What is Acid Reflux and GERD?

When we eat, the food we swallow goes through a canal known as the oesophagus, which is connected to the stomach. The stomach then releases acid to digest the food we eat to make it absorbable. The lining of the wall in the stomach is strong enough to withstand the strong acid, but the lining of the wall in the oesophagus cannot. To prevent acid or food from re-entering the oesophagus, a muscle called the gastroesophageal sphincter, located at the end of the oesophagus, before the stomach, prevents this backflow from happening. When it fails, the acid flows into the oesophagus. This is called acid reflux. If this occurs more than twice a week, then it is known as gastroesophageal reflux disease (GERD).

Symptoms

GERD or acid reflux occurs in all age groups. The most common symptom is the feeling of a burning sensation in the chest called heartburn. It is very similar to chest pain, which is a symptom of a heart attack. Unlike heart attacks however, acid refluxes are not life-threatening, albeit irritating. Therefore, if you are experiencing pain in the chest area, you should always begin by assuming it is a heart attack and seek medical attention to confirm it.

Other symptoms include regurgitation, difficulty or painful swallowing, abdominal bloating, burping/belching, persistent cough, hoarseness and sleep disturbances

Causes

The exact cause of acid reflux is not known. However, it is normally associated with obesity, especially in the abdominal area. The abdominal pressure increases the chances of the backflow of the acid in the stomach. The same phenomena may occur during pregnancy as well.

Smoking is also one of the identified triggers of acid reflux and GERD. The nicotine in the cigarette relaxes the gastroesophageal sphincter, which may cause it to malfunction.

Certain medications such as asthma medication, calcium channel blockers, antihistamines, sedatives and antidepressants can also cause acid reflux.

Another cause may be hiatal hernia. Hiatal hernia is a condition where the stomach is displaced above the diaphragm. This may occur due to age-related changes, injury, hereditary factors or continuous pressure onto the abdomen caused by laughing, coughing, vomiting or exercising.

Prevention

There are many ways we can prevent acid reflux or GERD, and most would require changes in our lifestyle. The options are as follows:

  • Reduce weight, especially in the abdominal area
  • Stop smoking
  • Eat meals in smaller portions
  • Avoid lying down after eating
  • Wear loose clothing
  • Reduce consumption of greasy foods, chocolates, coffee, tea, acidic foods and alcoholic drinks
Treatments

If you are suffering from acid reflux or GERD, you can opt to consume proton-pump inhibitors (PPIs) or H2 blocker medicines, both of which reduce the production of acid in the stomach. You may also consider buying over the counter (OTC) treatments, such as the antacid Gaviscon.

Please make sure to follow the instructions given on the packaging or the product or instructions given by your pharmacists. If medication fails to control symptoms, there are other procedures including surgery which can alleviate the symptoms of GERD.

Article approved by Dr Sandev Singh, Consultant Gastroenterologist, Hepatologist & Physician. Published 13 January, 2021.

Dr Sandev Singh

Consultant Gastroenterologist, Hepatologist & Physician
Resident Consultant
Specialty
Gastroenterology & Hepatology, Internal Medicine
Qualifications
MBChB (Manchester), MRCP (UK), SCE Gastroenterology (UK), CCST (General Medical Council, UK), Fellowship Advanced Endoscopy (Mumbai)
Suite Number
Level 1 - C-L1-01
Spoken Language
English, Malay

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