Feeling the burn from that last meal? Let’s talk about why that happens and how to make it stop.

Defining Acid Reflux

When you eat, food travels from your mouth down a long pipe called your esophagus that runs from your throat down through your chest to your stomach. The esophagus has a ring of muscle at the bottom where it meets your stomach. This muscle is called your lower esophageal sphincter (LES). Your LES acts as a one-way valve to allow food from your esophagus to enter your stomach and prevent stomach contents from backing up into your esophagus.

When your LES is not working properly, stomach contents can backflow into your esophagus. If your stomach contents only consisted of food, you would probably never notice the backflow. However, there’s more than just food in your tummy.

The cells lining your stomach wall secrete a substance called hydrochloric acid or stomach acid. This might sound frightening, but the hydrochloric acid serves some valuable purposes:

  • Aids in the breakdown of food.
  • Activates digestive enzymes.
  • Protects you from harmful bacteria and microorganisms that may be in your food.

The lining of the esophagus is not designed to tolerate stomach acid.

When stomach contents backflow into the esophagus, it is called gastroesophageal reflux, or GER. Most people experience this at least a few times in their lives. If this happens frequently, such as two or more times a week, it is called gastroesophageal reflux disease, or GERD. Approximately 20 percent of adults and 10 percent of children in the United States suffer from GERD.

Symptoms of Acid Reflux

How do you know if your discomfort is acid reflux? The most common symptoms include:

  • Asthma symptoms. The nerves in the esophagus connect to nerves in the lungs. Acid in the esophagus can trigger asthma symptoms like a chronic cough, shortness of breath, and wheezing. These asthma symptoms are usually more noticeable after eating.  
  • Backwash. Acid traveling back into your esophagus may give you a sour taste in your mouth or the back of your throat. You may also experience “wet burps,” where acid comes up into your throat or mouth when you burp.  
  • Burning sensation. Acid can burn the sensitive tissue in your esophagus. If you feel this sensation in your chest, it’s called heartburn. It is called indigestion if you feel the burning in your upper stomach.  
  • Chest pain. Pain in the esophagus stimulates the same nerves that heart pain stimulates so that acid reflux can feel like heart pain. If you have new chest pain, you should seek medical attention immediately.
  • Hoarseness. You may have a hoarse or raspy voice if the acid irritates your vocal cords.
  • Nausea or vomiting. The acid in your esophagus or delayed stomach emptying may cause nausea or vomiting.
  • Sore throat. Acid may backflow up your esophagus to your throat, making it feel sore. You might have trouble swallowing without pain or feel like there is a lump in your throat.

If you have any of these uncomfortable symptoms, come see us at MainStreet Family Care. We’d love to help you find relief!

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Risk Factors for Acid Reflux

Anything that causes your LES to relax and allow stomach contents to backflow into your esophagus is a risk factor for acid reflux. Let’s talk about some of the most common risk factors below.

Hiatal Hernia

A hiatal hernia occurs when part of your stomach moves up through a hole in your diaphragm. This usually occurs at the same location that your esophagus runs through the diaphragm.

A hernia can push your LES above the diaphragm, weakening it and making it less able to prevent stomach contents from backflowing into the esophagus. When the hernia presses against the esophagus, it can trap acid and make it more painful for longer.  

Food and Eating Habits

Certain foods may have a relaxing effect on your LES if consumed in large quantities. The most common culprits include:

  • Acidic juices
  • Alcohol
  • Carbonated beverages
  • Chocolate
  • Coffee
  • Fatty foods
  • Garlic
  • Mint
  • Onions
  • Spicy foods

Your eating habits may also place you at risk for acid reflux. For example, eating large meals can cause your stomach to overexpand and put pressure on your LES, leading to acid reflux. Also, lying down soon after eating puts pressure on your LES and may allow acid into your esophagus.

Some Medications

Some medications can relax your LES and contribute to acid reflux. Some examples include:

  • Antidepressant medications such as amitriptyline.
  • Asthma medications such as theophylline.
  • Blood pressure and heart medications such as calcium channel blockers, nitrates, and statins.
  • Hormone supplements such as estrogen and progesterone.
  • Pain medications such as codeine and hydrocodone.
  • Sedatives such as diazepam and temazepam.

Obesity

Being overweight, especially in your abdomen, can weaken your diaphragm muscles and lead to a hiatal hernia. Fat cells release the hormone estrogen, which relaxes your LES.

Pregnancy

Acid reflux during pregnancy is common for many reasons. Pregnancy hormones such as estrogen, progesterone, and relaxin can cause your LES to relax. Also, the large volume in the abdomen can reduce the contraction of your LES. Fortunately, pregnancy-related acid reflux is temporary and tends to resolve after delivery.

Smoking

If you need another reason to quit smoking, here are four. Cigarette smoke:

  • Causes a chronic cough, which opens your LES.
  • Causes more stomach acid production.
  • Relaxes your LES.
  • Weakens your diaphragm muscles and may lead to a hiatal hernia.

