What to know about acid reflux
Acid reflux is when the acid of the stomach leaks out from the stomach and up the oesophageal track, which will bring with it a sensation of chest pain or heartburn. It is quite common, and most people have experienced it now and then. In this article, consultant gastroenterologist Dr Vivek Goel explains the mechanism of acid reflux, and when to be concerned.
What is acid reflux?
In the stomach, there is a watery colourless fluid that is called gastric acid. It is produced by the stomach’s lining, and it is highly acidic for the purpose of breaking down food for digestion so that the body can easily absorb the nutrients and so that solids can move through the digestive tract. The stomach is connected to a muscular tube called the oesophagus, through which food travels from the mouth to the stomach. At the end of the oesophagus is a sphincter which can open and close to let the food pass through, and should ideally be a ‘one-way street’.
However, sometimes there is ‘backflow’ due to the sphincter not closing properly or opening too often, and the stomach acid comes up the oesophageal tract – this is what is known as acid reflux. The main symptom during acid reflux is chest pain, which is often referred to as heartburn due to the proximity of the oesophagus to the heart, but it has nothing to do with the heart’s health. Other likely symptoms are belching, a sore throat and hoarseness, and a bout of bad breath.
What causes acid reflux?
It can be triggered by lying down and bending over soon after eating due to gravity, or eating foods that are particularly spicy, rich, or fatty, such as:
- chocolate
- alcohol and carbonated drinks
- coffee
- alliums
- citrus fruits
- spicy foods
- tomato-based dishes
Is acid reflux a health concern?
Acid reflux is extremely common and will have happened to almost everyone at least once in their lives. However, frequent acid reflux can be indicative of dysfunction with the oesophageal sphincter and may develop into a condition known as gastroesophageal reflux disease (GERD). With GERD, acid reflux becomes almost a daily occurrence, risking the stomach acid burning and scarring the oesophageal tract, the throat and the mouth, and wearing away the enamel of the teeth, which causes them to be yellow and sensitive. It is not life-threatening, but there could be a chance of the stomach acid even getting into the airways and the lungs, and people with GERD have a slightly higher chance of developing oesophageal cancer.
GERD can affect anyone, but there are certain demographics more at risk, such as older people, smokers, pregnant women, and people with a history of bulimia.
What is the treatment for acid reflux?
To reduce cases of acid reflux, it is recommended to eat small portions but at more frequent intervals, avoid trigger foods, wear loose clothing around the waist, minimise drinking alcohol and smoking, and not eat within three hours of going to bed.
Non-prescription medicines like antacids help to neutralise the stomach acid and make it not as damaging to the oesophagus tissue, or alginates which are derived from seaweed and create an actual barrier between the acid and the oesophagus. There are also prescription options that disrupt the body’s production of stomach acid, such as histamine receptor antagonists (H2 blockers) and proton pump inhibitors (PPIs).
For patients with extreme GERD, the doctor may instead recommend surgeries. Nissen fundoplication is the most common surgery, a laparoscopic procedure in which the surgeon will wrap the top of the stomach around the lower oesophagus, essentially reinforcing that sphincter. Another option is the implantation of the LINX device, where small magnets are placed in the sphincter to support the separation between the stomach and the lower oesophagus.
For concerns regarding acid reflux or other gasterenterological issues, consult with Dr Goel via his Top Doctors profile.