Acid reflux occurs when gastric acid produced by the stomach flows up into the esophagus. This causes uncomfortable symptoms but can be helped with lifestyle changes and treatment.
What are the symptoms of acid reflux?
Heartburn is one of the most common symptoms of acid reflux. Heartburn is often described as a burning sensation in the chest and typically occurs after eating. Heartburn can be the only symptom of acid reflux, but some people may experience other symptoms such as (2):
- Regurgitation of food or acidic liquid
- Pain in the chest or upper abdomen
- Difficulty swallowing
- Sensation of a lump in your throat
- Persistent cough that cannot be explained by another cause
- Voice hoarseness due to inflammation of the vocal cords
- New onset or worsening asthma
Are there any risk factors for acid reflux?
There are several major risk factors that may cause acid reflux including (3):
- Obesity
- Hiatal hernia (bulging of the stomach through the diaphragm)
- Lower esophageal sphincter impairment
- Delayed stomach emptying
- Pregnancy
- Connective tissue disorders (scleroderma)
What are aggravating factors?
When someone is prone to acid reflux, one or more additional factors may provoke or exacerbate heartburn and the rest of the symptoms. They are called aggravating factors. The most common of them include (3,4):
- Eating big portions
- Eating close to bedtime
- Smoking
- Drinking coffee, alcohol, soda or tea
- Acidic foods (citrus, tomatoes, chocolate etc.)
- Fatty or fried foods
- Irritating foods (garlic, onions, peppermint or spearmint)
- NSAID medications (aspirin, naproxen or ibuprofen)
Acid Reflux vs. GERD
GERD (gastroesophageal reflux disease) occurs when acid reflux progresses into a more severe form of acid reflux. GERD can have a significant impact on the quality of life of an individual. About 1 in 5 Americans have GERD (5). If your healthcare provider suspects you have GERD, they may diagnose GERD based on a combination of your symptoms and diagnostic testing.
What are the complications of acid reflux and GERD?
Occasional acid reflux typically does not lead to any significant consequences. However, frequent and longstanding GERD can lead to a number of serious complications such as (2,6):
- Inflammation of the esophagus (esophagitis). When stomach acid repeatedly burns the tissues of the esophagus it leads to inflammation. This can result in difficulty swallowing or painful swallowing, bleeding, and the formation of ulcers in the esophagus.
- Narrowing of the esophagus (esophageal stricture). Inflammation from recurrent exposure to acidic contents may result in the formation of scar tissue in the affected areas. This narrows the esophagus and causes difficulty with the passage of food.
- Barrett’s esophagus. Continuous exposure of the healthy pink esophageal tissues to acid can over time alter these tissues to such an extent that they become precancerous. Due to changes on the cellular level the appearance of the tissues changes as well and becomes red in color. This condition is called Barrett’s esophagus, named after Dr. Norman Barrett. Some individuals with Barrett’s esophagus may have only minor symptoms or no symptoms at all.
- Esophageal cancer. When Barrett’s esophagus is not properly or timely treated, and the esophagus continues to be repeatedly exposed to stomach acid, it can result in further damage to the tissues leading to esophageal cancer. This condition is very rare.
Prevention and Treatment
As symptoms of acid reflux can mimic other life-threatening conditions, you should see your healthcare provider right away, especially if you are experiencing symptoms of chest pain or difficulty breathing. Your healthcare provider can rule out other medical conditions and provide an accurate diagnosis.
Your healthcare provider may recommend acid-reducing medications to help relieve symptoms of acid reflux. If heartburn becomes more frequent, it is best to consult your healthcare provider about your diet. In most cases of acid reflux and GERD, a combination therapy consisting of acid-reducing medication along with dietary and lifestyle adjustments is very effective at improving the quality of life and preventing potential complications.
References:
2) Gastroesophageal reflux disease (GERD)
3) Everything you need to know about acid reflux and GERD
5) Gastroesophageal reflux disease
6) GERD, Barrett’s esophagus and the risk for the esophageal cancer
