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Friday, February 8, 2008

Acid Reflux

What is Acid Reflux?
Acid reflux is a condition where gastric juices containing acid travel back from the stomach into the esophagus (gullet or swallowing tube). Symptoms of acid reflux include:

  • Heartburn (a burning feeling rising from the stomach or lower chest up towards the neck).

  • Regurgitation (bringing food back up into the mouth).

  • Chest pain.

  • Difficulty in swallowing (dysphagia).

  • Hoarseness, dental erosion and asthma (because acidic juices can make their way into the throat, mouth and air passages of the lungs).

How do you get Acid Reflux?
Some people experience this problem regularly and have a condition called gastroesophageal reflux disease or GERD.

  • The food in the stomach is partially digested by stomach acid and enzymes, which are special chemicals that help to break down food so the body can use it.

  • Normally, the partially digested acidic content in the stomach is delivered by the stomach muscle into the small intestine (bowel) for further digestion.

  • In patients with acid reflux, stomach acid content travels backwards into the esophagus, causing inflammation and damage.

  • Factors contributing to acid reflux include fatty foods, cigarettes, chocolate, caffeine, alcohol, obesity, pregnancy and delayed stomach emptying.

  • Obesity and pregnancy increase pressures within the abdomen (body trunk), pushing the stomach contents back into the esophagus.

  • Some patients have stomachs that empty their contents into the intestines very slowly.

  • A stomach full of food and acid is more prone to reflux, especially when the patient lies down (supine)..
  • How serious is Acid Reflux?
    For most people with acid reflux, the discomfort associated with symptoms can affect quality of life and everyday activities, including work. Acid reflux is also the cause of heartburn and in severe cases, this can be very troublesome. When esophagatis is present the lining of the esophagus is damaged and may become ulcerated and can result in narrowing, making swallowing of food and, sometimes, liquids, painful and difficult.

    How long does Acid Reflux last?
    Acid reflux can last several months or longer if not treated. Drug treatment is often only needed for a short time although it may have to be repeated since some symptoms may re-occur.

    How is Acid Reflux treated?
    Medications commonly used in the treatment of acid reflux include:

    • Acid suppressants, such as histamine2-receptor antagonists (blockers). Histamine is a chemical released in the body under different conditions, but particularly during inflammation. In the stomach it can release more acid, so blocking it reduces acid production.

    • Proton pump inhibitors, which reduce the production of acid in the stomach by acting on cells in the stomach wall that make acid and release it into the stomach.

    • Prokinetic agents, which promote emptying of the stomach so it does not overfill. They work by increasing the pressure of the lower esophageal sphincter (the muscular valve between the lower end of the stomach and the small bowel)
    • Antacids are over-the-counter medicines that are commonly used to treat mild acid-related symptoms, like heartburn or indigestion, and work by neutralising acid in the stomach. However, they are not usually recommended to treat the frequent heartburn suffered by people with GERD.

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