Acid reflux and heartburn stem from Gastro-oesophageal Reflux Disease (GORD), a common condition. GORD occurs when stomach acid escapes into the oesophagus, causing discomfort that can extend to the throat.
Triggers
Various factors can contribute to acid reflux and heartburn. The most prevalent is a malfunctioning lower oesophageal sphincter, a ring of muscles serving as a valve. If this sphincter doesn't seal properly, it allows stomach acid to flow upwards.
There are known triggers for these conditions, including:
- Being Overweight: Excess weight adds pressure on the stomach, weakening the lower oesophageal sphincter and facilitating acid reflux.
- Pregnancy: Fluctuating hormones during pregnancy can weaken the lower oesophageal sphincter.
- High-Fat Diet: Digesting fatty meals prolongs stomach acid disposal.
- Tobacco, Coffee, Alcohol or Chocolate: These substances can relax the lower oesophagus sphincter.
- Hiatus Hernia: When a part of the stomach protrudes through the diaphragm.
- Certain Medications: Calcium-channel blockers, nitrates and non-steroidal anti-inflammatory drugs can contribute to acid reflux and heartburn.
- Stress
- Eating Large Meals or Lying Down After Eating
Symptoms
Acid reflux typically results in regurgitated stomach acid in the throat and mouth, leading to a sour or acidic taste.
Heartburn, on the other hand, manifests as a burning pain beneath the breastbone, which can extend into the chest and throat. This pain is often more pronounced after meals, bending over or lying down.
For occasional, food-related symptoms, self-diagnosis and treatment may suffice. However, if symptoms worsen or become more frequent, consult a medical professional.
Less common symptoms from regurgitated stomach acid include:
- Nausea
- Nighttime cough
- Wheezing
- Chest pain
- Tooth decay
- Laryngitis
If you experience any of these, consult your GP.
Diagnosis
Doctors can diagnose GORD through symptoms and medical history for mild, infrequent cases associated with known causes. However, a physical examination is required for symptoms like pain or difficulty swallowing, ineffective prescription medication, new symptoms or serious symptoms such as severe pain or blood in stools.
Diagnostic methods include:
- Endoscopy: A flexible tube with a camera to visualise the oesophagus for damage.
- Manometry: A small tube with pressure sensors to assess sphincter function.
- Barium Swallow Test: Ingesting barium solution for X-ray detection of blockages or muscle problems.
- 24-hour pH Monitoring: Measures acidity levels around the oesophagus over 24 hours.
Treatments
Treatment options vary, with over-the-counter medications like Pepto Bismol, Maalox, and antacids suitable for mild cases. Proton-pump inhibitors (PPIs) like omeprazole are effective in reducing stomach acid production. H-2 antagonists such as famotidine can also block acid production.
If medications prove ineffective or long-term use is undesirable, consult your GP about potential surgical options.
Prevention
Taking steps to reduce the risk of acid reflux and heartburn includes:
- Losing Weight: Reducing pressure on the stomach can alleviate symptoms.
- Eating Smaller, Frequent Meals: Avoid three large meals and eat your last meal 3-4 hours before bedtime.
- Avoiding Trigger Foods: Cut out alcohol, coffee, chocolate, fatty or spicy foods.
- Quitting Smoking: Smoking irritates the digestive system, exacerbating symptoms.
- Elevating the Bed: Raise the head of your bed to reduce symptoms.
- Reviewing Medications: Discuss with your GP if any medication may be causing your symptoms.
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