Acid Reflux and Gastroesophageal Reflux Disease (GERD)

Acid Reflux and Gastroesophageal Reflux Disease (GERD)

Tell me about acid reflux

Gastroesophageal is pronounced gas-troh-i-sof-uh-jee-uh l. 

Acid reflux is a very common condition, it is also known as heartburn, which is a symptom of acid reflux, referring to the burning pain or sensation in your chest area. Don’t get confused by this though, as the heart has nothing to do with it.

This article will explain to you what acid reflux really is, how to deal with it, what causes it and gets into detail about Gastroesophageal Reflux Disease (GERD) and the treatment and diagnosis of it. 

Have a look at the questions section at the end of the article to find out anything more you might want to know. 

Getting into more detail about acid reflux

To understand what it is, it makes sense to first know what the word ‘reflux’ means. Reflux refers to the liquid flowing back or returning. In the case of acid reflux, the term refers to the return of stomach acid flowing back up through the food pipe.

The food pipe, medically known as the(oesophagus), which is a pipe that starts from the back of the throat and ends when it joins the stomach below the diaphragm. Where the oesophagus joins the stomach there’s the lower oesophageal sphincter which is a muscular ring found in the digestive tract.

When you swallow food, your oesophageal sphincter opens to allow the food to pass through to the stomach and then closes to prevent the contents of the stomach coming back up, it works like a valve or rather a door for your food. When your oesophageal sphincter is damaged or weakened in some way, it does not close properly, therefore the stomach contents come back up, causing acid reflux.

The stomach contains hydrochloric acid which helps to break down food and protect you against harmful bacteria. It is important to keep in mind that the lining of the stomach is strong enough to protect itself from this acid, however, your oesophagus is not. 

What does Gastroesophageal Reflux Disease (GERD) mean?

Recurrent acid reflux, often when it happens more than twice a week, is diagnosed as GERD, therefore it is a chronic disorder. GERD is seen in people of a variety of ages, children and infants also suffer from this. Recurring acid reflux often occurs during pregnancy.

Luckily, GERD can often be treated through a change in diet and lifestyle, but in some cases, it needs to be treated with medication. It is often the result of lifestyle factors, but there may also be instances in which the causes cannot be prevented – please consult with your doctor should you think you might have GERD, this article is a merely a source of information and is intended to act as a guideline not a diagnosis or prescription for treatment. 

What are the causes of acid reflux (GERD)?

Acid reflux can be a very uncomfortable sensation and happens more commonly when lying down, after eating a hearty meal, including fats and spices, or even when bending over.

One cause of GERD, a more serious one, is known as hiatal, or hiatus hernia. A hernia occurs when there is a hole or a weakness in the muscular wall that keeps in the organs in place. In this case, the hiatus is the small opening in the diaphragm through which the food pipe runs and attaches itself to the stomach. The stomach can, therefore, push through this opening and result in a hiatal or hiatus hernia, thus causing GERD.

In most situations, when there is a small hiatal hernia, it doesn’t cause problems, and you may only discover you have one when consulting with your doctor. However, a large hiatal hernia allows for acid and food being sent back up through your food pipe, resulting in heartburn. This can sometimes require surgery, but please consult with your doctor should you be experiencing chronic acid reflux.

Hiatal hernias can often be caused by:

  • Consistent vomiting
  • Injury to the area (diaphragm, muscular wall separating chest contents from abdominal contents)
  • Decreased muscle tone in the abdominal cavity, thus obese people and pregnant women may suffer from these
  • Weakened membrane elasticity because of ageing

More controllable risk factors to acid reflux:

  • Smoking, or a history of smoking
  • Decreased digestive time before resting or sleeping
  • A low fibre diet
  • Very little physical exercise
  • Obesity - especially around the central organs
  • High alcohol or caffeine consumption
  • Some chronic medications 

How do I know I have acid reflux and what can I do to stop it?

GERD explained

It is important to remember that GERD is a result of chronic acid reflux. When your symptoms persist then the diagnosis is often GERD.

