Conditions - A

Acid reflux happens when contents from your stomach move up into your esophagus. It’s also called acid regurgitation or gastroesophageal reflux.

If you have symptoms of acid reflux more than twice a week, you might have a condition known as gastroesophageal reflux disease (GERD).

Heartburn, the commonest symptom of acid reflux affects one in four adults in the United Kingdom every month and one in ten every week. It is one of the commonest reasons for people visiting their GP and is most definitely an illness of our times. Fifty years ago everyone had stomach ulcers. Ulcers are found far less often these days at endoscopy, but heartburn has taken over and is now very common indeed.

In these pages, we explain the causes, symptoms and treatments for acid reflux. We also introduce you to a number of remedies which you can try yourself as well as cures which the doctor has available to help you. We will also tell you a little about surgery and the novel endoscopic techniques, which claim to cure reflux symptoms. We will show you why you should be careful before taking the surgical route. There is no doubt that surgery is appropriate for some people, but by no means for everyone. Many people get significant benefit if they are careful with their diet, whereas others need conventional, or sometimes, second line medication.

Curiously, most acid reflux attacks occur during the day, but some people are bothered particularly at night. These people are most at risk from chronic cough, a symptom which is often not recognised as being related to stomach problems as they often do not have heart burn or other more typical symptoms.

Please note that not all indigestion symptoms are related to acid at all. In one interesting study, older people with osteoporosis frequently complained of heartburn, even though they did not have acid reflux. This is something we see quite frequently in our practice. It is probably due to the nerves feeding the oesophagus being pinched due to the poor back posture (kyphosis) that these people have. It is therefore important to sort out the cause of heartburn so that the correct treatment can be offered.

GERD symptoms

If you have acid reflux, you might develop a sour or bitter taste at the back of your mouth. It might also cause you to regurgitate food or liquid from your stomach into your mouth.

In some cases, GERD can cause difficulty swallowing. It can sometimes lead to breathing problems, like a chronic cough or asthma.

GERD causes

Acid reflux happens when your LES doesn’t tighten or close properly. This allows digestive juices and other contents from your stomach to rise up into your esophagus.

They might also suggest taking over-the-counter medications, like:

• antacids
• H2 receptor blockers
• proton pump inhibitors (PPIs)

In some cases, they might prescribe stronger H2 receptor blockers or PPIs. If GERD is severe and not responding to other treatments, surgery might be recommended.

Some over-the-counter and prescription medications can cause side effects. Find out more about the medications that are available to treat GERD.

Surgery for GERD

For example, your doctor might recommend surgery if lifestyle changes and medications alone haven’t stopped your symptoms. They might also suggest surgery if you’ve developed complications of GERD.

Diagnosing GERD

If your doctor suspects you might have GERD, they’ll conduct a physical exam and ask about any symptoms you’ve been experiencing.

They might use one or more of the following procedures to confirm a diagnosis or check for complications of GERD:

• barium swallow: after drinking a barium solution, X-ray imaging is used to examine your upper digestive tract
• upper endoscopy: a flexible tube with a tiny camera is threaded into your esophagus to examine it and collect a sample of tissue (biopsy) if needed
• esophageal manometry: a flexible tube is threaded into your esophagus to measure the strength of your esophageal muscles
• esophageal pH monitoring: a monitor is inserted into your esophagus to learn if and when stomach acid enters it

GERD in infants

It’s normal for babies to spit up food and vomit sometimes. But if your baby is spitting up food or vomiting frequently, they might have GERD.

Other potential signs and symptoms of GERD in infants includes:

• refusal to eat
• trouble swallowing
• gagging or choking
• wet burps or hiccups
• irritability during or after feeding
• arching of their back during or after feeding
• weight loss or poor growth
• recurring cough or pneumonia
• difficulty sleeping

Many of these symptoms are also found in babies with tongue-tie, a condition that can make it hard for them to eat.

