How Is Acid Reflux Disease Diagnosed
Its time to see your doctor if you have acid reflux symptoms two or more times a week or if medications dont bring lasting relief. Symptoms such as heartburn are the key to the diagnosis of acid reflux disease, especially if lifestyle changes, antacids, or acid-blocking medications help reduce these symptoms.
If these steps dont help or if you have frequent or severe symptoms, your doctor may order tests to confirm a diagnosis and check for other problems. You may need one or more tests such as these:
- Barium swallow can check for ulcers or a narrowing of the esophagus. You first swallow a solution to help structures show up on an X-ray.
- Esophageal manometry can check the function and movement of the esophagus and lower esophageal sphincter.
- pH monitoring can check for acid in your esophagus. The doctor inserts a device into your esophagus and leaves it in place for 1 to 2 days to measure the amount of acid in your esophagus.
- Endoscopycan check for problems in your esophagus or stomach. This test involves inserting a long, flexible, lighted tube with a camera down your throat. First, the doctor will spray the back of your throat with anesthetic and give you a sedative to make you more comfortable.
- A biopsymay be taken during endoscopy to check samples of tissue under a microscope for infection or abnormalities.
First What Is Acid Reflux
To understand why stomach acid might move in the wrong direction, lets start with a quick anatomy refresher: The tube that stems from your mouth to your stomach is your esophagus, and at the very end of your esophagus is your lower esophageal sphincter , which is a bundle of muscle that acts as a valve above your stomach1.
This valve allows food to pass through into the stomach and, when operating properly, prevents powerful stomach acidswhich break down what you just atefrom splashing back up into the esophagus.
Thats the ideal operation. But when theres weakness or relaxation in your LES, then the valve doesnt close as tightly as it should. Thats when youre at higher risk of stomach acid and partially digested food coming up into the esophagus. This upward flow is called gastroesophageal reflux, according to the National Institue of Diabetes and Digestive and Kidney Diseases .
Many people who arent familiar with acid reflux may assume the issue is happening just near the stomach, but acid can come all the way up the esophagus, especially if youre lying down, Gokulakrishnan Balasubramanian, M.D., a gastroenterologist who focuses on esophageal, neurogastroenterology, and motility disorders at the Ohio State University Wexner Medical Center, tells SELF. For example, you may get acid damage in the vocal cords or trachea, and that acid may then go down into the lungs as well, so you could have coughing or other respiratory symptoms.
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 wonât go away
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What Are The Long
Long-term acid reflux may lead to GERD, which is a more chronic form of acid reflux. Over time, this can damage the esophagus, leading to a condition known as Barrettâs esophagus, which is typically a precursor to esophageal cancer. On average, less than 10% of GERD patients have some form of esophageal cancer.
Are There Any Tests For Heartburn
If it is obvious from the symptoms that a person has heartburn, no tests or exams may be necessary. Advice in regard to lifestyle modifications, diet, or medications may begin immediately.
If your health care professional is not sure about the diagnosis, or if he or she is concerned about damage done by chronic heartburn, tests may be ordered. This is true especially if the patient has already been prescribed medications that are not relieving the heartburn.
There is no simple blood test for heartburn. The tests used to diagnose heartburn include the following:
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Whats The Difference Between Heartburn Vs Acid Reflux
Heartburn is just what that term implies: You feel a burning pain in your chest just behind the breastbone. Asking whether you have heartburn or acid reflux is actually a trick question because heartburn is simply considered a symptom of acid reflux, per the NIDDK. If you have heartburn, youre experiencing some form of reflux. Its similar to asking whether you have swollen gums or gingivitisthe former is a symptom of the latter.
However, not everyone who has acid reflux experiences heartburn, just as you may not have swollen gums even though you struggle with gingivitis. But its more likely that you will deal with heartburn since its the most common symptom of acid reflux, says Dr. Balasubramanian. Heartburn implies that your acid reflux has come up to the level of your heart, and its usually worse after eating common trigger foods like chocolate or tomatoes or when lying down after eating or drinking. You may also have a bitter or acidic taste in the mouth, which Dr. Balasubramanian says is an effect of the acid traveling higher up your throat.
Dont Drink Too Much Citrus Juice
Many types of citrus juice, including orange juice and grapefruit juice, are considered common triggers for heartburn .
