Acid Reflux Management Guideline

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  1. What is acid reflux?
  2. Is acid reflux, heartburn and GERD same thing?
  3. Causes of acid reflux.
  4. Symptoms of acid reflux.
  5. How to test and diagnose acid reflux?
  6. Acid reflux treatments.
  7. Food that causes acid reflux
  8. What kind of food fight acid reflux?
  9. Do the natural remedies for acid reflux work?
  10. Indigestion problem and heartburn during pregnancy is it common?
  11. Can acid reflux cause chronic cough?
  12. What is silent Acid reflux?
  13. Acid reflux after sex
  14. Why acid reflux happens in infants?

What is acid reflux?

Acid reflux refers to the flow back of stomach contents into the esophagus. When you have acid reflux, you feel a burning sensation internally around the lower chest area. In medical science acid reflux is called Gastroesophageal reflux (GER). It is also called acid regurgitation. Our stomach contains digestive enzymes (proteases) and strong acids to help in food digestion. When some stomach acid comes back to the esophagus, we feel heartburn, sore throat, nausea etc. Our stomach lines are designed as digestive acid resistant, but the esophagus line can be vulnerable because of this reflux. This acid may caustic to the esophagus line.

acid reflux

Mechanism of the stomach .

How stomach acid flow back? The bottom of the esophagus and the stomach is connected by lower esophageal sphincter (LES), a ring shaped muscle. This LES works as a valve, it’s open to take food and close right after eating. When the LES does not work properly or does not close properly the stomach content comes up into the esophagus.

Why you should be concerned about acid reflux? According to a research of the American college of Gastroenterology, around 60 million Americans complain about this reflux at least once in a month and around 15 million of them experience reflux daily. After a long-term research a group of researcher from Norway found that, people who experience acid reflux at least once a week have grown nearly 50 percent comparing last 10 years. This study also shows that women are more likely to suffer from reflux than men. More severe symptoms are likely to occur in middle age and above.

Is acid reflux, heartburn and GERD same thing?

Most of the people use these terms interchangeably. Are all the same? The answer is no. They are of course significantly related, but not the same. Heartburn is a symptom of acid reflux. Most the people feel heartburn because of this reflux. So most of us use these two terms simultaneously.

Gastroesophageal reflux disease, in sort GERD is the disease condition of acid reflux. This is more severe than any other condition of reflux. If you are feeling acid reflux more than twice a week. You are taking reflux reduction pills frequently, then it is time to see a doctor. You should not ignore the signs of GERD. Your doctor may suggest you some tests to make sure you have gastroesophageal reflux disease. The untreated reflux disease may lead to serious complications like stomach cancer in the future.

Causes of acid reflux?

Most of us can feel reflux occasionally associated with food and beverages. It can be minimized by changing lifestyle and food habit. Some causes may not be controllable. The exact causes of reflux are unknown. It varies person to person, your stomach may not react to a food while it can cause havoc to any other person’s reflux condition.

The risk factor you may not able to prevent is stomach abnormality called a hiatal hernia. This problem is more likely to occur in women, obese people and older people (aged above 50 years).

Hiatal (or hiatus) hernia can cause displacement of your stomach.Hiatus is an opening in the diaphragm, a muscular wall separating the chest cavity and abdomen. This anatomical abnormality allows the upper part of the stomach to enter the chest cavity. This is less common, but leads to GERD.

The common risk factors which are related to your lifestyle and food habit are:

  • Being Overweight or obesity.
  • Taking a large meal at a time.
  • Lying down after taking heavy meals.
  • Lack of physical activity.
  • Smoking.
  • Pregnancy. Your womb can put extra pressure to the stomach.
  • Caffeinated drinks (e.g. Soft drinks, alcohols).
  • Some fruits like tomato, orange.
  • Some type of medications may increase your reflux (e.g. painkillers, asthma, seductive and antidepressants).

Symptoms of acid reflux?

Some common symptoms are:

  • Heartburn or chest pain. An internal pain under the breast bone.
  • Regurgitation.
  • Nausea.
  • Difficulty swallowing.
  • Dysphagia. A feeling like food is stuck in throat.
  • Chocking.
  • Sore throat.
  • Hoarseness.
  • Dry cough.
  • Frequent hiccups sometimes.

More about acid reflux symptoms.

How to test and diagnose acid reflux?

