This Factsheet Is About Heartburn & Acid Reflux
Heartburn is extremely common, affecting up to 25% of UK adults. It is a chest pain that occurs after eating, lying down or bending over and is most usually described as burning. The pain is located at the lowest end of the breastbone in the centre of the chest with the discomfort often rising upwards and outwards.
Acid reflux is the regurgitation of some stomach contents including gastric acid into the oesophagus and is the major symptom of gastroesophageal reflux disease. Reflux mostly occurs without us being aware that it is happening.
Understanding The Oesophagus And Stomach
When we eat, food passes down the gullet into the stomach. Cells in the lining of the stomach make acid and other chemicals which help to digest food. Stomach cells also make mucus which protects them from damage from the acid. The cells lining the oesophagus are different and have little protection from acid.
There is a circular band of muscle at the junction between the oesophagus and stomach. This relaxes to allow food down but then normally tightens up and stops food and acid leaking up into the oesophagus. In effect, the sphincter acts like a valve.
Acid Reflux and Oesophagitis
Signs Of Deficient Stomach Acid
- Gas, bloating and burping shortly after a meal
- Feeling of fullness or food not digesting
- Heartburn and/or gastric reflux
- Bad breath
- Loose stools in the early morning
- Food allergies
- Dialated blood vessels on the cheeks and nose – Rosacea
- Pernicious anemia or iron deficiency
- Anal Itching
- Nausea especially after taking vitamins and minerals
- Weak or cracked nails
- Parasites – or at least increased susceptibility to parasitic infections
- Chronic yeast infections
- Acne in adults – especially if you have other symptoms from the list
Since low levels of stomach acid result in poor absorption of nutrients, many symptoms that accompany a deficiency of that vitamin or mineral makes this list much longer. The nutrients most affected are calcium, iron, folic acid, vitamin K and many B vitamins.
If you’re nervous about trying supplemental hydrochloric acid, you can do a trial with 1-2 TBSP of organic apple cider vinegar mixed with 1/8 to 1/4 cup of water after a meal. If it makes you feel better and does not hurt, you most likely would benefit from taking 300 – 500 mg of Betaine HCl with your meals. Start slowly and work up to this.
If you are afraid of HCl, you can take a dropperful of Gallbladder Bitters with your meals which stimulates digestive juices including both HCl and bile. To curb sugar cravings, take the bitters after your meal as well.
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Not All Of Them Are Obvious
Feel like you just cant keep that nasty stuff in your belly from bubbling up into your throat? What youre experiencing might not be run-of-the-mill heartburn. It could be a case of gastroesophageal reflux diseaseGERD, for shorta condition that causes the acid and food in your stomach to rise into your esophagus, and sometimes even enter your mouth or lungs. GERD is far from rare: In fact, it occurs in 20 percent of the U.S. population, according to the medical journal Gastroenterology. But there are also several factors that make some people an easier target for the disease.
Everyone has a small, normal amount of gastroesophageal reflux, but an abnormal amount of acid reflux occurs when the one-way valve between the esophagus and the stomach, called the lower esophageal sphincter, becomes too loose, says Ketan Shah, M.D., gastroenterologist at Saddleback Medical Center in Laguna Hills, California. This can occur for multiple reasons that cause intra-abdominal pressure to be abnormally elevated, including being overweight or obese, frequent overeating, lying down too soon after eating, chronic straining or coughing, or chronic heavy lifting. These are typically the people who are more susceptible to GERD.
Heartburn won’t go away
Heart Attack Feeling
Treating And Managing Chronic Reflux
Factors such as overeating, exercising and sleeping after meals, and certain foods and drinks like spicy foods, fatty foods, alcohol, chocolate and acidic foods do NOT cause chronic acid reflux . Instead these are contributing factors to acute attacks. Unless the causes above are not addressed, chronic reflux will persist for years or even decades. In the chronic state, the reflux often goes unnoticed except for acute attacks and complications such as LPR reflux.
Medication is essential in treating and managing chronic acid reflux. Acid suppressing drugs like proton pump inhibitors and H2-blockers reduces gastric acid secretion. Antacids help to neutralize the stomach acid and provides quick symptomatic relief. Sucralfates help to protect the lining of the esophagus. Prokinetic drugs speed up gastric emptying and esophageal clearance. This is discussed further under Stomach Acid Medication.
Conservative measures are however essential for the long term management of chronic reflux. This includes the eating guidelines and meals tips outlined in the acid reflux diet. Elevating the head of the bed by a few inches will also help with night time flare ups. Weight loss is an important component of management in overweight and obese patients.
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What Else Should I Know
Early diagnosis and treatment can help reduce or even stop uncomfortable GERD symptoms. Untreated GERD can cause permanent damage to the esophagus.
You’ll probably find that one of the simplest ways to make living with GERD easier is to avoid the things that trigger your symptoms. Some people will have to limit certain foods others may have to give them up entirely. It all depends on your symptoms.
It can be hard to give up sodas or favorite foods at first. But after a while, lots of people discover that they feel so much better that they don’t miss the problem foods as much as they thought they would.
