What Is Acid Reflux? What Causes Acid Reflux?
The word “reflux” comes from the Medieval Latin word refluxus which comes from the Latin word refluere, meaning “to flow back, to recede”. If you suffer from acid reflux the acids from your stomach “flow back” into your esophagus, causing discomfort and pain – this discomfort is known as heartburn.
What is the esophagus?
In simple terms, the esophagus is the tube between the stomach and the pharynx, which is at the back of your throat. According to Medilexicon’s Medical Dictionary, “the esophagus is the portion of the alimentary canal between the pharynx and stomach. It is about 25-cm long and consists of three parts: the cervical part, from the cricoid cartilage to the thoracic inlet; the thoracic part, from the thoracic inlet to the diaphragm; and the abdominal part, below the diaphragm to the cardiac opening of the stomach.”
The esophageal sphincter
The esophageal sphincter lies at the junction where the stomach and the esophagus join. Your stomach produces strong acids and enzymes (gastric juices) which are used in food digestion. The inner lining of your stomach has several mechanisms to protect itself from the effect of the gastric juices on itself, but the lining of the esophagus does not. There is a valve that stops the gastric juices from going up the esophagus – it is called the lower esophageal sphincter.
When the lower esophageal sphincter becomes weakened gastric juices can seep upwards into the esophagus.
Most of us have acid reflux problems now and again. In majority of cases this is harmless. If the problem becomes persistent and goes untreated, the heartburn can develop into GERD (Gastroesophageal Reflux Disease). In chronic and severe cases the esophagus can become scarred – the patient may have difficulty swallowing, and the risk of developing cancer of the esophagus increases significantly.
What is the difference between acid reflux and heartburn?
Acid reflux is the action, while heartburn is the sensation. The pain is heartburn, while the movement of acid into the esophagus from the stomach is acid reflux.
- Asthma – gastric juices seep upwards into the throat, mouth and air passages of the lungs
- Chest pain – part of the heartburn sensation
- Dental erosion
- Dysphagia – difficulty swallowing
- Heartburn – a burning feeling rising from the stomach or lower chest towards the neck
- Regurgitation – bringing food back up into the mouth
What causes acid reflux?
Acid reflux commonly occurs when the lower esophageal sphincter (LES) does not work properly, and allows acid to seep upwards from the stomach to the esophagus. Although we know that a faulty LES is a common cause, we are not sure why it becomes faulty. One of many reasons could be that pressure in the stomach rises higher than the LES can withstand.
Here are some common causes of acid reflux:
Pregnancy – more commonly found during the third trimester of a pregnancy. As the growing baby presses on the stomach, contents may back up into the esophagus. Doctors say antacids will not relieve acid reflux caused by pregnancy. Patients find that if they eat smaller meals but eat more meals per day, it helps. In the vast majority of cases the acid reflux will disappear soon after the baby is born.
Large meals and eating habits – people who have large meals will usually find that their acid reflux will improve if they cut down portion sizes. Patients who kept a food diary, noting down everything they ate and linking certain foods to incidences of acid reflux, have experienced a reduction in acid reflux.
Bending forward – this movement will not usually cause acid reflux unless there is another underlying trigger or problem.
Hiatus hernia (hiatal hernia) – a condition where the upper part of the stomach protrudes into the chest through a small opening in the diaphragm. Hiatal hernias are commonly caused by severe coughing, vomiting, straining, sudden physical exertion, pregnancy, and obesity.
Peptic ulcers and insufficient digestive enzymes – peptic ulcers and not enough digestive enzymes in the stomach may slow down the digestive process, causing an accumulation of gastric acids that back up into the esophagus.
Asthma – experts still argue about which came first, the asthma or the acid reflux – did the asthma cause the acid reflux or did the acid reflux cause the asthma? Nobody has a definite answer to the relationship between asthma and acid reflux. Some say that the coughing and sneezing brought on by asthmatic attacks can cause changes in the chest which trigger acid reflux. Others blame asthma medications – they are taken to dilate the airways, but might also relax the esophageal sphincter.
Most asthma sufferers say that their asthma is worsened by acid reflux because the acid that seeps into the esophagus from the stomach stimulates the nerves along the neck into the chest, causing bronchial constriction and breathing problems.
Smoking – research has shown that the saliva of smokers contain lower levels of bicarbonates, which neutralize acids. Cigarette smoking also reduces the production of saliva. Smoking also stimulates the production of stomach acid, weakens the esophageal sphincter, promotes the movement of bile salts from the intestine to the stomach (making the acids more harmful), and slows down digestion (making stomach pressure last longer because it takes more time to empty).
The vast majority of people with acid reflux will get better if they make some changes to their diet. Some foods are safe for heartburn sufferers, while others are major triggers of it.
It would be easy to say that there is a reflux diet. Unfortunately, we all react differently to different foods.
Below is a list of foods/drinks that commonly cause irritation and/or heartburn:
Chili and chili powder
Citrus fruit, pineapple
Tomatoes, tomato sauce, tomato juice, ketchup
Acid suppressant – these have been shown to be effective, such as histamine2-receptor antagonists (blockers). Histamines are good at reducing inflammation. An inflamed stomach produces more acid – blocking this extra production of acid helps prevent the acids from building up and seeping upwards.
Propton pump inhibitors – these reduce the production of acid in the stomach. They act on cells in the stomach wall and produce stomach acids.
Prokinetic agents – these promote the emptying of the stomach, stopping it from becoming overfull.
Antiacids – commonly used to treat mild acid-related symptoms, such as heartburn or indigestion. They neutralize the acids in the stomach. These are not recommended for frequent heartburn for patients with GERD.
