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Acid Reflux

Introduction

Acid reflux occurs when the acidic content of the stomach flows up into the 'food pipe' (medical term - the oesophagus - connecting the stomach to the mouth). This in turn causes a sensation of burning in the chest sometimes referred to as 'heartburn' (although it is not connected to the heart) or 'indigestion' or simply 'reflux'. Acid reflux commonly occurs after meals or exposure to triggering foods and can last anywhere from a few minutes to a few hours.

Causes

There is a one-way valve that sits at the junction of the oesophagus and the stomach, specifically to stop the acidic stomach content flowing back into the oesophagus. If the valve doesn't function correctly, or is stretched by a big meal, digestive juices spill back into the oesophagus causing the burning sensation known as acid reflux.

If this happens continually, it can develop into a condition known as Gastro Oesophageal Reflux Disease, often shortened to 'GORD' (or in the US 'GERD', reflecting the American spelling 'esophagus').

The following factors may cause or contribute to acid reflux:

  • Large meals.
  • Obesity.
  • Pregnancy.
  • Hernia.
  • Stress.
  • Highly processed foods.
  • Slouching while eating food.

Symptoms

Acid reflux tends to affect people over 40 years old more than younger people. It causes a range of symptoms, including:

  • Acid taste in the mouth (from the stomach acid).
  • Cough (not related to any other infection/cause).
  • Dysphagia (where a person has difficulties swallowing).
  • Heartburn / Indigestion – a burning sensation in the throat or chest.
  • Pain in the area of the abdomen and/or the chest.
  • Sore throat.
  • Voice changes – a hoarse voice.
  • Post nasal drip.

Often these symptoms are just temporary, but if symptoms persist or you can't pinpoint a specific cause of acid reflux for longer than a year, medical treatment should be sought as it could be a symptom of a more serious problem.

Treatment

There are a number of options that can help people who have acid reflux. In many cases lifestyle changes may alleviate or eliminate the condition. There are also a range of over-the-counter medicines for people with acid reflux, including antihistamines and antacids which reduce the symptoms of the condition.

The following options are generally recommended before progressing to surgical approaches for acid reflux sufferers:

  • Certain foods may cause or aggravate the condition (note that problem foods are different for everyone). Many sufferers have relief of the symptoms by avoiding or eliminating one or more of the following:
    • Highly processed foods.
    • High fat foods.
    • Spicy foods.
    • Coffee.
    • Chocolate.
  • Making sure there is at least a three-hour period between eating and lying down / going to bed.
  • Stopping smoking.
  • If overweight, reducing weight.
  • Avoiding eating large meals, and replacing them with more frequent smaller 'snack' size meals.
  • Chewing food thoroughly.
  • Giving up (or reducing consumption of) alcohol.
  • Staying upright at least three hours after a meal.
  • Changing the angle of the bed – raise the bed head or mattress at the head end by 15-20cm.

Other Symptoms

Some symptoms which may appear similar to the symptoms listed above may indicate a much more serious condition.

If you develop any of the following conditions you are strongly advised to visit your doctor or otherwise seek immediate medical assistance:

  • Blood present in either vomit or in bowel motions.
  • Pain in the chest.
  • Any difficulties when eating e.g. choking, problems swallowing (dysphagia), food feeling 'stuck' after swallowing.
  • Unexplained loss of weight.

When to contact Dr Silverman

If you have already undertaken surgery and are now experiencing Acid Reflux, please promptly arrange a consultation with Dr Silverman.