There are several possible causes or risk factors that determine whether or not a person develops acid reflux, also called gastroesophageal reflux disease (GERD), including a malfunction of the lower esophageal sphincter (LES). The lower esophageal sphincter is a ring of muscle surrounding the lower part of the esophagus where it meets the stomach. As this muscle contracts, it prevents the passage of foods and acids from the stomach from backing up into the esophagus causing that burning sensation.
Normally, this muscle relaxes temporarily when we eat, allowing food to pass into the stomach, and then closing again. An abnormal relaxation of the LES may last for several minutes, usually after meals, which allows for the backflow of acid to enter the esophagus. Abnormally weak contractions of the esophageal sphincter are another cause as this condition allows acids from the stomach to pass into the esophagus.
While the exact causes for a hiatal hernia aren’t clear, several theories exist as to why this condition may contribute to acid reflux disease. With this type of hernia, a small part of the stomach that’s attached to the esophagus pushes through the diaphragm, causing the LES to malfunction. Normally, there is a flap of tissue between the esophagus and stomach that acts as a valve, but when this type of hernia is present, this part of the esophagus is pulled up into the chest area, preventing this valve-like structure from working properly.
Acid reflux disease may be a serious issue for some pregnant women. Elevated hormone levels may be to blame for decreased pressure in the LES, while the growing fetus may cause an increase in abdominal pressure making the condition worse.
Symptoms of Acid Reflux Disease
– Heartburn: A burning sensation usually in the middle of the chest that occurs most often after eating and worsens when lying down. In severe cases, the pain may be sharp, mimicking heart pain.
– Nausea: Although not as common as heartburn, nausea may be accompanied by vomiting in people with acid reflux disease.
– Regurgitation: Small quantities of acids and digested foods in liquid form may back up into the esophagus and throat, passing through the upper esophageal sphincter (UES).
More serious complications of acid reflux disease include ulcers, a chronic cough, asthma, sinusitis, and a condition known as Barrett’s esophagus.
Treatment and Prevention
Medication to inhibit the production of acid produced by the stomach is commonly used to alleviate symtptoms of acid reflux disease. Non-prescription medication such as antacids, which may either be aluminum, magnesium, or calcium-based, are used to help to neutralize the acids in the stomach.
Making certain lifestyle changes, particularly in the types foods we eat, is perhaps one of the simplest ways to prevent or lessen acid reflux. Changes in eating habits are extremely important when dealing with a condition such as acid reflux disease as certain foods are known for causing an excess of acid production and should be avoided, including chocolate, caffeine, alcohol, fatty foods, and foods with a high acid content such as tomatoes and citrus fruits.
Since a reflux of acid occurs easier and more commonly when lying down, elevating the head of the bed, or sleeping on a wedge pillow helps to reverse the effects of gravity. For this to be effective, the upper body as well as the head must both be elevated.
For more severe cases of acid reflux disease, surgery may be necessary using a procedure known as a fundoplication or anti-reflux surgery. This effective surgical procedure is done using a laparoscope and a tiny incision in the abdomen and usually brings relief in 80% of patients for as long as five to ten years.