How Acid Reflux Occurs
Acid Reflux occurs when the tube that you uses to intake the food from the throat to stomach is not strong enough to handle the acid. The food intaken by you is digested by the stomach with the help of an acid produced and stored by it. The stomach walls are built strong enough to store that acid without causing damage.
For unknown reasons when acid flows back into the oesophagus from stomach it creates heartburn, which is widely considered the first symptom of acid reflux or GERD. It leaves a constant chest burning sensation. You may find these acid reflux symptoms occurring to everyone once in a while, but when it happens regularly over a period of 2 to 3 times in a week with no visible relief even after medication, then you have acid reflux or GERD. A change in diet intake can give you relief to an extent from acid reflux attack, but if it reoccurs then one needs medical attention.
The main cause of acid reflux attack is when the lower oeasophageal sphinter which is a divider between stomach and oeasophagus giving up at inappropriate times, thereby not blocking the entry of acid into easophagus. This stomach acid when flows back into the easophagus, it causs severe heartburn right in between the chest.
How is acid reflux disease diagnosed?
It’s time to see your doctor if you have acid reflux symptoms two or more times a week or if medications don’t bring lasting relief. Symptoms such as heartburn are the key to the diagnosis of acid reflux disease, especially if lifestyle changes, antacids, or acid-blocking medications help reduce these symptoms.
If these steps don’t help or if you have frequent or severe symptoms, your doctor may order tests to confirm a diagnosis and check for other problems. You may need one or more tests such as these:
- Barium swallow (esophagram) can check for ulcers or a narrowing of the esophagus. You first swallow a solution to help structures show up on an X-ray.
- Esophageal manometry can check the function of the esophagus and lower esophageal sphincter.
- pH monitoring can check for acid in your esophagus. The doctor inserts a device into your esophagus and leaves it in place for one to two days to measure the amount of acid in your esophagus.
- Endoscopy can check for problems in your esophagus or stomach. This test involves inserting a long, flexible, lighted tube down your throat. First, the doctor will spray the back of your throat with anesthetic and give you a sedative to make you more comfortable.
- A biopsy may be taken during endoscopy to check samples of tissue under a microscope for infection or abnormalities.
The worst case scenario in Acid Reflux
If not treated appropriately, acid reflux attack for a prolonged period can wear out the inner protective lining of oeasophagus. Doctors call this erosive oesophagitis. A doctor can find out whether you have this condition through a simple endoscopy. He can also treat you for this acid reflux condition depending on the extent of damage.
There are a lot of advices out there for people who suffer from acid reflux or heartburn about what they should not do. There are always a bunch of food items you are not supposed to eat. Here we are discussing a few things you can do and reduce your acid reflux problem.
It is known to be beneficial to sleep on the left side of your stomach than your right side. Sleeping on you left side is better for you not to experience acid reflux symptoms like heartburn.
If you make it a habit to sleep with your head in an elevated position that would reduce heartburn during your sleep. This can be achieved using one or two extra pillows. If you can afford it, getting a bed that can be raised, a bed similar to the ones used in hospitals would be a great idea. If not, you can raise the head side of your bed with blocks of wood or some thing similar.
Eat any time you feel like eating. But make it very small portions. If you skip food in between for so long, you will end up eating a big meal in the end and it is going to cause the worsening of your acid reflux condition. Any person who tries to avoid meals in between for whatever reasons may end up over filling your stomach when you finally have food. This must be avoided at all cost.
In between meals, it would be helpful to you make it a habit of chewing gums. This would create a lot of saliva in your mouth and this can wash down any left over acids from your esophagus and throat. Saliva is alkaline in nature and is going to neutralize the acids to some extent. When choosing chewing gums avoid mint flavored ones. Mint is known to worsen acid reflux condition in many people.
Instead of chewing gums, you can suck on cough drops like halls or antacids, and they will provide you with the same effect.
Drinking water can dilute the stomach acids and can be helpful in reducing your heartburn condition.
It is an absolute no no to hit the bed right after a big meal. You need to walk for a little while before you go to sleep. The ideal case is to sleep only four hours after having your dinner. So have your dinner earlier around 5 or 6 O’clock, as was the practice of yesteryears.
Natural Antacids To Treat Acid Reflux
It is better to take natural antacids instead of the synthetic antacids available over the counter. Most of the time these natural foods which work as antacids are available in your home. So they may cost you less compared to the store bought antacids.
There are a few foods that reduce the stomach acid levels. These are natural antacid foods. But all the natural antacid foods may not work for your situation. So you will have to try and see which ones work for you in reducing stomach acids. You should find the best antacid that works for you.
You should also consider your general health condition and your other health problems when introducing these natural antacid foods in your diet.
- Dietary fiber – increasing dietary fiber can reduce heartburn for many people.
- Banana – banana works for many as it is a natural antacid food. But do consult your doctor as bananas are high in potassium.
- Milk – milk is a natural antacid drink. A glass of milk soothes the stomach. Cold milk is better but warm milk also works well before bed time. But before you try milk as antacid, make sure that you do not have allergy to dairy products.
- Ice cream – ice cream, being a milk product, is a natural antacid food. Be careful about the flavor you choose. Vanilla is better than chocolate or peppermint. Again, make sure you do not have allergy to dairy products.
- Yogurt – yogurt helps in heartburn because of the active culture. The healthy bacteria is useful in the digestive tract to breakdown foods for digestion.
Good News for Acid Reflux patients
Acid Reflux is a medical condition which if diagnosed in time can be treated. Contact your doctor or contact for further advise and guidance on overcoming your acid reflux condition.