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Acid Reflux: Common Symptoms, Causes, and Treatment

Acid reflux is when stomach acid regurgitates back up the esophagus into the mouth. Individuals also typically experience heartburn with reflux. Keep reading for a complete breakdown of acid reflux, GERD, some of its causes, and how to get rid of it.

The medical terminology for persistent and damaging acid reflux is gastroesophageal reflux disease (GERD). The condition occurs when stomach acid frequently flows back up into the mouth via the esophagus. This backwash can taste unpleasant and irritate the lining of your esophagus. 

When an individual has GERD, they experience mild, severe, or moderate reflux one or more times per week. 

In the medical community, there’s no standard definition for GERD. However, a panel of world experts recently came together to define GERD as the condition that develops when the reflux causes additional complications or concerning symptoms. 

Occasional acid reflux is a normal physiological process. Most instances are brief and don’t cause complications, symptoms, or injury to the esophagus. Acid reflux only becomes a disease when it causes esophageal damage or additional symptoms. 

GERD has two classifications:

  • Erosive esophagitis — This type of GERD is when the individual has endoscopically visible damage (breaks) in the esophageal mucosa. Erosive esophagitis can come with or without additional symptoms. 
  • Nonerosive reflux disease — This type of GERD includes troublesome symptoms but may or may not have a visible esophageal mucosal injury. 

Approximately 10–20 percent of people in western countries have GERD. The prevalence is much lower in Asia, with estimations at only 5 percent. However, these estimations aren’t entirely accurate, as they assume that regurgitation or heartburn (or both) are the only indicators of the condition.

Common acid reflux symptoms include:

  • Heartburn, a burning sensation in your chest, after eating or late at night
  • Trouble swallowing food or drink
  • The feeling of a lump in your throat 
  • Chest pain
  • Regurgitation of food or stomach acid (tastes sour)

If you have nighttime reflux, some additional symptoms of acid reflux you may experience are a chronic cough, new or worsened asthma, laryngitis, and trouble sleeping. 

The symptoms of GERD are similar to acid reflux symptoms but often more intense:

  • Regurgitation of food or stomach acid 
  • Nausea and vomiting
  • Heartburn
  • Abdominal pain
  • Symptoms that occur after meals
  • Difficulty swallowing (dysphagia) or experiencing pain while swallowing (odynophagia) 
  • Chronic cough, wheezing, or hoarseness 
  • Inflammation or irritation of the esophagus (esophagitis)
  • Having excessive saliva (water brash)
  • The feeling of having a lump in your throat (globus sensation)

Some common causes of acid reflux include:

  • Being pregnant
  • Being overweight
  • Hiatal hernia
  • Smoking
  • Some foods
  • Certain blood pressure medicines
  • Aspirin or ibuprofen 
  • Lying down after a meal
  • Bending down after a meal
  • Eating late at night

GERD is caused by continuous acid reflux. When you swallow, the muscles around your lower esophageal sphincter relax to allow food or liquid to slide down to your stomach. After swallowing, the sphincter closes again. 

When the sphincter weakens or reopens, stomach acid can flow back up into your mouth. With GERD, the constant backwash of stomach acid can irritate and inflame the lining of the esophagus. 

The feeling of acid reflux is quite strong and prevalent. Reflux feels like liquid regurgitating from your stomach back into your mouth. It often has a warm and sour taste, sometimes with food particles. Reflux typically occurs after eating or when lying down.

Acid reflux also commonly occurs with heartburn, which is a feeling of burning in the chest.

Some people are more at risk of developing GERD. Individuals who have the following conditions are at risk:

  • Obesity
  • Connective tissue disorders (for example, scleroderma)
  • Pregnancy
  • Delayed stomach emptying 

Some factors that can aggravate acid reflux or increase its frequency are:

  • Smoking
  • Eating large meals
  • Eating late at night or right before bed
  • Eating fatty, fried, or carbonated foods or drinks
  • Drinking acidic beverages, such as alcohol and coffee
  • Taking some medications 

Treatment for acid reflux will depend on the frequency of the reflux and the symptoms. Dietary modifications and lifestyle changes may help relieve acid reflux. A review of 16 randomized trials showed that weight loss and elevating the head while sleeping helped alleviate some GERD symptoms. 

