Acid reflux, also known as reflux, is caused by acid escaping from the stomach through a valve called the oesophageal sphincter.
Reflux causes include:
- Eating too much
- Being overweight
- Eating right before bedtime
- Lying down after a meal
- Eating acidic food (garlic, onions, tomatoes, citrus fruit, chocolate, fatty or spicy foods)
- Drinking cold drinks, coffee, tea or alcoholic beverages
- Taking certain medications (ibuprofen, aspirin, blood pressure medication, or muscle-relaxing medications)
- Hiatal hernia (a condition where the small part of the stomach bulges through a hole in the diaphragm)
If you experience chronic acid reflux, you could develop gastro-oesophageal reflux disease (GORD).
What are its symptoms?
If you have reflux symptoms you are most likely feeling very uncomfortable. Common symptoms include:
- Regurgitation – bitter acid moves from the stomach into your mouth or throat
- Heartburn – a burning sensation that can move from your stomach to your chest, or even into your throat
- Burning when you swallow a hot drink
- Unintended weight loss
These symptoms tend to come and go but are usually worse after a meal. A few less common symptoms include:
- Coughing persistently at night – acid reflux irritates the windpipe, and asthma or wheezing can also be caused by acid moving up into the chest cavity, which can also cause a sore throat
- Chest pain
- Bad breath or the feeling there’s a lump in your throat
- A narrowing of the swallowing tube (oesophagus), which can feel as though there’s food stuck in your throat
How is it diagnosed?
Your doctor will normally ask you about your symptoms to diagnose reflux, however, if you have severe or recurrent symptoms he may do some of the following tests to determine if you have GORD, for example:
- X-rays done after you have swallowed barium, a chalky liquid, which helps the doctor check whether there is a narrowing of your oesophagus or whether you have an ulcer.
- Monitoring the pH level, how much acid, is in your oesophagus.
- Using an endoscope, the doctor will look for problems in the oesophagus (narrowing) and/or stomach (for example, irritable bowel syndrome).
- The doctor may also take a tissue biopsy using the scope so that he can check for obstructions or infections.
- Oesophageal manometry uses a tube that is sensitive to pressure to check that your oesophagus and stomach valve (lower oesophageal sphincter) are functioning normally.
What are your treatment options?
Medicinal reflux treatments include over-the-counter medications like antacids, which neutralise the acid in the stomach. However, if you take other medication, make sure they aren’t going to prevent absorption of these.
If antacids don’t do the trick, your doctor may prescribe proton-pump inhibitors (PPIs) that reduce the amount of acid your stomach produces, or H2 blockers that relieve the symptoms of acid reflux.
Non-medical treatments include not smoking, not eating at least a couple of hours before going to bed and raising the head of your bed by around 20cm. If you are overweight, exercise and change your diet to lose the excess weight. Tight clothes can also trigger reflux, so only wear comfortable clothes.
You may also find that eating smaller meals at regular intervals during the day may reduce your symptoms. Experiment with different foods to find out which ones cause reflux – acidic, fatty or spicy foods, and alcohol, are common triggers.
If you take chronic medication, check whether that may have caused your reflux.
Can it be prevented?
Certain foods and drinks are more likely to precipitate an attack of reflux. Here is a list of the usual suspects, however, we all react differently to food and drink, so it’s critical for sufferers to identify their triggers and avoid them, if possible.
- Dairy: milkshakes, sour cream, cottage cheese and ice-cream
- Meats: mincemeat, chicken nuggets and chicken wings
- Fruit and veggies: fried chips, mashed potatoes, potato salad, tomato, raw onion
- Beverages: citrus juices, lemonade, alcohol, coffee and tea
Other ways to prevent reflux are to not eat too much fast food, eat smaller portions at mealtimes, and try to keep a diary of what you’ve eaten when you have an attack. This will help you identify your reflux-producing habits.
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