Acid reflux most commonly occurs at night when lying down. The most common symptom is heartburn. This tends to feel like a burning pain in the chest area, it can be described as food coming back into the mouth leaving a bitter and sour taste in your mouth from the stomach acid. This pain can last about two hours and will only get worse by eating or lying down. Try standing up or taking a PPI (please refer to the section on this below).

Vomiting and Regurgitation

With the acid from the stomach sending food back up to your mouth, you may experience regurgitation, this is the food and bile moving up your throat. However, vomiting is more common in infants than adults.

Burning and Sore Throat
The acid reflux can often feel like it is burning the insides of your throat, resulting in a croaky voice or the feeling of a lump in your throat. This may also lead to a difficulty in swallowing.

Also, referred to as dyspepsia, can be a feeling of a burning sensation in the upper middle part of your stomach. The pain can come and go, and heartburn is often the symptom of this. You may feel bloated, nauseous, bloated or just generally uncomfortable due to the feeling of indigestion. If these symptoms persist, they must be taken seriously and we recommend you consult with your doctor as soon as possible. They may also be the result of ulcers which can cause bleeding. This is only if the symptoms are chronic and result in severe pain or discomfort. 

Other Symptoms
Some other symptoms may include:

  • Dry cough from the feeling of having a lump in your throat, or scratchy irritation on the back of your throat and feeling the need to repeatedly cough to get rid of it. However, this feeling is only due to the acid build-up creating an uncomfortable sensation in your throat.
  • Asthma symptoms such as wheezing being worsened due to the stomach acid agitating the airways.

How do I know if it is serious?
GERD is a common disorder and can be easily treated. However, your symptoms can often resemble those of a heart attack. If your symptoms seem more severe than the ones described above, then we suggest you immediately consult with your doctor or physician. This is often the case when your heartburn seems more severe than normal, you experience severe chest pain, a crushing feeling on your chest, a shortness of breath during physical activity or nausea when exercising accompanied with the above. These symptoms warrant an immediate visit to a specialist.

PPIs, known as Proton Pump Inhibitors (common brands include Nexium (Esomeprazole), Prilosec (Omeprazole), Prevacid (Lansoprazole), Protonix (Pantoprazole). These help to reduce in the build-up of acid by blocking the enzyme in the wall of the stomach responsible for producing acid. They are only used when suffering from GERD and other conditions resulting in the formation of acid from the stomach, such as stomach ulcers. They are taken by mouth and are available in tablet or capsule form. You can buy some brands of PPIs without a prescription. Please talk to your doctor should you feel that the use of them is becoming chronic, in other words you are taking them on most days to aid in heartburn or GERD.

Some of the side effects may include headaches, constipation, itching or diarrhoea. Should your acid reflux persist, you experience side effects or you are experiencing unusual symptoms, please call your doctor immediately. 

So how do I prevent acid reflux?

Medicinal Solutions
As mentioned above, PPIs are often the common solution to heartburn associated with GERD and acid reflux. Speak to your physician or pharmacist about the possible PPIs available to you suited to your symptoms.

In some very rare cases, untreatable and unresponsive GERD patients should have surgical intervention, where a procedure called fundoplication is conducted. This is a very minimally invasive operation which is done in order to restore the function of valve between your stomach and food pipe.

Lifestyle Changes
More often than not, GERD or acid reflux is the result of an unhealthy lifestyle and can be easily treated by changing your diet and regime. This can often prevent and help to stop the symptoms by:

  • Controlling the portion size of your meals
  • Wearing looser clothing to not put pressure on your stomach
  • Improving your posture, sitting up straighter can help prevent acid coming back up through your food pipe
  • Quitting smoking
  • Eating at least 2 to 3 hours before bed, lying down after a meal can cause acid reflux
  • Reduce the intake of fizzy drinks, acidic juices, caffeine and chocolate
  • Losing weight if you are overweight or obese 

I have some more questions

What is the difference between heartburn, acid reflux and GERD?

Technically speaking, heartburn is the sensation you feel in your chest, having nothing to do with the heart, when stomach acid moves up from the stomach. It is often referred to as acid reflux and the two are used interchangeably, as acid reflux is when the stomach acid moves up the food pipe.

GERD, otherwise known as Gastroesophageal Reflux Disease is when the heartburn or acid reflux becomes chronic, meaning that it is often occurring, sometimes in the case of more than two times a week.