These ingredients are highly acidic and contain compounds like ascorbic acid, which could cause indigestion if you consume them in large amounts .
In addition to being acidic, certain compounds found in citrus juice could irritate the lining of the esophagus .
While citrus juice probably doesnt cause acid reflux directly, it could make your heartburn worse temporarily.
Some people with acid reflux report that drinking citrus juice makes their symptoms worse. Certain compounds in citrus juice, in addition to acids, can also irritate the lining of the esophagus.
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Diagnosing Heartburn Acid Reflux And Gerd
Although your health care provider will probably be able to tell whether you have heartburn, acid reflux, or GERD based on your symptoms and a physical exam, they may choose to perform certain procedures to enable a more in-depth examination of the esophagus and stomach. These procedures may include:
- Upper endoscopy: This procedure uses a flexible, lighted tube, inserted through the mouth, to assess the esophagus and stomach for signs of damage. An endoscopy can also be used to perform a biopsy to evaluate for signs of Barretts esophagus.
- Esophageal manometry: This esophageal motility study assesses the strength and coordination of the esophageal muscles and LES during swallowing to measure the ability of the esophagus to move food to the stomach efficiently.
- Barium swallow: After drinking a chalky liquid, X-rays are taken to view the esophagus, stomach, and duodenum to assess for changes related to GERD.
Questions To Ask Your Doctor About Frequent Heartburn
You have gastroesophageal reflux disease . This condition causes food or stomach acid to come back up from your stomach into your esophagus. This is known as acid reflux. It can cause heartburn and other symptoms.
Below are some questions you should ask your doctor or nurse to help you take care of your heartburn and reflux.
- If I have heartburn, can I treat myself or should I need the doctor?
- What foods will make my heartburn worse?
- How can I change the way I eat to help my heartburn?
- How long should I wait after eating before lying down?
- How long should I wait after eating before exercising?
- Will losing weight help my symptoms?
- Do cigarettes, caffeine and alcohol make my heartburn condition worse?
- What changes should I make in my bed, if I have nighttime heartburn?
- What medicines will help my heartburn?
- Will antacids help my heartburn?
- Are there other drugs or medicines which can help my symptoms?
- Do I need a prescription to buy them?
- Do they have any side effects?
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How Is Heartburn Diagnosed
Often all that a health-care professional requires is a thorough history and physical to make the preliminary diagnosis of heartburn. To evaluate if there is any damage and how severe your heartburn is, the doctor my suggest some of the following tests:
- Endoscopy: A flexible scope is passed down the esophagus to examine the esophagus as well as the stomach. Biopsies can be taken if indicated. This lets the doctor see if there is any obvious damage, and also eliminate other reasons for the patient’s symptoms .
- Upper GI series : After drinking a liquid that coats the inside of the digestive tract, X-rays are taken. These X-rays will show the outline of the digestive system.
- Ambulatory pH testing: This test measures the acidity in the esophagus via a small tube that goes through the nose into the stomach.
What Do I Do If I Think I Have Gerd
With GERD when reflux and heartburn happen more than once in a while the tissue lining your esophagus is getting battered regularly with stomach acid. Eventually the tissue becomes damaged. If you have this chronic acid reflux and heartburn you can see its affecting your daily eating and sleeping habits.
When GERD makes your daily life uncomfortable in this way, call your healthcare provider. Although GERD isnt life-threatening in itself, its chronic inflammation of the esophagus can lead to something more serious. You may need stronger prescription medications or even surgery to ease your symptoms.
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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.
Acid Reflux Heartburn & Gerd: The Symptoms Causes And Treatments Explained
Find out more about acid reflux symptoms, acid reflux causes and also acid reflux treatment options as we explain in depth about these topics in this video.
What causes heartburn or acid reflux?Acid reflux occurs when the sphincter muscle at the lower end of your esophagus relaxes at the wrong time, allowing stomach acid to back up into your esophagus. This can cause heartburn and other signs of gerd symptoms. Frequent or constant reflux can lead to gastroesophageal reflux disease .
What do acid reflux feel like?Common symptoms of acid reflux are: heartburn, chest pain, bloating, burping, dysphagia and many more.
What helps acid reflux?In many cases, lifestyle changes combined with over-the-counter medications are all you need as gerd treatments to control the heartburn symptoms.