If you have above signs of reflux more than two times a week and the medications are not giving you long lasting relief. Then it is recommended to consult with a doctor. He may suggest you some test to make sure you have GERD disease. The test is necessary for proper diagnosis of GERD. Some tests are as follows:

  • Barium swallow: Here doctors will do an X-ray of the upper digestive system. This process is known as upper GI series or barium swallow. In this process, you need to drink a chalky liquid. It will fill the inside of your digestive tract.  This test helps to see the structure of the esophagus. The X-ray will show the picture of your duodenum (upper intestine), stomach and esophagus. If your esophagus is narrowed down because of GERD, then it will be easily detected.
  • Esophageal motility test: This test will measure the movement and pressure of your esophagus (food tube). A thinner catheter through your nose will be placed into the esophagus to continue this test.
  • pH-probe test: A test is done to monitor the amount of ambulatory acid (pH) in your esophagus. For this test, an acid measuring device will identify when acid regurgitates into your esophagus and the duration of it. A thin catheter with a probe will be placed in your esophagus via your nose. During the test the catheter will remain in your esophagus and it is connected to a small computer. You may have to admit in a hospital to do the test.  The probe will transmit signals to the small computer, it will remain in your esophagus for about two days. The probe will fall off after two days and will pass with stool. You will be suggested to stop GERD medicines you are taking.
  • Endoscopy: This is also a way to measure the esophagus condition visually. This test also involves sending a catheter, but here doctor will insert a camera (endoscope) with light and send to the esophagus. By this test, doctors are able to collect samples of tissues (called a biopsy) for further testing. Biopsy involves checking the tissue under microscope to see if there is any infection or other abnormalities. This test is useful for serious esophageal complications.

Acid reflux treatments

When you are diagnosed with reflux disease or you have occasional heartburn and other reflux related symptoms. The treatment of GERD is done by some acid counter medicine. Doctors will prescribe you some medications. If they don’t work properly may need surgery, using more than twice per week.

Basic acid reflux treatment involves:

  • Antacids: Antacids are able to give you instant relief. In severe conditions antacids have no use. Frequent use of some antacids can show side effects (e.g. constipation, diarrhea).
  • H-2 receptor blockers: This medicine does not work as fast as antacids, but able to give you long lasting relief.  Doctors may suggest you if antacid doesn’t work. These medicines reduce acid reproduction.
  • Proton pump inhibitors: This type of medications stops acid reproduction and allows the damage cells of esophagus to recover.  Example, Omeprazole, Lansoprazole.
  • Prokinetic agents: These medications help to get strong of the lower esophageal sphincter (LES).  After taking these medications, it will help your stomach to get empty more rapidly and the LES will close tightly. There are some side effects of this medicine (e.g. depression, anxiety, fatigue etc.). You should not take this without prescription.

When Surgery is needed?

Most of the patient of GERD found medications helpful. In some cases you may need surgery. GERD surgery involves tightening the LES valve or this LES valve can be replaced by surgery.

Food that causes acid reflux?

We all know the proverb “you are what you eat”. Some foods may trigger your GERD condition. We have tried to give it in a generalized way. Some food may not cause reflux for everyone, as our immunity and digestive system vary from person to person. Here are some foods that may cause reflux to every person.

  • Too much spicy food.
  • Deep fried foods (e.g. fried chicken).
  • Red meat (e.g. pork, beef, lamb etc.).
  • Different type of Indian masala rice with meat (e.g. Biryani).
  • Smoking.
  • Caffeinated beverage (e.g. alcohol, tea, coffee). Excluding green tea.
  • Chocolates and ice creams.
  • Citrus fruits and their juice (e.g. orange juice).
  • Specific vegetables (e.g. Broccoli, raw garlic, raw onion).

More about food to avoid with acid reflux.

What kind of food fight acid reflux?

Some foods are good for you for reflux acid and in general to keep good health. Following foods not only reduce your reflux, but it can eliminate your reflux permanently in a long run, if you do some lifestyle change along with food.

  • Oatmeal. You can make different recopied using oatmeal.
    Acid reflux

    Aloe Vera fight against reflux very strongly.

  • Ginger.
  • Fennel.
  • Aloe Vera Juice.
  • Salads.
  • Highly iodized salt.
  • Fruits (e.g. Papaya, Pineapple, Banana).
  • Fish and Seafood.
  • Yogurt.
  • Warm milk.

Know more details about food to include in your acid reflux diet.

Do the natural remedies for acid reflux work?

Some best working home remedies will give you instant relief from acid reflux and heartburn. This home remedies are completely natural and they have no side effects. From different case studies, in more than 80 percent of cases home remedies are more effective than medications. But the business policy of the medicine industries will not let you know about the truth. We are not saying medications are bad, you may obviously need some medicine. But if your condition in not severe and you have occasional reflux or you are suspecting you are developing GERD, then lifestyle change and dietary change will be much more effective. Natural remedies for GERD involves:

  • Practice small but frequent feeding. Six meals per day instead of large, heavy meals.
  • Always do some physical activity. Walking, sports, cycling, swimming.
  • Manage your weight.
  • Stop snacking before going to bed. The minimum gap between bed time and dinner should be two/three hours.
  • Stop smoking and alcohols.
  • Green tea.
  • Ginger tea or raw ginger is helpful.
  • Baking soda with water.
  • Aloe Vera juice.
  • Basil leaves.
  • Yogurt.
  • Surprisingly chewing gum is a home remedy for heartburn and reflux. Make sure it is sugar free.
  • Raw almonds.
  • Drink lots of water per day (minimum 8 glasses).

