Acid reflux

Acid reflux


Acid reflux is a common condition that features a burning pain, known as heartburn, in the lower chest area. It happens when stomach acid flows back up into the food pipe.

Causes

Acid reflux is when some of the acid content of the stomach flows up into the esophagus, into the gullet, which moves food down from the mouth. Despite the name, heartburn has nothing to do with the heart.

The stomach contains hydrochloric acid, a strong acid that helps break down food and protect against pathogens such as bacteria.

The lining of the stomach is specially adapted to protect it from the powerful acid, but the esophagus is not protected.

A ring of muscle, the gastroesophageal sphincter, normally acts as a valve that lets food into the stomach but not back up into the esophagus. When this valve fails, and stomach contents are regurgitated into the esophagus, the symptoms of acid reflux are felt, such as heartburn.

Risk factors

GERD affects people of all ages, sometimes for unknown reasons. Often, it is due to a lifestyle factor, but it can also be due to causes that cannot always be prevented.

One cause that is not preventable is a hiatal (or hiatus) hernia. A hole in the diaphragm allows the upper part of the stomach to enter the chest cavity, sometimes leading to GERD.

Other risk factors are more easily controlled:

obesity
smoking (active or passive)
low levels of physical exercise
medications, including drugs for asthma, calcium-channel blockers, antihistamines, painkillers, sedatives, and antidepressants
Pregnancy can also cause acid reflux due to extra pressure being placed on the internal organs.

Diet

Food and dietary habits that have been linked to acid reflux include:

caffeine
alcohol
a high intake of table salt
a diet low in dietary fiber
eating large meals
lying down within 2 to 3 hours of eating a meal
consuming chocolate, carbonated drinks, and acidic juices
A recent study suggests that dietary choices may be as effective as using proton pump inhibitors (PPIs) in treating acid reflux.

Treatment

The main treatment options for acid reflux are:

PPIs, including omeprazole, rabeprazole, and esomeprazole
H2 blockers, including cimetidine, ranitidine, and famotidine
Over-the-counter treatments, such as antacids
Alginate drugs, including Gaviscon
The main treatment options for people who repeatedly experience acid reflux in GERD are either PPIs or H2 blockers, both of which are medications.

PPIs and H2 blockers decrease acid production and reduce the potential for damage caused by acid reflux.

These medications are generally safe and effective, but like any prescription drug, they are not appropriate for all people with reflux disease and can cause side effects.

For instance, they can cause problems absorbing nutrients. This can lead to malnutrition.

OTC remedies for acid reflux

For people who experience heartburn or indigestion infrequently, perhaps in association with occasional food and drink triggers, OTC treatments to reduce the acidity of the stomach contents are available.

These liquid and tablet formulations are called antacids, and there are dozens of brands available, all with similar effectiveness. They may not work for everyone, and any need for regular use should be discussed with a doctor.

Antacids provide rapid but short-term relief by reducing the acidity of the stomach contents.

They contain chemical compounds such as calcium carbonate, sodium bicarbonate, aluminum, and magnesium hydroxide. They can also inhibit nutrient absorption, leading to deficiencies over time.

Alginate drugs such as Gaviscon

Gaviscon is probably the best-known heartburn therapy. It has a different mode of action than antacid drugs. Alginate drugs such as Gaviscon vary slightly in composition, but they usually contain an antacid.

The alginic acid works by creating a mechanical barrier against the stomach acid, forming a foamy gel that sits at the top of the gastric pool itself.

Any reflux is then relatively harmless as it consists of alginic acid and not damaging stomach acid.

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