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Diagnosing GERD

Your healthcare provider will review your symptoms and risk factors for acid reflux.

If one of your symptoms is new chest pain, they may perform tests to rule out other possible problems, like heart disease, pneumonia, or a pulmonary embolus (a blood clot in your lungs). These tests may include blood work, an EKG (a picture of the electrical activity in your heart), and a chest X-ray.  

If your symptoms are not conclusive or do not respond to lifestyle changes or medications, your healthcare provider may suggest testing to diagnose GERD, such as:

  • Esophageal manometry measures the muscle contraction activity in your esophagus to evaluate if they are working correctly.
  • Esophageal pH test measures the amount of acid in your esophagus.
  • Esophagram takes x-ray pictures of your esophagus while you swallow. This may also be called a swallow study.
  • Upper endoscopy, in which your healthcare provider can look at the inside of your esophagus using a camera that enters through your mouth. You will be sedated for the procedure and not feel any pain or discomfort.

Complications from Acid Reflux

Rare or occasional acid reflux (GER) will not likely have any long-term complications. However, chronic acid reflux (GERD) can cause some complications, including:

  • Asthma. Acid reflux can irritate your airways and worsen existing asthma or cause new-onset asthma.
  • Barrett’s esophagus. If your esophagus is repeatedly exposed to acid, it causes inflammation and changes to the cells in the esophagus. Barrett’s esophagus is a risk factor for esophageal cancer.
  • Esophageal stricture. Scar tissue can form in the esophagus from repeated exposure to acid. This scar tissue can cause narrowing and make it difficult to swallow food and beverages.
  • Esophagitis. Repeated exposure to acid in the esophagus can cause inflammation, chronic pain, and ulcers called esophagitis. Long-term esophagitis can lead to cancer due to the inflammatory cell changes and esophageal strictures from scar formation.
  • Laryngopharyngeal reflux. Acid reflux that regularly travels high enough to reach the vocal cords can cause growths on the vocal cords and a hoarse voice.

Acid Reflux Treatment

There are three primary methods for treating GERD: home remedies, medications, and surgery.

Acid Reflux Home Remedies

You can try relieving acid reflux by reducing your risk factors. For example:

  • Avoid or reduce the quantity of foods that trigger acid reflux for you.
  • Eat dinner earlier to avoid lying down with a full stomach.
  • Eat smaller meals to prevent a full stomach from putting pressure on your LES.
  • Elevate the head of your bed when you lie down.
  • Lose weight if you are overweight to reduce the pressure in your abdomen and reduce the amount of LES relaxing estrogen you produce.
  • Sleep on your left side to put your LES in a position above your stomach contents.
  • Stop smoking.
  • Take a walk after eating to help you remain upright and promote food digestion.
  • Take small sips of water after eating to help wash acid down.
  • Try an over-the-counter medications and antacids such as Tums® or Rolaids®.

If you take an antacid twice a week or more, it’s time to see your healthcare provider. MainStreet Family Care can help if you are not getting relief with home remedies.

Acid Reflux Medications

If you are not obtaining relief from acid reflux pain with home remedies, or if your acid reflux is severe and interfering with your daily activities, you may need prescription medication. There are two primary classes of GERD medications:

  • Histamine receptor antagonists, or H2 blockers, block histamine production. Histamine is a chemical that signals your stomach to produce stomach acid. H2 blockers work well if your acid reflux is due to excessive stomach acid.
  • Proton pump inhibitors, or PPIs, block the production of stomach acid by interfering with the production process at the cellular level in the stomach lining. PPIs are more effective than H2 blockers and might be your healthcare provider’s first choice of medication if your GERD is severe.

Prokinetic agents, such as baclofen, may be taken in addition to an H2 blocker or a PPI. Baclofen helps move food along the digestive tract by stimulating contractions.

Acid Reflux Surgery

If your acid reflux is severe, you may need surgery. Even if you are getting pain relief with medications, surgery may be necessary to prevent long-term complications mentioned earlier.

The two most common surgical procedures are outpatient procedures with a fast recovery time.

  • LINX Reflux Management System is a ring of magnets placed around the LES to prevent acid reflux. When you swallow, the magnets temporarily pull apart to allow contents from the esophagus to enter the stomach and then close back to prevent backflow into the esophagus.  
  • Nissin fundoplication is a procedure in which the surgeon wraps the top of your stomach around your LES and then tightens the LES with stitches to prevent backflow into the esophagus.

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Step 2: Schedule Your First Appointment 

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Turn to MainStreet Family Care

Looking for relief from acid reflux? MainStreet primary care services can help!

Schedule an appointment today through your patient portal. We’re open seven days a week with extended hours and multiple locations for your convenience. We can often schedule same-day or next-day appointments!