Acid reflux is a digestive disorder caused when the lower oesophageal sphincter (LOS) isn’t working properly.
It is common and two to three times more likely to occur for men, than women.
The LOS is a ring of muscles located at the base of the oesophagus, which relaxes to allow food to pass into the stomach. It also contracts to prevent food, or acid from the stomach from passing back upwards.
When this muscle is not functioning properly, acid or stomach contents can travel back up the oesophagus causing various symptoms from a burning sensation in the chest to a nasty, acidic taste in the mouth.
Causes of acid reflux can simply be related to diet and lifestyle choices, as well as eating habits. Sometimes a change in one or more of these factors is enough to relieve symptoms.
Causes of acid reflux can be linked to:
- Weight, particularly obesity
- Foods that affect the LOS include caffeine, chocolate and fatty foods
- Eating large meals that overload the digestive system
- Eating meals late at night and then lying down too soon
- Tight fitting clothing
- Certain drug (e.g. tricyclic antidepressants, anticholinergics, nitrates and calcium-channel blockers)
- Colonisation of stomach with H.pylori – a bacterial infection that can exacerbate these symptoms
Consultation with a specialist that can conduct the necessary diagnosis tests is the first step.
Are you experiencing any of these symptoms on a regular basis?
- A burning feeling in the stomach and lower chest, usually after eating
- Regurgitation of acid or bile, or food contents shortly after eating
- Vomiting after eating
- Excessive salivation
- Pain when swallowing
- Respiratory symptoms, including hoarse voice, cough, wheezing and shortness of breath
Longer term, persistent acid travelling back up toward the mouth can cause erosion of the oesophagus lining, as well a scarring or ulcers that cause the oesophagus to narrow.
Acid reflux can also lead to changes in the cells lining the oesophagus, a condition known as Barrett’s oesophagus. Whilst rare, Barrett’s oesophagus can lead to oesophageal cancer, so precautions need to be taken to correctly identify the condition and treat the symptoms at the right time.
Treatment can be as simple as making lifestyle changes:
- Reduce meal sizes and altering timing of meals
- Avoiding laying down for several hours following eating
- Avoiding smoking and limiting alcohol consumption
- Raise the head of the bed by 6-8 inches
- Chewing gum may help
- Losing weight
Other treatment options include:
- Use of antacids, such as Rennies or Gaviscon, which can relieve mild symptoms
- For more severe symptoms, prescribed medication may be more suitable, such as Ranitidine, which work to reduce the amount of stomach acid your body produces
- Newer anti-acid medication such as proton pump inhibitors, (e.g omeprazole, esomeprazole), which also act to reduce the stomach acid levels
- Treating H.pylori infection with a specific course of antibiotics
In severe cases that do not respond to lifestyle measures and medication, a review by a surgeon and further investigations may be necessary to determine the need for advanced keyhole surgery, to help tighten the muscles of the LOS and prevent reflux.