What is Acid Reflux?
Acid Reflux or Gastro esophageal reflux disease (GERD) is not a disease rather it is a condition. Over stuffing and under eating, excess use of spicy foods, regular drinking of alcohol and smoking accompanied with no exercise are considered as primary causes for acid reflux. In acid reflux the food in the stomach starts coming back to the esophagus. Food that is rising in the esophagus is not the simple food. It also contains strong acids and digestive enzymes. This acidified food burn the protective mucosal lining of the lower esophagus due to this burning mucosal lining becomes weak and even it is destroyed completely. This burning and destruction makes mucosal lining more sensitive to have ulcers and cancers. Most prominent sign and symptoms include burning sensation behind rib cage and stabbing pain in chest. Other symptoms include frequent coughing, difficulty in swallowing, sinusitis, voice changes due to damage of voice box and nausea. In case of improper treatments and ignorance acid reflux will be converted in to serious diseases like ulcers, strictures, inflammation of throat, larynx and lungs and even cancers.
Acid Reflux Treatments
Acid Reflux can be treated in two ways. One is proper medication and other is simple alteration in life style and eating habits. Whatever you use as acid reflux treatment it is highly recommended to consult with doctor. This is because of the fact that medicines used to treat other diseases can inhibit drugs used to treat Acid Reflux. Acid Reflux Treatments can be classified in to three broad categories.
– Changes and Alteration in Life Styles
– Surgery or Laparoscopic Surgery
Changes and Alteration in Life Styles
In this treatment patients are advised to change their life style from eating habits to sleeping habits and even body postures during physical workouts. If we talk about eating habits patients will have to quit spicy foods, coffee, alcohol. It is also suggested to reduce the consumption of cruciferous vegetables such as broccoli and cauliflower. It is also recommended to have smaller meal but more than 3 times. Avoid having meal just before going to bed. This will reduce stomach expansion during digestion. Chewing gum just after having meal will increase the production of saliva that in turns neutralize the acid in esophagus and in turn give relief in acid reflux. Patients are advised to follow the following guidelines
– Give up smoking.
– Cut down caffeine intake.
– Bring down stress
– Try to maintain ideal body weight.
– Try to avoid wearing waist fitted clothes.
– Do not do physical workouts after having meal.
Bad body postures such as bending or slumping that causes contraction of stomach can increase the chances of GRED. Patients are recommended to try to keep their body in straight and comfortable posture. Don’t sleep without pillow. Keep your upper body elevated this will not let the fluid come in esophagus.
Proton Pump Inhibitor Drugs
Specific drugs are also designed to use as acid reflux treatments. Some drugs lower down the acid production by deactivating cell surface molecules (proton pumps) in gastric lining. Proton pumps work with positively charged Hydrogen ions and increase acid production. Proton pump inhibiting drugs have serious side effects.
Mild cases are treated with Antacids. Aluminum hydroxide, Magnesium hydroxide, Calcium hydroxide and Sodium bicarbonate are common antacids used as acid reflux treatments. Antacids increase the pH of stomach and decrease acidity by neutralizing acid in stomach. Antacids must be taken after one hour of having meal. Because antacid can not stay longer in the empty stomach and leave the stomach with in the hour. Meal increases the retention time of antacid in stomach. Other than lowering pH antacids have certain undesirable side effects. Aluminum containing antacids can cause constipation while magnesium containing antacids can cause diarrhea. Liquid antacids are preferred over tablets. Strongest liquid antacids available are Maalox II, Mylanta II, Gelusil II and Extra Strength Riopan
Alginic acid is the active component of foam barrier tablets. Foam barrier tablets contain Alginic acid in combination with aluminum hydroxide gel and magnesium trisilicate. Alginic acid in tablet form protective coating on stomach and lower esophageal mucosal lining. This allows cells to regenerate and repaired. Foam barrier tablets forms foam in stomach. This foam starts floating on the top of the liquid content of stomach. Foam act as physical barrier and does not let liquid to rise in esophagus. Two foaming barriers Gaviscon and Algicon are commercially available. It is recommended to chew well after 30 to 60 minutes of having meal or before going to bed.
Antihistamines are also used to treat acid reflux. Stomach walls produce histamine. Histamine accelerates acid production by binding specific receptors present on acid producing cells of stomach. Antihistamine drugs bind to these receptors and block histamine binding that in turn reduces the acid production. Ranitidine, Famotidine, Cimetidine and Nizatidine are commonly used antihistamines or histamine antagonists. They are available without prescription as over-the-counter (OTC) but the dose of OTC is lower than those available by prescription. Antihistamine drugs are taken 30 minutes earlier than meal. This will make antihistamine available in higher concentration when stomach is actively producing acids to digest food. Antihistamine gives fast relief from primary heartburn and inflammation of esophagus.
Prokinetics drugs act on lower esophagus muscles. As a result muscles become tough and accelerate the departure of food from stomach. Due to this food does not get the chance to return to lower esophagus. Due to dangerous side effects it is not recommended to use. Drugs have been withdrawn from the market.
Sucralfate are used for proper functioning of digestive muscles. They improve the healing of esophageal muscles. It protects the sensitive mucosal lining. It is normally used in combination with anti GERD drugs.
Surgery or Laparoscopic Surgery
Severe Acid reflux can be treated through surgery. Surgical procedures are use to support lower esophagus. This will stop the rising of acidified food in esophagus. Surgical procedure used to accomplish this is called as Fundoplication. In this method stomach is wrapped over esophageal sphincter. Surgical treatment of acid reflux is very complicated. Before surgery extensive investigation has carried out to check the patient condition. These investigations include combine pH-impedance, testing assessing non acid, and acid reflux. Surgery is invasive procedure and must perform with extreme care. In contrast laparoscopic surgery is less invasive method. In this method tiny holes are made in belly button and upper abdomen. Patients get fast recovery. Laparoscopic surgery must performed by qualified and experienced surgeons.