Thursday, May 30, 2024

What Causes Stomach Acid Reflux

How Is Gerd Treated

GERD (Acid Reflux): Causes, Symptoms, Treatment | Jay Prabha Medanta Patna

Treatment for GERD depends on how severe symptoms are. For some people, treatment may just include lifestyle changes, such as changing what they eat or drink. Others will need to take medicines. In very rare cases, when GERD is particularly severe, a doctor will recommend surgery.

These lifestyle changes can help ease the symptoms of GERD or even prevent the condition:

  • quitting smoking
  • losing weight if you are overweight
  • eating small meals
  • avoiding carbonated beverages
  • avoiding foods that trigger reflux

It also can help to not lie down for 3 hours after a meal and to not eat 2 to 3 hours before going to bed. Doctors sometimes also recommend raising the head of the bed about 6 to 8 inches. Before you start a major bedroom makeover, though, talk to your doctor and your parents about the best sleeping position for you.

If symptoms continue, doctors might prescribe medicine, such as:

  • H2 blockers, which can help block the production of stomach acid
  • proton pump inhibitors, which reduce the amount of acid the stomach makes
  • prokinetics, which help the esophageal sphincter work better and the stomach empty faster. This can prevent reflux episodes.

Where Are The Esophageal Sphincter Muscles

The upper esophageal sphincter keeps stomach acid out of the pharynx and larynx. When it doesn’t work properly, you can develop symptoms such as hoarseness, loss of voice, chronic cough, phlegm in the back of the throat, and a feeling that something is stuck in the throat. Although the stomach contents come in contact with the lower esophagus before reaching the throat, only about 35% of people with LPR also experience GERD. Experts don’t know why. It may be that the larynx and pharynx are more sensitive to acid than the esophagus. Also, refluxed acid is more likely to pool in the larynx and pharynx, resulting in prolonged exposure. GERD symptoms are usually worst when you are lying down, while LPR often occurs when you are standing or bending over or exercising.

LPR is usually diagnosed by symptoms, although a specialist may look directly at the area with a laryngoscope for signs of swelling and inflammation. The treatment of LPR begins with changes in diet and behavior, including these:

If diet and behavior changes don’t help, a medication may be prescribed usually, treatment starts with a proton-pump inhibitor . Commonly prescribed PPIs include rabeprazole , esomeprazole , lansoprazole , omeprazole , and pantoprazole . They all work by reducing the amount of acid made in the stomach.

Celeste Robb-Nicholson, M.D.

Ways To Prevent Heartburn And Acid Reflux

Most of us are all too familiar with the painful, burning sensation in the center of the chest thats associated with heartburn.

In fact, up to 28% of adults in North America experience gastroesophageal reflux disease , a common condition that causes heartburn. GERD occurs when acid is pushed up from the stomach back into the esophagus, which leads to the heartburn sensation .

Although people often use medications to treat acid reflux and heartburn, many lifestyle modifications can also help you reduce symptoms and improve your quality of life.

Here are 14 natural ways to reduce your acid reflux and heartburn, all backed by scientific research.

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What Is Gastroesophageal Reflux

Gastroesophageal reflux , also called reflux, is when food and acid from the stomach go back up into the esophagus. This causes an uncomfortable feeling in the chest, often called heartburn.

With GER, reflux happens after nearly every meal and causes noticeable discomfort. After eating, people with GER feel a burning sensation in the chest, neck, and throat.

While it’s more common in adults, kids, teens, and even babies can have gastroesophageal reflux.

Study Links Duration Of Heartburn To Severity Of Esophageal Disease


Esophageal disease may be perceived in many forms, with heartburn being the most common. The severity of heartburn is measured by how long a given episode lasts, how often symptoms occur, and/or their intensity. Since the esophageal lining is sensitive to stomach contents, persistent and prolonged exposure to these contents may cause changes such as inflammation, ulcers, bleeding and scarring with obstruction. A pre-cancerous condition called Barrett’s esophagus may also occur. Barrett’s esophagus causes severe damage to the lining of the esophagus when the body attempts to protect the esophagus from acid by replacing its normal lining with cells that are similar to the intestinal lining.