Heres How To Control Your Symptoms
When your symptoms flare up, there are a few things you can try:
- Avoid foods that trigger your heartburn, especially in the afternoon or evening
- Elevate the head of your bed to enlist gravity to help fight regurgitation
- Take over-the-counter antacids like Tums or Rolaids, or acid suppressors such as Prilosec, Nexium, or Pepcid
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Causes And Risk Factors
The food pipe becomes narrower just before it reaches the stomach. This narrow part is normally kept shut by the muscles in the food pipe and diaphragm. But this doesn’t work properly in GERD. It is often not clear why.
In some people it is caused by a hiatal hernia . The diaphragm is a sheet of muscle that separates the chest and abdominal cavities from each other. The food pipe passes through a small hole in the diaphragm and enters the stomach just below it. In people who have a hiatal hernia, the upper part of the stomach pushes up through the hole in the diaphragm and into the chest cavity. As a result, the diaphragm can no longer help to close the entrance to the stomach.
There is some debate about whether being overweight, smoking and drinking alcohol can affect the sphincter or the risk of reflux and heartburn. Many of those affected say that their symptoms are triggered or made worse by stress or by certain foods or drinks. The symptoms may also get worse after physical activities or through certain positions, such as bending forward or lying down.
Sometimes reflux symptoms and heartburn are caused by a problem with the food pipe. For instance, the food pipe might not move rising stomach juices back down into the stomach fast enough, or it might react very sensitively. The symptoms can also be made worse by medications such as birth control pills and certain drugs against high blood pressure.
Heartburn And Gerd In Pregnant Women
Heartburn and GERD are commonly associated with pregnancy and can occur in women who may never have had GERD symptoms before. Pregnant women usually experience GERD symptoms around the first trimester. It then worsens in the last trimester. The good news is that when your baby is born, your symptoms usually go away.
Pregnancy can increase levels of the hormone progesterone, which can cause the muscles of the lower esophagus to relax. This makes it more likely that acid will reflux. Increased pressure on the stomach from a growing uterus can also increase a womans likelihood for having GERD.
Symptoms include pain that gets worse after a meal and acid regurgitation. Because the symptoms tend to be temporary, a woman usually doesnt experience the long-term complications associated with GERD, like ongoing inflammation.
Doctors usually avoid prescribing too many medications while a woman is pregnant because the medicine can be passed along to the fetus. Instead, doctors usually recommend making lifestyle changes, such as avoiding foods known to cause acid reflux and sleeping with the head slightly elevated. Taking antacids that contain magnesium, aluminum, and calcium may be permitted. However, antacids with sodium bicarbonate should be avoided in pregnant women because they can affect a womans fluid volumes.
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Overeating And Back Pain
Dumping large amounts of food in your stomach puts enormous strain on the digestion.
The tell-tale signs of digestive distress as a result of overeating are stomach aches, bloating and indigestion.
As the stomach bloats and expands it puts stress on the spine and back muscles causing discomfort and pain.
But you can easily remedy the problem with a simple lifestyle change.
Rather than sitting down to 3 heavy meals a day or binge eating at the down town all you can eat buffet…
You can still eat as much as by eating smaller quantities frequently throughout the day.
Your digestion will thank you for it as its better able to cope with smaller quantities of food and liquid.
What Lifestyle Changes Relieve Heartburn
There are several ways to treat and avoid heartburn with lifestyle changes .
Lose weight and maintain your ideal weight. Excess weight increases the pressure on the stomach, increasing the chance of acid reflux into the esophagus.
Avoid foods that aggravate heartburn and replace them with healthy foods. Avoid foods that trigger heartburn . Consider keeping a food journal to alert you to foods that make your heartburn worse. Decrease the amount of food you eat.
Elevate the head of the bed: If you are experiencing heartburn at night, elevating the head of the bed will decrease reflux.
Tips To Keep Heartburn On The Backburner
To prevent occasional bouts of heartburn, try taking the following five steps:
1. Avoid eating within three hours of the time you go to bed.
2. Take any acid suppressant medication, such as a proton pump inhibitor, first thing in the morning. “Because of the way proton pump inhibitor-type medications activate, it’s not helpful to take these medications at night on an empty stomach,” says Brown.
3. Sleep on a slight incline, with your head elevated, and/or sleep on your left side. If you have chronic heartburn, falling asleep in the wrong position enables acid to sneak into the esophagus. Keeping your head raised slightly keeps that from happening. Studies have also found that while sleeping on the right side actually aggravates heartburn, flipping over to your left side is likely to calm it, although the reason why is unknown.
4. Avoid foods that may cause acid reflux, such as peppermint, coffee and chocolate. “Interestingly, spicy foods haven’t been shown to cause heartburn,” says Brown. “And there’s some evidence that spicy foods may actually protect the body from ulcers.”
5. If you smoke or use other tobacco products, quit. Not only does smoking relax the lower esophageal sphincter, allowing stomach acid to move up into the esophagus where it doesn’t belong, but it also can slow the production of saliva, which protects against acid in the esophagus.