Do I have heartburn or GERD?

Heartburn is often treated with over the counter medication such as antacids which neutralise the stomach, some examples of these can include:

  • Milk of Magnesia
  • Gaviscon
  • Pepto-Bismol

GERD is when the heartburn persists, such as over a period of two weeks when you have been treating it with over the counter medicine. If you experience the symptoms frequently and if you feel like they interfere with your everyday life. Should any of that occur, we suggest you get medical attention as you may have GERD.

I’m still not sure what PPIs are

PPIs known as proton pump inhibitors are strand of very effective medicines used to treat heartburn and GERD, they are not always necessary but can help to ease the symptoms the you may be experiencing. Basically, what they do, is prevent the build-up of acid in the stomach. They are the most potent medicine in the prevention of acid secretion available.

What foods are bad for acid reflux?

Heartburn and acid reflux are easily avoided if you stay clear of the following foods that aid in the build-up of acid in the stomach. These foods are what you need to avoid in consume in moderation if you want to try and steer clear of acid reflux:

  • Citrus fruits
  • Tomatoes
  • Salt and pepper – don’t forget that pepper adds spice to foods!
  • Garlic and onions
  • Butter and high-fat foods – try limiting fatty foods in your diet, these needs more acid to break them down
  • Peppermint – this may seem interesting, but in actual fact, peppermint aids in relaxing the sphincter which is the muscle or rather the valve between your food pipe and stomach, letting acids flow back freely into your food pipe.
  • Sugary foods
  • Spicy foods
  • Red meat
  • Fizzy drinks
  • Caffeine
  • Dairy – many people will tell you to drink milk to neutralise acid, unfortunately in some who do not tolerate lactose well, this may have the opposite effect.

What is acid indigestion?

Acid indigestion is sometimes just a fancy word for heartburn, although the symptoms of indigestion can often mean consulting with a medical professional, it refers to the burning sensation or discomfort of acid moving through your food pipe from your stomach. The feeling often comes from the middle of your chest. It can also be referred to as gastric reflux.

What exactly is GERD?

Chronic heartburn is the most common symptom of GERD. To bring this into simple terms, when you start to suffer from acid reflux or heartburn on common occasions, your doctor will diagnose you with GERD.

How is GERD diagnosed?

The diagnosis of GERD is based on the following:

  • Your symptoms depicting the occurrence of frequent heartburn and other symptoms.
  • Ambulatory acid probe tests are conducted using a device to measure for acid over 24 hours. An example of this is a flexible and thin catheter, or otherwise known as a tube which is inserted in your nose to get to your food pipe (oesophagus). This is then connected to a very small computer worn around your waist, it also has a strap going over your shoulder. This test picks up when your stomach sends acid into your food pipe and for how long.
    • Another way of doing this is conducting an endoscopy, using a thin instrument with a camera attached to the end of it, to examine your body from the inside. In this case, a detached probe is placed in your food pipe and passed through your stool, before this however, it transmits a signal to a small computer you are wearing to monitor your stomach movements.
    • However, your doctor may also conduct a general endoscopy (specifically gastroscopy also known as an upper GI scope or oesophageo gastro duodenoscopy) using a small camera to examine your insides. This routine procedure may require light sedation and day visit to the hospital.
  • X-rays of your upper digestive system, sometimes referred to an upper GI series or a barium swallow, involve drinking a liquid that fills your digestive tract allowing this to show up on your X-rays. Giving the doctor a silhouette of your food pipe and stomach.

Is GERD life threatening?

Although GERD can rarely result in surgery, the chances of it being life threatening are minimal. Gastroesophageal Reflux Disease may hinder your everyday life and activities, but with the understanding of it and the proper treatment, most people tend to find relief from the symptoms.

However, depending on the severity of the reflux, especially in instances where others may be suddenly woken up by the feeling of vomiting or regurgitation while sleeping, the stomach contents may enter the airway(aspiration) by mistake and cause the food to go into the lungs causing a pneumonia known as aspiration pneumonia. This requires urgent medical care.

Disclaimer - is for informational purposes only. It is not intended to diagnose or treat any condition or illness or act as a substitute for professional medical advice.