Research was conducted to determine whether the duration of heartburn symptoms increases the risk of having esophageal complications. The study found that inflammation in the esophagus not only increased with the duration of reflux symptoms, but that Barrett’s esophagus likewise was more frequently diagnosed in these patients. Those patients with reflux symptoms and a history of inflammation in the past were more likely to have Barrett’s esophagus than those without a history of esophageal inflammation.

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Sleep Disturbances Aggravate Both Acid Reflux And Depression

Sleep deprivation is associated with an increase in acid reflux symptoms. Schey et al. have observed that sleep deprivation increases sensitivity to acid reflux.

Sleep deprivation may lower our pain bearing threshold and increase pain sensitivity.

Reduced pain sensitivity or disturbance in pain processing pathways can cause increased severity of acid reflux symptoms.

Sleep disturbances are a common complaint in patients with anxiety and depression. Also GERD patients experience sleep issues due to bloating or night time reflux.

Quick Gist: Sleep disturbances are a common factor in the pathogenesis of both GERD and Major Depressive Disorder. Sleep disturbances worsen acid reflux symptoms and are also associated with an increase in depression and anxiety symptoms.

What Is Acid Reflux

Gastro-esophageal reflux disorder, commonly known as GERD, acid reflux, reflux, or simply heartburn is a problem that affects millions of people worldwide. While the fancy title might be GERD, lets just call it reflux or heartburn.

Reflux is when the acid from the stomach travels up into the esophagus causing the familiar burning sensation in the chest and sometimes throat, this is why it is also called heartburn, even though it has nothing to do with the heart. There is also silent reflux which does not cause the burning sensation, it can be hard to identify but it often causes a buildup of mucus in the throat, this can lead to a chronic dry cough or a frequent need to clear the throat.

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Gerd Or Acid Reflux Symptoms

GERD or acid reflux symptoms are caused by the regurgitation of acidic liquid stomach contents back up into the esophagus. The most common symptom of GERD is heartburn.

Other symptoms that can occur as a result of GERD include:

  • nausea,
  • acid-induced erosions of the teeth,
  • nausea,

What To Know About Gerd

The Real Causes of Acid Reflux, Heartburn & GERD Dr.Berg
  • GERD is a condition in which the acidified liquid content of the stomach backs up into the esophagus.
  • Causes of GERD are complex and may involve multiple factors.
  • GERD may damage the lining of the esophagus, thereby causing inflammation , although this is uncommon.
  • Symptoms of uncomplicated GERD include:
  • ulcers and strictures of the esophagus,
  • Barrett’s esophagus,
  • inflammation and infection of the lungs, and
  • a collection of fluid in the sinuses and middle ear.
  • GERD may be diagnosed or evaluated by a variety of procedures and tests.
  • GERD is treated with lifestyle changes, diet, over-the-counter and prescription drugs , pro-motility drugs), and surgery.
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    Betaine Hcl And Pepsin

    Betaine HCL and Pepsin help to replace the low stomach acid. For younger people, this may be a good short term fix while you address the underlying cause, but if you are over 60 years of age it may be a useful long term supplement to help increase your diminished stomach acid levels.

    I recommend the Thorne Research Betaine HCL and Pepsin which you can get from or

    • Follow the lifestyle tips, slow down your eating and eat in a relaxed environment.
    • 3CDSA and/or SIBO testing to identify if Helicobacter pylori infection of the stomach or a bacterial overgrowth of the small intestine is the underlying cause. This testing is available through Planet Naturopath and you will be helped with a treatment plan to eliminate these infections.
    • 4Replace digestive enzymes and address the inflammation of the mucosa with the recommended supplements.

