digestion by activating enzymes pepsinogen-an inactive form to pepsin – an active form. This enzyme later acts upon protein and break them down which is called proteolysis. The acid dissolves the food and also kills the bacteria. Approximately, two liters of acid per day is produced in a healthy adult.
The structure of the stomach shows the presence of a valve at the entrance of the stomach. This valve is composed of muscles and called LES (lower esophageal sphincter). It avoids the backward movement of food to the esophagus by closing the stomach entrance immediately after the passage of food. The problem occurs when it is kept open for a long time or opens very often. In this condition, the movement of acid occurs backward and it reverses back to the esophagus. In some patients, it may move to the throat or to mouth also. This results in acid reflux and heartburn.
- It is important to know what causes acid reflux. The problem with the proper closing of sphincter present between esophagus and stomach is the main reason for acid reflux. There can be some more causes for acid reflux.
- Overweight or obesity causes acid reflux because of the pressure put on the stomach, which makes the valve to open forcibly after the intake of food.
- The people already suffering from acid reflux may suffer more when under stress or in tensed situations.
- Foods rich in fat, fried foods, milk, and milk products cause the relaxation of sphincter and hence the valve is not closed.
- Foods which are responsible for the production of more quantity of acid are alcohol, spicy foods, coffee or caffeinated drinks. Excessive consumption of these foods can cause acid reflux.
- Sometimes, the intake of a large number of meals also stimulates more acid production and cause acid reflux.
- Triggering of acid reflux occurs in people who have the habit of lying down immediately after having food.
- In some people, the muscles around the sphincter become weak. Hence the valve is unable to close, which is a common cause of acid reflux.
- Acid reflux occurs if the mucous – a protecting substance produced in the stomach is produced in less quantity.
- In the case of hiatus hernia, a gap is created in the diaphragm, which allows some parts of the stomach to move to the thoracic region causing acid reflux.
- Acid reflux is a common side effect in patients regularly taking painkillers and anti-inflammatory drugs.
- In pregnant women, acid reflux is very common.
How is Acid Reflux Noticed?
Acid reflux is felt when the acid flows back in an upward direction to the esophagus causing heartburn or chest pain. Some people experience a bitter taste in the mouth due to the presence of salts in gastric juice or sour due to the presence of hydrochloric acid. This condition is referred to as regurgitation.
Other symptoms of acid reflux are as follows:
- Burping or belching
- Hiccups
- Nausea
- Vomiting with blood
- Bloodstains in stools
- The feeling of sucking of food in the throat
- Weight loss in absence of any other disease or without dieting
- Dry cough
- Sore throat
- Bad breath
- Difficulty in swallowing
Diagnosis of Acid Reflux
The key symptom of acid reflux is heartburn. The condition is called Gastroesophageal reflux disease (GERD) if the acid reflux is observed two or more times per week.
- Doctors opt for some tests to confirm the acid reflux or related problems.
- The pressure of the esophagus is measured using an instrument called esophageal manometry.
- Acidity test is conducted to know the pH of the content of the stomach.
- A solution containing barium is swallowed and then X-ray is taken to know the abnormalities of the stomach.
- A thin tube having a small camera at the end is inserted into the esophagus to get images. This procedure is called endoscopy.
- The rate of movement of fluid inside the esophagus is observed in the method called impedance monitoring.
Complications of Acid Reflux
Acid reflux can lead to several complications if it is not treated or if it persists for a long time. Complications include ulcers, infections, GERD, etc. In some patients, untreated acid reflux can lead to esophagitis. Irritation, bleeding with inflammation are the main symptoms of this disease. The scar may also be developed which causes food to get stuck inside the esophagus. If acid reflux is left untreated for long, it increases the risk of a serious complication, called Barrett’s esophagus. This can even lead to the development of potential cells to cancer cells.
Treatment for Acid Reflux
Acid reflux, after diagnosis, needs to be treated properly. Some of the medicines used to treat acid reflux include the following,
- Antacids are used which neutralize the acid to salts and water.
- Some Proton Pump Inhibitors such as rabeprazole, omeprazole are used to reduce the production of acid.
- Over the counter, medicines are sometime used by people which include calcium carbonate, magnesium hydroxide, aluminum hydroxide, sodium bicarbonate, etc. The main disadvantage of these OTC medicines is that, if they are used for a long time, they affect the absorption of nutrients.
- Gaviscon is a medicine containing alginic acid and is normally referred to as alginate drug. As it forms a gel-like substance, floats on the gastric juice and if regurgitation occurs, alginic acid is moved up which does not harm the layers of stomach or esophagus.
- SSRIs (Selective Serotonin Reuptake Inhibitors) are sometimes used.
- Transient lower esophageal sphincter relaxation reducers are used to stimulate the closure of the valve.
Ultimately, when all the above methods fail to bring improvement, laparoscopic fundoplication is performed. It is an operation done to create a new valve which is functional to prevent acid reflux.
Diet and Lifestyle Tips to Overcome Acid Reflux
Acid reflux is related to certain food habits and consumption of certain foods can aggravate it. Studies have shown that foods like chocolates, coffee, or sometimes spicy food can trigger acid reflux in some people.1 It is also known that having heavy meals or lying down or sleeping soon after having meals can worsen acid reflux. Hence, such practices should be avoided and a healthy diet and lifestyle plan must be followed.
Some of the important diet and lifestyle tips to overcome acid reflux include
- Eat small and frequent meals to manage acid reflux
- Avoid spicy foods, chocolates, stimulants, and caffeinated drinks
- Avoid lying down or sleeping immediately after eating
- Rest your head in a slightly elevated position to avoid regurgitation
- Reduce body weight and exercise regularly
- Regular yoga and exercises to reduce anxiety and stress
- Perform pranayama to calm the mind and improve digestion
- Avoid self-medication as far as possible and follow medical advice.
Conclusion
Gastric acid is necessary for digestion. The acid effect is neutralized by the alkaline substances produced in the stomach and intestine. Except under some specific conditions, acid reflux is not a serious problem if it is attended in time. Knowing the causes of acid reflux helps to seek timely medical advice. It is an easily manageable condition if changes are brought in diet and lifestyle. Follow the diet and lifestyle tips to overcome acid reflux along with medical advice. It can be serious also if neglected and proper care is not taken. Immediate medical help is needed if acid reflux is repeated more frequently and is not controlled with mild antacids and lifestyle changes.
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