Acid reflux explained


Being overweight or obese increases your risk of acid reflux.– AFP

Understanding acid reflux and what you can do to alleviate the problem.

IT’S estimated that 50% of the Malaysian adult population suffer from at least one gastrointestinal condition. And among such gastrointestinal problems, acid reflux is one of the most common.

The onset of acid reflux occurs when you swallow. Normally, the lower oesophageal sphincter (LES) — a circular band of muscle around the bottom part of your oesophagus — relaxes to allow food and liquid to flow down into your stomach and closes soon after; it acts much like a valve.

However, if this valve relaxes abnormally or weakens (i.e. hiatal hernia), stomach acid flows back up into your oesophagus, causing frequent heartburn.

If symptoms persist more than twice a week, you may be suffering from acid reflux disease.

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You are what you eat

Don’t be surprised, but some daily routines and habits may increase your risk for acid reflux, and most of them are controllable factors stemming from the mundane, but necessary task of eating:

  •  Eating large meals or lying down right after a meal.
  •  Being overweight or obese.
  •  Snacking close to bedtime.
  •  Eating certain foods, such as citrus, tomato, chocolate, mint, garlic, onions, or spicy or fatty foods, all of which may be highly acidic.
  •  Drinking certain beverages, such as alcohol, carbonated drinks, coffee or tea, which may lead to impairment, irritation or a weakened LES.
  •  Smoking damages mucous membranes, impairs muscle reflexes in the throat, increases acid secretion, and reduces LES muscle function and salivation.
  •  Being pregnant (increased hormones and pressure from the growing baby).
  •  Taking aspirin, ibuprofen, certain muscle relaxers or some blood pressure medications.

Looking for signs

Symptoms of acid reflux disease – also referred to as gastroesophageal reflux disease (GERD) – are numerous, but some are more commonly experienced than others:

Regurgitation – Described by the feeling of acid backing up into your throat or mouth. Usually followed by a sour or bitter aftertaste as you vomit a little portion of your stomach’s content.

Heartburn – Burning sensation that causes discomfort, usually occurring in the middle of the abdomen or chest. Contrary to its name, heartburn or acid indigestion has nothing to do with the heart.

Dyspepsia – Many people with acid reflux disease also have a syndrome called dyspepsia. Dyspepsia is a general term for stomach discomfort or indigestion with its own set of symptoms, such as burping, loss of appetite, nausea after eating, stomach fullness, or bloating and upper abdominal pain and discomfort.

Smoking damages mucous membranes, impairs muscle reflexes in the throat, increases acid secretion and reduces LES muscle function and salivation. – AFP
Smoking damages mucous membranes, impairs muscle reflexes in the throat, increases acid secretion and reduces LES muscle function and salivation. – AFP

Prolonged suffering of symptoms may cause an array of complications, and these could include:

  •  Narrowing of the oesophagus caused by acid exposure, which leads to formation of scar tissue or oesophageal stricture.
  •  Oesophageal cancer.
  •  A change in the tissue lining of the lower oesophagus that may increase the risk of cancer (Barrett’s oesophagus).
  •  Worsening of asthma.
  •  Bronchospasm (irritation and spasm of the airways due to acid).
  •  Chronic cough or hoarseness of voice.
  •  Dental problems.

Relief with drugs

Drugs and medication may help you relieve the pain of acid reflux.

Antacids are often used to neutralize stomach acid, but their effects are short-lived and overuse may result in side effects (i.e. diarrhoea and constipation).

On the other hand, H-2 receptor blockers are used to reduce acid production. However, they do not act as fast as antacids, though they provide longer lasting relief.

Similarly, proton pump inhibitors (PPI) also reduce acid production and they help heal oesophageal tissue over time.

Some of these medications are used in combination for better effectiveness. If all else fails, and depending on the severity of your GERD, your doctor may suggest a more invasive option, surgery – more specifically, the Nissen fundoplication procedure or the more recent LINX reflux management system.

In general, both options are designed to strengthen and reinforce the LES.

Nevertheless, because the risk factors for GERD are controllable, most of the time, simple lifestyle changes are sufficient to help you relieve your symptoms.

Eat better, healthier and more balanced foods. Couple that with regular daily exercise, and you’re well on your way towards better digestive health and overall well-being.

Consult your doctor if you are in doubt, and remember that prevention is better than cure – a medical cliché definitely, but true nonetheless.

Dr Lee Hock Bee is a gastrointestinal surgeon and committee member of the Digestive Health Advisory Board. The author is not associated with and does not endorse any brands or products. For a free digestive health info guide or more information, contact 03-5632 3301.


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