    If you need one on one support to help guide you through this process to help you optimize your digestion and health, you can schedule an appointment with Planet Naturopath here

    High Stomach Acid Symptoms In The Gullet

    • heartburn
    • bending over or stooping forwards
    • lying flat

    Interestingly, pregnant women are more susceptible to acid reflux, particularly in the later stages because the baby begins to push upwards onto the stomach. Lets face it, theres not much room in there! Thankfully though, it usually goes away once the baby is born, although some women experience heartburn for a little while after.

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    Is Chronic Acid Reflux Disease A Serious Condition

    Chronic acid reflux is not a serious condition. Only in the long term, if not treated well, it can cause complications, such as:

    • Esophagitis: Esophagitis refers to the irritation and inflammation caused by the acid reflux in the lining of the esophagus. Esophagitis can cause ulcers in the esophagus. These ulcers can bleed and cause blood loss.
    • Barrett’s esophagus: Barrett’s esophagus is a condition that develops in about 10 percent of people with long-term gastroesophageal reflux disease. The condition increases the chances of developing cancer of the esophagus.
    • Esophageal cancer: This may result due to Barrets esophagus or from squamous cells .
    • Strictures: Narrowing of the esophagus due to scarring of the damaged lining of the esophagus.

    Diagnosis And Tests For Acid Reflux

    TIF Procedure for Frequent Heartburn

    Doctors typically start by asking questions about your medical history and how long youve been experiencing symptoms of acid reflux. They usually move on to performing a physical exam. Your physician may also recommend other tests to determine whether you have GERD or another kind of acid reflux, like:

    • Endoscopy A thin, flexible tube gets inserted down your throat. The end contains a light and a camera, which allows a doctor to view the inside of the stomach and esophagus.
    • Ambulatory acid probe test Your doctor places a monitor into your esophagus to observe when your stomach acid regurgitates, and for how long. The monitor feeds information to a small computer worn around your waist or held up by your shoulder with a strap. It typically passes out of your body through stool after a few days.
    • Digestive system x-ray After drinking a special liquid that coats your digestive tract, your doctor takes x-rays that lets doctors see the outline of your stomach, esophagus, and lower intestine. Your physician may also ask you to take a barium pill that helps diagnose whether you have an esophageal stricture.

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    Can Acid Reflux Disease Be Treated With Diet And Lifestyle Changes

    One of the most effective ways to treat acid reflux disease is to avoid the foods and beverages that trigger symptoms. Here are other steps you can take:

    • Eat smaller meals more frequently throughout the day and modify the types of foods you are eating..
    • If you’re overweight or obese, take steps to lose weight with exercise and diet changes.
    • Also, ask your doctor whether any medication could be triggering your heartburn or other symptoms of acid reflux disease.

    Acid Reflux Medication And Dementia

    The commonly prescribed PPI reflux medication also impairs cognitive function. A 2016 study found that regular PPI users had a 44 percent increased risk of dementia compared with those not using the drugs. A different study published in 2015 that assessed cognitive function in PPI users versus controls found significant impairment in visual memory and attention, this is a concern with the ever increasing levels of dementia in developed countries.

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    What Are The Signs & Symptoms Of Gerd

    Often, people who have GERD notice that they regularly have the pain of heartburn in the chest or stomach. This can last up to a couple of hours. Many notice their heartburn is worse after eating.

    Regurgitation when food and liquid containing stomach acid comes back up into the throat or mouth is also a sign of GERD. But, like heartburn, occasional regurgitation is common for everyone.

    Other symptoms of GERD include:

    • a sore, raw throat or hoarse voice
    • a frequent sour taste of acid, especially when lying down
    • a feeling of burping acid into the mouth
    • trouble swallowing
    • bad breath

    Can Acid Reflux Disease Be Treated With Medications

    Gastroesophageal Reflux (GERD)

    In many cases, lifestyle changes combined with over-the-counter medications are all you need to control the symptoms of acid reflux disease.