Alginate Drugs Such As Gaviscon
Gaviscon is probably the best-known heartburn therapy. It has a different mode of action than antacid drugs. Alginate drugs such as Gaviscon vary slightly in composition, but they usually contain an antacid.
The alginic acid works by creating a mechanical barrier against the stomach acid, forming a foamy gel that sits at the top of the gastric pool itself.
Any reflux is then relatively harmless as it consists of alginic acid and not damaging stomach acid.
The active ingredientalginateis found naturally in brown algae.
If you want to buy Gaviscon, then there is an excellent selection available online.
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Diseases Associated With Low Stomach Acid
- Sjogren’s Syndrome
Interestingly, even though one with low stomach acid might experience indigestion just after a meal, later on you could experience a feeling of too much acidity and wake in the night from this as well. This overproduction of acid later on can still be associated with low stomach acid. Try supplemental HCl for a few days and watch to see if these symptoms subside. They should decrease gradually.
What Kinds Of Complications Are Caused By Frequent Heartburn
- Excess stomach acid in the esophagus can cause ulcers, damage to the inner layers of the esophageal wall, and narrowing .
- Very rarely, the esophagus may bleed or tear completely because it is so damaged. In severe cases, a person may vomit blood or have small amounts of blood in bowel movements, found only on testing the stool.
- Regurgitated stomach acid can damage the respiratory tract, causing asthma, hoarseness, chronic cough, sore throat, or tooth damage . A person may feel as if he or she has a lump in the throat.
- If the acid exposure continues for long periods of time, the esophagus becomes thick and damaged. A person may then have difficulty swallowing and food becomes stuck.
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Don’t Lie Down Too Soon After Eating
Lying down with a full stomach can cause stomach contents to press harder against the lower esophageal sphincter , increasing the chances of refluxed food. Try these tips:
- Wait at least two to three hours after eating to go to bed.
- Avoid late-night snacking.
- If one of your meals ends up being larger than the others, aim to eat that meal for lunch instead of supper.
Heartburn Acid Reflux And Gerd
The terms heartburn, acid reflux, and GERD are often used interchangeably. They actually have very different meanings.
Acid reflux is a common medical condition that can range in severity from mild to serious. Gastroesophageal reflux disease is the chronic, more severe form of acid reflux. Heartburn is a symptom of acid reflux and GERD.
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Ways To Relieve Acid Reflux Without Medication
A few lifestyle changes are worth trying before resorting to drugs for controlling gastroesophageal reflux.
If you are sounding a little hoarse and have a sore throat, you may be bracing for a cold or a bout of the flu. But if you’ve had these symptoms for a while, they might be caused not by a virus but by a valveyour lower esophageal sphincter. That’s the muscle that controls the passage between the esophagus and stomach, and when it doesn’t close completely, stomach acid and food flow back into the esophagus. The medical term for this process is gastroesophageal reflux the backward flow of acid is called acid reflux.
Acid reflux can cause sore throats and hoarseness and may literally leave a bad taste in your mouth. When acid reflux produces chronic symptoms, it is known as gastroesophageal reflux disorder, or GERD. The most common symptom of GERD is heartburnpain in the upper abdomen and chest that sometimes feel like youre having a heart attack.
Three conditionspoor clearance of food or acid from the esophagus, too much acid in the stomach, and delayed stomach emptyingcontribute to acid reflux, says Dr. Jacqueline Wolf, a gastroenterologist and associate professor of medicine at Harvard Medical School and author of A Woman’s Guide to a Healthy Stomach: Taking Control of Your Digestive Health.
If you’ve been having repeated episodes of heartburnor any other symptoms of acid refluxyou might try the following:
How Is Gerd Diagnosed
Usually your provider can tell if you have simple acid reflux by talking with you about your symptoms and medical history. You and your provider can talk about controlling your symptoms through diet and medications.
If these strategies dont help, your provider may ask you to get tested for GERD. Tests for GERD include:
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What You Should Know About Gerd
When the one-way valve that connects your esophagus to your stomach malfunctions and does not close properly, it allows acid and stomach juices to come back up into your esophagus. You know, its that acidic sour liquid you get in your mouth from time to time when you try to sleep.
You have probably tried all types of OTC antacids, but it only helps for a while. GERD is not a temporary type of indigestion or heartburn, nor is it the result of your diet. It is a disease called gastroesophageal reflux disease. When it happens chronically, or more than 2 times per week, it may have lasting complications.
Dont live with and ignore the common symptoms like bad breath, sore throat, regurgitation, cough, chest pain, difficulty swallowing, and indigestion.
Acid Reflux Bad Breath
GERD bad breath is an unpleasant manifestation of chronic heartburn. When stomach acid ends up in the mouth cavity, it can erode hard tissues and tooth enamel. This creates cavities that trap food where bacteria can feed and multiply.
Often, your dentist can tell whether bad breath is caused by acid reflux or because of poor dental hygiene and smoking that also cause dysbiosis of the oral microbiome. GERD patients tend to have teeth erosion, redness around the tonsils, tongue and gum irritation, and sour breath.
TIPProper dental hygiene and over-the-counter medications can usually alleviate bad breath in a week or so.
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