More about natural remedies for acid reflux and home remedies for heartburn is here.

Indigestion problem and heartburn during pregnancy is it common?

This is very common in expectant women. In later pregnancy, women feel heartburn and other indigestion problems, specifically near second and third trimester. One common cause behind this, your increased size womb pressurizes the stomach. As a result the LES may relax or stomach acid can splash up to the food pipe (esophagus). Also usual suggestions of acid reflux are suggested to the expectant mother. During pregnancy, you will not be able to do heavy exercise. But you can keep yourself active. Weight loss diet or exercise is also not recommended during pregnancy. You should take a healthy diet so that reflux is minimized and your baby gets enough nutrition.  You may feel like spit up, nausea, vomiting and burning sensation in the chest area.

You may feel pregnancy heartburn if:

  • You are obese.
  • You had indigestions problem before pregnancy.
  • You had pregnancy before.

Your doctor may suggest antacids or some advance medications like omeprazole. If you are feeling severe heartburn you may need more careful follow up. Know how to get rid of heartburn during pregnancy.

Can acid reflux cause chronic cough?

Yes, in some cases of acid reflux patients complain about dry cough. It may be an uncommon symptom of acid reflux cough. The symptoms of cough usually happen at night. While you are sleeping at night you should keep your head up with a comfortable pillow, minimum six inches. The persistent cough can stay more than 8 weeks. The problem with acid reflux cough is you may not able to detect the cause of this type of cough. Most of the time the cough is nonproductive and dry. Most of the time patient who has GERD cough may not feel other symptoms of reflux like heartburn or chest pain. Avoid smoking. Each time you take a cigarette, a silent reflux happens in your stomach.

The diagnosis is very difficult and sometimes doctor mix up with chronic cough. The best way to test GERD cough is pH-probe test. Here are some home remedies for acid reflux cough with treatments.

What is silent Acid reflux?

Silent acid reflux is also a matter of concern. Reflux is silent in case there is little reflux than usual and not able to cause heavy reflux. So you will also not see any typical sign of reflux. The chronic GERD cough is an example of silent reflux. Silent acid reflux can cause asthma, bad breath, tooth decay and some other serious complications. The formal name of silent reflux is Larygopharyngeal reflux (LPR). Along with chronic cough some other symptoms of silent reflux can be not gaining proper weight, hoarseness, spitting up or in hailing foods etc.

Test of silent reflux may involve pH monitoring, Barium swallow. Some more foods may have to add in you avoid food listing.  Read more about silent acid reflux.

Acid reflux after sex

In some cases, some people may suffer from acid reflux after or during sex. This type of reflux can be avoided by some easy tricks. Hope it will helpful to avoid acid reflux during sex.

Why acid reflux happens in infants?

Like most of the adults, infants are also not free from acid reflux. This type of reflux may happen in newborns and it disappears with the baby get old. 25 percent of all infants in America feel some symptoms of GERD. Symptoms of infant reflux in infants involve:

  • Spitting up most of the time.
  • Recurrent vomiting.

Spitting up is always not bad. In happens in most of the infants and is called happy spitting. If your baby is healthy and eating properly or not crying frequently, sometimes blood will be seen with stool, then it is not a matter of concern. If the baby is not getting proper weight or you can see frequent vomiting right after eating you should consult with a pediatrician.

Some causes of acid reflux in infants are as follows:

acid reflux

Baby sleeping on back.

  • Immature lower esophageal sphincter of infants is a common cause of reflux.
  • Their food pipe (esophagus) is also shorter than an adult.
  • Diet may be also a fact, depending on the children age.
  •  Over feeding is not recommended and can cause reflux.
  • Keeping positing while feeding can also be a cause of reflux.

Some remedies to avoid infant reflux:

  • Keep proper positing during and after eating. Upright positing is recommended.
  • Smaller meals and frequent feeding can help to reduce reflux.
  • Burping after feeding also help.
  • Sleeping positions is also an important factor. Try to keep the baby in his/her back while sleeping.

More about diagnosis, home remedies and treatment of acid reflux in infants is here. Treatment should be done under expert supervision. If the reflux remains untreated, it can cause serious problems (e.g. blockage, allergy) in the future.

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