Acid reflux or GERD is commonly known as acidity. When we eat, food passes down the esophagus into the stomach. Cells in the lining of the stomach make acid and other chemicals which help to digest food. There is a circular band of muscle (a 'sphincter') at the junction between the esophagus and stomach. This relaxes to allow food down, but then normally tightens up and stops food and acid leaking back up (refluxing) into the esophagus. Acid reflux is when some acid flows back (refluxes) into the esophagus.
- Sphincter not working well
- High pressure in the stomach
- Heavy drinking
- Over weight
- Lying down or bending forward a lot immediately after consuming food
- Certain kinds of food and drinks
- Heartburn is the main symptom. It is a burning feeling which rises from the upper abdomen or lower chest up towards the neck.
- Pain in the upper abdomen and chest
- Feeling sick
- Acid taste in the mouth
- Burning pain when you swallow hot drinks
Like heartburn, these symptoms tend to come and go, and tend to be worse after a meal.
- A persistent cough, particularly at night
- Hoarseness or asthma symptoms
- Severe chest pain (may be mistaken for a heart attack).
- Antacids: These are alkali liquids or tablets that neutralize the acid. A dose usually gives quick relief.
- Acid-suppressing medicines: Two groups of medicines are used - proton pump inhibitors (PPIs) and histamine receptor blockers (H2 antagonists). They work in different ways but both reduce (suppress) the amount of acid that the stomach makes. PPIs include omeprazole, lansoprazole, pantoprazole, rabeprazole, and esomeprazole. H2 antagonists include cimetidine, famotidine, nizatidine, and ranitidine. The treatment plan with acid-suppressing medicines can vary from person to person. You may be advised to take a full dose course for a month or so. This often settles symptoms down and allows any inflammation in the esophagus to clear. Some people need a course of treatment every now and then when symptoms flare up. Some people need long-term daily acid suppressing treatment. Without medication, their symptoms return quickly. Long-term treatment is thought to be safe, and side-effects are uncommon. The aim is to take a full dose course for a month or so to settle symptoms. After this, it is common to 'step-down' the dose to the lowest dose that prevents symptoms.
- Surgery: This is an option if medicines fail to subside and prevent symptoms, or if you need medication every day to control symptoms. An operation can 'tighten' the lower esophagus to prevent acid leaking up from the stomach. It can be done by 'keyhole' surgery, and has a good success rate.
Anyone can get GERD. A healthy lifestyle can help prevent acid reflux from happening.