Individuals with GERD can attempt the following changes:

  • Diet and exercise to lose weight (if overweight)
  • Using additional pillows to elevate the head when sleeping (only necessary for individuals experiencing sleeping issues or laryngeal symptoms)
  • Avoiding eating two to three hours before bed
  • Avoiding lying down immediately after eating
  • Eliminating reflux-triggering foods such as spicy foods, coffee, alcohol, carbonated beverages, fatty foods, chocolate, sugary foods, and peppermint
  • Avoiding wearing tight clothing
  • Chewing gum to help increase salivation, which can increase the rate of esophageal clearance
  • Avoiding smoking
  • Engaging in abdominal breathing exercises to reinforce the esophageal sphincter 

Most doctors will recommend making lifestyle and diet modifications before they prescribe any medication. If you’ve made lifestyle and diet changes and haven’t noticed any improvement, the answer may be medication or surgery. Options include:

  • Antacids may provide temporary relief. However, antacids cannot heal an inflamed, irritated, or damaged esophagus. Additionally, overusing antacids can cause its own set of problems, such as diarrhea and kidney problems.
  • H-2 receptor blocker medication can reduce acid production. This type of medication isn’t as fast-acting as antacids but provides longer relief (up to 12 hours). Individuals can get lower concentrations of H-2 receptor blocker medication over the counter, while stronger versions are available via prescription. Long-term use may include a slight risk of vitamin B12 deficiency and bone fractures. 
  • Proton pump inhibitors block acid production and help heal the esophagus. This type of medication is stronger than H-2 receptor blockers. You can purchase proton pump inhibitors over the counter, and there are also proton pump inhibitors that are prescription strength. Some side effects include headaches, nausea, diarrhea, the risk of hip fractures, and vitamin B12 deficiency. 
  • Some medication can reinforce the lower esophageal sphincter, such as baclofen. This medication may cause nausea and fatigue.

If lifestyle changes and medication don’t ease symptoms, your doctor may recommend surgery. Both of these surgeries for GERD can be minimally invasive. 

  • Fundoplication surgery is when the surgeon tightens the esophageal sphincter to prevent reflux. The top of the stomach is wrapped around the lower esophageal sphincter. The wrapping can be partial or complete. 
  • A device can be inserted in your body to wrap around the meeting point of the stomach and the esophagus. The device keeps the junction closed to refluxing acid while still allowing food through. 

If you think you have GERD, your doctor may perform an upper endoscopy to look for the presence of Barrett’s esophagus or erosive esophagitis. 

It is recommended to  see a doctor when:

  • Your symptoms last a long time. 
  • Your symptoms are severe.
  • You cannot control your symptoms. 
  • Your symptoms haven’t improved with lifestyle changes.

You should see a doctor immediately if you:

  • Are unintentionally losing weight
  • Have frequent chest pain
  • Have trouble swallowing or choke when you eat
  • Vomit blood
  • Have bowel movements that are black or red

Acid reflux is when the acid in your stomach comes up into the esophagus, creating an unpleasant and sour taste. Continuous instances of acid reflux could be an indication of GERD. Acid reflux and GERD aren’t life-threatening conditions, but they can be unpleasant to live with. Luckily, there are many treatment options for GERD, including lifestyle changes, medication, and surgical options. 

https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940

https://www.gastrojournal.org/article/S0016-5085(08)01606-5/fulltext#sec1

https://www.uptodate.com/contents/medical-management-of-gastroesophageal-reflux-disease-in-adults

https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-gastroesophageal-reflux-in-adults?sectionName=CLINICAL%20FEATURES&topicRef=2258&anchor=H13576047&source=see_link#H13576047

https://www.medicalnewstoday.com/articles/146619.php

https://www.uptodate.com/contents/acid-reflux-and-gastroesophageal-reflux-disease-in-adults-the-basics?topicRef=2265&source=see_link

https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959

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