Heartburn can happen after a huge meal or going to bed too early after dinner. Stomach acid rises into the esophagus, causing acidity and other symptoms. Occasional heartburn can be preserved at home, but chronic heartburn (GERD) may require treatment. Over time, GERD can damage the tissues of the esophagus.
What is acid reflux?
Stomach contents should only move in one direction: downward. Once stomach acid flows back into the esophagus and throat, it’s called acid reflux. When acid enters places it shouldn’t, you’ll feel it. The acid irritates and inflames the tissues of the esophagus, which runs from the stomach, through the chest, to the throat.
Almost everyone knowledges acid reflux from time to time. It can feel like indigestion (a burning pain in the stomach after eating) or heartburn (a burning pain in the chest nearby the breastbone).
Occasional acid reflux is painful, but it’s not a disease. However, some people experience reflux constantly. Chronic acid reflux can significantly affect quality of life and cause serious tissue damage.
What is GERD?
GERD stands for gastroesophageal reflux disease. Depending on anywhere you live, it may be spelled GERD (gastroesophageal reflux disease). Regardless of how it’s spelled, GERD is chronic acid reflux into the esophagus. Acid reflux is considered chronic if it occurs at least twice a week for several weeks.
Temporary situations can cause temporary acid reflux. However, GERD is an ongoing mechanical problem. This means that the mechanisms that are supposed to keep acid in the esophagus aren’t working properly.
How common are acid reflux and GERD?
Occasional, uncomplicated gastroesophageal reflux (GER) and gastroesophageal ebb disease (GERD) are common. It is estimated that GERD affects approximately 20% of adults and 10% of children in the United States.
Symptoms and Causes
What are the symptoms of reflux and GERD?
Symptoms of reflux and GERD may include:
- Reflux. You may notice acid, food, or liquid rising from your stomach into your throat after eating. This is also called vomiting. You may taste acid as it rises.
- Hearing. Acid literally burns the tissues of the esophagus. If the sensation is located in the chest, it is called heartburn. If it is located closer to the stomach, it may be called acid indigestion.
- Chest pain not related to the heart. Some people experience pain in the esophagus that is not a burning sensation. Esophageal pain affects the same nerves as heart pain, so it can be similar.Acid Reflux & GERD
- Nausea. Too much acid or reflux can cause nausea or loss of appetite. Even if you have eaten for a while, you may feel like there is still a lot of food in your stomach to digest. Sore throat. Acid that comes back up into the throat can cause pain. You may feel a lump in your throat or have difficulty swallowing. Reflux often occurs at night.
- Asthma symptoms. GERD can cause asthma-like symptoms, such as a chronic cough, wheezing, and shortness of breath. The entry of acidic particles into the airways can cause them to narrow.
GERD symptoms may worsen:
- At night or when lying down.
- After eating a large or fatty meal.
- After bending over.
- After smoking or drinking alcohol.
Do babies get GERD?
It’s normal for babies to spit up. This spit-up may contain acid, but usually not enough to cause serious discomfort. GERD is a more serious condition that causes discomfort or difficulty feeding.
Premature babies are more likely to develop GERD if they were born prematurely or have esophageal problems. Your pediatrician may test your baby for GERD if they seem to be having any difficulty.
Symptoms of GERD in babies (or toddlers) may include:
- Excessive irritability.
- Trouble sleeping.
- Refusal to eat.
- Mild vomiting.
- Wheezing or hoarseness.
- Bad breath.
What causes acid reflux?
For acid to reach the esophagus, it must pass through a valve at the bottom of the esophagus that normally prevents food from coming back up. This valve is called the inferior esophageal sphincter (LES).
The LES is a circular muscle that opens when you swallow and closes to retain stomach contents. It also opens slightly to release gas bubbles when you burp or hiccup. Acid reflux happens when the LES weakens or relaxes enough to allow acid to pass through. Some temporary factors can relax the LES, such as lying down after a large meal. But if you have GERD, it means that the LES relaxes frequently. Many factors can donate to the weakening of the LES, either temporarily or permanently. Occasional acid reflux sometimes turns into chronic GERD when these factors overlay or persist for a long period.
Common causes of acid reflux and GERD:
- Hiatal hernia. A hiatal hernia happens when the higher part of the stomach bulges through the opening in the diaphragm where the esophagus passes. This puts pressure on the esophagus, compressing it and trapping acid. It also displaces the lower esophageal sphincter above the diaphragm, where it loses some of its muscular support. Hiatal hernias are very common, especially with age. They usually develop gradually and can progressively worsen.
- Pregnancy. Pregnancy is a common cause of temporary acid reflux. The pressure and volume in the abdomen can push, stretch, and weaken the diaphragm muscles that support the lower esophageal sphincter. Pregnancy hormones can also contribute to the relaxation of the lower esophageal sphincter. Pregnancy brings high heights of the hormone relaxin, which relaxes the muscles so they can stretch and make room for the baby. It is also accompanied by high levels of estrogen and progesterone, which can also relax the lower esophageal sphincter.
- Obesity. Obesity increases abdominal pressure and volume, which affects the lower esophageal sphincter in a similar way to what happens during pregnancy. Obesity also tends to last lengthier than pregnancy, which can lead to more permanent weakening of the muscles. This is a common factor in the development of a hiatal hernia. Since fatty tissue secretes estrogen, excess fat also increases estrogen levels.
- Smoking. Tobacco smoke relaxes the lower esophageal sphincter, whether you smoke or are uncovered to secondhand smoke. Smoking also causes coughing, which opens the lower esophageal sphincter. Smoking and chronic coughing can weaken the diaphragm muscles and contribute to the development of a hiatal hernia. Smoking also slows digestion and increases stomach acid production.
What helps with reflux at home?
To manage reflux at home, try:
- Eat small meals. Large meals expand the stomach and put pressure on the lower esophageal sphincter (LES). Small meals are digested more quickly and do not stimulate the production of large amounts of stomach acid.
- Eat dinner earlier. Gravity contributes to maintaining heartburn, so it is recommended to eat a few hours before going to bed or lying down in the living room.
- Sleep on your left side. This places the lower esophageal sphincter in an air pocket over the stomach contents. Lying on your back or right side submerges the valve.
- Reduce intra-abdominal pressure. Wear loose clothing or consider losing weight if you are overweight or obese. This can help both in the short and long term.
- Stop smoking and drinking alcohol. Tobacco and alcohol weaken the lower esophageal sphincter (LES). They also affect the stomach, increasing its acidity and slowing digestion.
- Over-the-counter medications. It’s helpful to have antacids and alginates on hand, especially if you know you’re eating large or acidic foods that can increase heartburn.
What to do during a reflux attack?
If it’s happening to you right now, try:
- Stand up. Gravity is on your side.
- Take a sip of water. Don’t drink a lot, but small sips can help flush out the acid.
- Loosen your belt. Take it off or change your clothes if that helps.
- Take an antacid. If you don’t have one, Pepto Bismol® may work.
When should you see a doctor about reflux?
If you have reflux frequently, see your doctor. It’s important to figure out how it’s affecting your body. GERD isn’t just a nuisance; it can cause real damage. Plus, it’s highly treatable.
Overview
Almost everyone knowledges acid reflux from time to time. Heartburn, indigestion, and acidic burps can ruin a night. There are steps you can take to reduce the frequency of these incidents.
If you experience acid reflux frequently and it significantly impacts your life, you may have GERD. It’s worth discussing your symptoms with your doctor. They can assess whether treatment will help.