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Large Meals And Fatty Foods
Heartburn most commonly occurs after eating a large and fatty meal. The effect of this doubles if the meal I consumed at night just before sleeping.
Heavy and fatty meals are very hard to digest.
Such type of food pressurizes the stomach, increases the acid production and relaxes the lower oesophageal sphincter muscle.
Indigestion also causes the food to be retained in the stomach for a longer time.
All these factors become worse at night time or just before lying down because it is even harder for the gut to digest food while the body is in a relaxation mode. Lying down should be avoided for at least 2 hours after eating.
How to avoid: for people with frequent heartburns or those who have tracked down their triggers to heavy and fatty meals, it is important that they should avoid fatty food or consuming food in very large quantities at a time.
Eating smaller and frequent meals help a lot in reducing heartburn as it doesnt pressurize the stomach to digest all the food at once. Also, it is important to note that fatty and heavy meals should be avoided before sleep at all costs.
A minimum of 2-hour gap should be kept between eating and lying down.
What Are The Signs & Symptoms Of Gerd
Often, people who have GERD notice that they regularly have the pain of heartburn in the chest or stomach. This can last up to a couple of hours. Many notice their heartburn is worse after eating.
Regurgitation when food and liquid containing stomach acid comes back up into the throat or mouth is also a sign of GERD. But, like heartburn, occasional regurgitation is common for everyone.
Other symptoms of GERD include:
- a sore, raw throat or hoarse voice
- a frequent sour taste of acid, especially when lying down
- a feeling of burping acid into the mouth
- trouble swallowing
- bad breath
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Maalox: Best Heartburn Medication For Immediate Relief
Maalox is an antacid used for very fast-acting relief from heartburn. In Maalox, Simethicone is used to help destroy gas bubbles within the gut, and aluminum and magnesium work to reduce acid levels in the stomach. This form of heartburn medication only works on existing stomach acid.
Maalox usually works within five minutes of consumption. However, the catch is that it will only work for 30 minutes to 60 minutes at the most. Thus, if you continue to experience symptoms for up to two weeks following your initial date of taking Maalox, you may need a stronger heartburn medication.
Typically, Maalox should be taken after meals or around bedtime. The most common side effects of Maalox include constipation and diarrhea. If these side effects persist for over two weeks, though, you may consider contacting a physician.
What Are The Complications Associated With Heartburn
Occasional heartburn isnt typically a cause for concern. However, frequent heartburn may be a symptom of GERD. This condition may require treatment with prescription medication or surgery.
If left untreated, GERD may lead to additional health problems, such as an inflammation of the esophagus, which is called esophagitis, or Barretts esophagus, according to a 2018 review . Barretts esophagus causes changes in the lining of the esophagus that can increase your risk of esophageal cancer.
Long-term heartburn can also affect your quality of life. See your doctor to determine a course of treatment if you find it difficult to carry on your daily life or are severely limited in your activities due to heartburn.
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A War Correspondents New Enemy: Barretts Esophagus
Esophageal Ulcer This is an open sore in the esophagus, caused by tissue damage from stomach acid. It can lead to pain, bleeding, and problems with swallowing.
Barretts Esophagus This is a precancerous condition in which the lining of the esophagus changes to one that more closely resembles the lining of the intestines.
While Barretts esophagus can reduce symptoms of heartburn, it increases your risk of esophageal cancer by a factor of about 30.
Esophageal Cancer This lethal cancer, which current treatments cant do much to slow, can result from years of untreated GERD.
What Are The Common Signs Of Gerd
The most common sign is heartburn. Heartburn is a pain in the middle of your chest. The pain from heartburn can be very strong. Sometimes the pain can be so strong that you think youre having a heart attack.
GERD can cause other signs, too. You can even have GERD without having heartburn.
Sometimes GERD can cause problems in your throat. It can make you feel like you have a lump in your throat or like you always have to clear your throat. It can also cause hoarseness. You might be more hoarse when you first get up in the morning.
GERD can give you a burning feeling in your mouth. It can cause you to have a sore throat or to have trouble swallowing. You may feel like food is sticking in your throat. GERD may also make you feel like youre choking or that your throat is tight. A dry cough is another sign. GERD can also cause bad breath. It can even cause pain in your ears.
If you have any of these signs, you may have GERD. Be sure to tell your doctor about any of these signs.
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