Acid Reflux Disease

Also called GERD (Gastroesophageal Reflux Disease).

Acid reflux, also known as gastroesophageal reflux disease or GERD, occurs when acid flows back into the esophagus from the stomach. It can produce symptoms such as heartburn, chest pain and sore throat. Over time, the back flow of stomach acid into the esophagus can cause other health complications, such as damage to the cells of the esophagus, worn down tissues in the esophagus that cause open sores to develop and even precancerous esophageal changes. It can lead to a condition called Barrett's Esophagus and cancer.

At the top of your stomach (the "gastro" part of "GERD") and bottom of your esophagus (the "esophageal" part of "GERD") is a coiled muscle, called the LES (lower esophageal sphincter). This muscle helps keep your stomach contents from fluxing back up (the "reflux" part of "GERD") into your esophagus. To function properly, the LES muscle needs to be clamped tightly shut when you are not eating, and opened properly when you are. If your stomach contents are allowed to flow up into your esophagus, the lining of your esophagus can become injured.

Symptoms

Heartburn is the initial symptom. In more progressive stages more symptoms may develop. Other symptoms include difficulty swallowing; chronic sore throat; persistent coughing or hoarseness; laryngitis; frequent belching or vomiting; upset stomach. In even more advanced stages inflammation of the gums; erosion of tooth enamel, and mourth sores may develop.

Extra-esophageal manifestations

Some GERD patients do not experience the typical heartburn symptoms. Instead, they suffer symptoms known as extra-esophageal manifestations, which may include asthma, laryngitis, chronic cough, pneumonia and dental disease. These manifestations typically occur at night when the effect of gravity is less and acid is able to reflux all the way up the esophagus and into the windpipe, larynx or mouth.

There have been reports of canker sores (mouth sores), or oral ulcers, occurring as a result of GERD. The reason is probably acid-induced damage to the lining of the mouth.

Types of Acid Reflux

There are two kinds of reflux: acid reflux and alkaline reflux. Basically, these two kinds of reflux refer to the chemical balance found in your stomach contents. If the stomach contents are too acidic, and the sphincter lets them back up into your esophagus, you get acid reflux. If your stomach contents are not acidic enough (too alkaline) and the sphincter lets them back up into your esophagus, you get alkaline reflux.

The alkaline reflux type is less common and involves fluids from your duodenum (top part of the intestine) escaping into the stomach and up into the esophagus. This condition is also known as bile reflux and DGER, or duodenogastroesophageal reflux. Sometimes these fluids are non-erosive as they cause no damage to the esophagus.

Barrett's Esophagus

Barrett's esophagus is a disorder in which the lining of the esophagus is damaged. This damage occurs when parts of the esophageal lining are repeatedly exposed to stomach acid, and are replaced by tissue that is similar to what is found intestine. This process is called intestinal metaplasia.

With Barrett's esophagus, abnormal intestinal-like cells develop in the throat.

Source: Barrett's Esophagus

Treatment

If your acid reflux symptoms become chronic, contact your doctor so that he or she can determine whether or not there has been damage to the esophagus.

Your doctor can provide you with the proper medication to treat the disease, such as with proton pump inhibitors, H2 blockers or promotility agents.

Source: Tips for Acid Reflux Relief

Position

Gravity plays an important factor in keeping acid out of the esophagus. Try to keep your posture upright, especially after eating, to allow digestion to occur properly. Give yourself at least 2-3 hours in between eating and lying down. If acid reflux occurs often during the night, raise the head of your bed 6-8 inches.

Diet Change

Avoid foods that are known to contribute to acid reflux.

Smoking: Quit smoking. Smoking causes the lower esophageal sphincter to function improperly, triggering acid reflux.

Foods to Avoid

• onions (undercooked or raw)
• fried and fatty foods
• chocolate
• spicy foods
• heavily seasoned foods
• garlic
• black pepper and chili powder
• alcohol
• citrus fruits
• oranges and grapefruit
• orange juice
• tomato juice
• peppermint
• caffeine

Source: Multiple Sources

Foods that Help

For overall healthy digestion and to minimize acid reflux, make sure you get plenty of fiber from a variety of vegetables, non-citrus fruits, and whole grains. Drink enough fluids to help your body absorb important nutrients and lubricate food waste.

Use low-fat methods when cooking, for example, substituting broth for butter or oil when you saute, and replacing oil with applesauce (cup for cup) when you're baking.

Herbal chamomile tea is said to have a calming effect on the stomach, so try some after you eat or before bed.

Eat foods that are easy for the body to digest.

Oatmeal is high in fiber, low in saturated fat and cholesterol, provides 20 percent of your daily vitamin A, and delivers 41 percent of your RDA for iron.

• Oatmeal
• Turkey Sandwich
• Salmon, Zucchini, and Potato Kabob
• Grilled Chicken with Carrots
• Apples and Grapes

Dietary Changes

1. Milk – try changing from whole milk to skim, 1% or 2% milk. This will reduce your fat intake allowing your stomach to not produce as much acid

2. Desserts – try ones that are low-fat which are not only healthier for you but also decrease the amount of acid needed

3. Meats – leaner cuts of meat that do not have a high fat content such as skinless chicken (baked) or extra lean ground beef also ease the work of the digestive system by decreasing the fat needed

4. Vegetables – incorporating more vegetables into your diet such as potatoes (baked), broccoli, green beans and peas can facilitate gastric motility

5. Fruits – an intake of non-acidic fruits such as bananas and apples help neutralize acid in the stomach

6. Bread – low fat, multigrain bread that decrease your fat intake

7. Beverages – increase your intake of water and try to switch from caffeinated products to decaffeinated products.

8. Dairy – incorporate more fat free cream cheese or sour cream in your diet to replace foods that are higher in fat content

9. Salad Dressings – Switch to low fat salad dressings to go with your healthy salad

10. Cooking Oil – Consider using broth instead of cooking oil or butter to try and reduce fat intake

Source: 10 Food Diets That Help Cure Acid Reflux

Sore Throat Relief

Sore throat pain is a symptom of GERD. Problems with the throat may develop when GERD is left untreated. The burning that stomach acids cause to the throat can lead to other issues such as ulcers and even esophageal cancer.

• Gargle with warm salt water each evening.

Gargle warm salt water every evening. Use a high concentration of salt to water ratio has been shown to help prevent a night time acid reflux sore throat.

Source: How to Avoid an Acid Reflux Sore Throat

Medication

• Antacids
• H-2 receptor blockers
• proton pump inhibitors

• Prokinetic agents

Prokinetic agents are sometimes perscribed to strengthen the esophageal sphincter