If you suspect your baby might have GERD or another health condition, make an appointment with their doctor. Learn how to recognize GERD in infants.

Risk factors for GERD

• obesity
• pregnancy
• hiatal hernia
• connective tissue disorders

Some lifestyle behaviors can also raise your risk of GERD, including:

• smoking
• eating large meals
• lying down or going to sleep shortly after eating
• eating certain types of foods, such as deep fried or spicy foods
• drinking certain types of beverages, such as soda, coffee, or alcohol
• using nonsteroidal anti-inflammatory drugs (NSAIDS), such as aspirin or ibuprofen

If you have any of these risk factors, taking steps to modify them may help you prevent or manage GERD. 

Potential complications of GERD

Potential complications of GERD include:

• esophagitis, an inflammation of your esophagus
• esophageal stricture, which happens when your esophagus narrows or tightens
• Barrett’s esophagus, involving permanent changes to the lining of your esophagus
• esophageal cancer, which affects a small portion of people with Barrett’s esophagus
• asthma, chronic cough, or other breathing problems, which may develop if you breath stomach acid into your lungs
• tooth enamel erosion, gum disease, or other dental problems

To lower your chances of complications, it’s important to take steps to prevent and treat the symptoms of GERD.

Diet and GERD

• high-fat foods
• spicy foods
• chocolate
• citrus fruit
• pineapple
• tomato
• onion
• garlic
• mint
• alcohol
• coffee
• tea
• soda

Dietary triggers can vary from one person to another. 

Home remedies for GERD

For example, it might help to:

• quit smoking
• lose excess weight
• eat smaller meals
• chew gum after eating
• avoid lying down after eating
• avoid foods and drinks that trigger your symptoms
• avoid wearing tight clothing
• practice relaxation techniques

Some herbal remedies might also provide relief.

Herbs commonly used for GERD include:

• chamomile
• licorice root
• marshmallow root
• slippery elm

Although more research is needed, some people report experiencing relief from acid reflux after taking supplements, tinctures, or teas that contain these herbs.

But in some cases, herbal remedies can cause side effects or interfere with certain medications.

Anxiety and GERD

If you suspect that anxiety is making your symptoms worse, consider talking to your doctor about strategies to relieve it.

Some things you can do to reduce anxiety include:

• limit your exposure to experiences, people, and places that make you feel anxious
• practice relaxation techniques, like meditation or deep breathing exercises
• adjust your sleep habits, exercise routine, or other lifestyle behaviors

If your doctor suspects you have an anxiety disorder, they might refer you to a mental health specialist for diagnosis and treatment. Treatment for an anxiety disorder might include medication, talk therapy, or a combination of both.

Pregnancy and GERD

Hormonal changes during pregnancy can cause the muscles in your esophagus to relax more frequently. A growing fetus can also place pressure on your stomach. This can increase the risk of stomach acid entering your esophagus.

Many medications that are used to treat acid reflux are safe to take during pregnancy. But in some cases, your doctor might advise you to avoid certain antacids or other treatments. 

Asthma and GERD

More research is needed to understand the exact relationship between asthma and GERD. It’s possible that GERD might make symptoms of asthma worse. But asthma and some asthma medications might raise your risk of experiencing GERD.

If you have asthma and GERD, it’s important to manage both conditions

IBS and GERD

• abdominal pain
• bloating
• constipation
• diarrhea

GERD-related symptoms are more common in people with IBS than the general population.

If you have symptoms of both IBS and GERD, make an appointment with your doctor. They might recommend changes to your diet, medications, or other treatments. 

Drinking alcohol and GERD

Depending on your specific triggers, you might be able to drink alcohol in moderation. But for some people, even small amounts of alcohol trigger symptoms of GERD.

If you combine alcohol with fruit juices or other mixers, those mixers might also trigger symptoms.

The difference between GERD and heartburn

But if you get heartburn more than twice a week, you might have GERD.

GERD is a chronic type of acid reflux that can cause complications if left untreated.