    Antacids, such as Alka-Seltzer, Maalox, Mylanta, Rolaids, or Riopan, can neutralize the acid from your stomach. But they may cause diarrhea or constipation, especially if you overuse them. It’s best to use antacids that contain both magnesium hydroxide and aluminum hydroxide. When combined, they may help counteract these gastrointestinal side effects.

    If antacids don’t help, your doctor may try other medications. Some require a prescription. Your doctor may suggest more than one type or suggest you try a combination of medications such as these:

    • Foaming agents coat your stomach to prevent reflux.
    • H2 blockers decrease acid production.
    • Proton pump inhibitors also reduce the amount of acid your stomach makes.
    • Prokinetics can help strengthen the LES, empty your stomach faster, and reduce acid reflux.

    Don’t combine more than one type of antacid or other medications without your doctor’s guidance.

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    Low Stomach Acid Causes Heartburn Or Acid Reflux

    The functional medicine approach has uncovered causal factors regarding heartburn and uses an approach to remedy it different from conventional practices. The functional medicine practitioner wants to treat the root cause of the problem. Drugs, such as Prilosec can just mask the symptoms instead of treating the cause of the problem, and many have severe adverse effects.

    Heartburn, however, isnt caused by too much stomach acid, that is to say, too much HCl, as conventional practitioners have been taught heartburn is caused by not enough stomach acid. Acid-blocking drugs not only have adverse side effects, but they do not treat the cause of the problem, they just exacerbate it.

    It may seem a little counter-intuitive that HCl is necessary, but it will make more sense with a little understanding of digestive physiology. There are several reasons HCl is important. The stomach acid we call HCl, or hydrochloric acid, is your bodys first line of defense against pathogenic bacteria and microbes. An optimum level of healthy stomach acid will kill pathogens and keep them from turning into an infection.

    How Deficiency in Stomach Acid, or HCl Leads to Heartburn

    Tips for Increasing HClBecause the gut is a first line foundation for physical wellness, achieving a healthy level of stomach acid is avery important step in supporting the health of your brain and body. If you suspect that you have low stomachacid, here are some tips for naturally increasing HCl production:

    What Tests Are Used To Diagnose Gerd

    Esophageal acid testing

    Esophageal acid testing is considered a “gold standard” for diagnosing GERD. As discussed previously, the reflux of acid is common in the general population. However, patients with the symptoms or complications of GERD have reflux of more acid than individuals without the symptoms or complications of GERD. Moreover, normal individuals and patients with GERD can be distinguished moderately well from each other by the amount of time that the esophagus contains acid.

    The amount of time that the esophagus contains acid is determined by a test called a 24-hour esophageal pH test. For this test, a small tube is passed through the nose and positioned in the esophagus. On the tip of the catheter is a sensor that senses acid. The other end of the catheter exits from the nose, wraps back over the ear, and travels down to the waist, where it is attached to a recorder. Each time acid refluxes back into the esophagus from the stomach, it stimulates the sensor and the recorder records the episode of reflux. After a 20 to 24 hour period of time, the catheter is removed and the record of reflux from the recorder is analyzed.

    Esophageal motility testing

    Gastric emptying studies

    Symptoms of nausea, vomiting, and regurgitation may be due either to abnormal gastric emptying or GERD. An evaluation of gastric emptying, therefore, may be useful in identifying patients whose symptoms are due to abnormal emptying of the stomach rather than to GERD.

    Acid perfusion test

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    How Is Gerd Or Acid Reflux Diagnosed And Evaluated

    There are a variety of procedures, tests, and evaluation of symptoms to diagnose and evaluate patients with GERD.

    Symptoms and response to treatment

    GERD is typically diagnosed by its characteristic symptom, heartburn. Heartburn is most frequently described as a sub-sternal burning that occurs after meals and often worsens when lying down. To confirm the diagnosis, physicians often treat patients with medications to suppress the production of acid by the stomach. If the heartburn then is diminished to a large extent, the diagnosis of GERD is considered confirmed. This approach of making a diagnosis on the basis of a response of the symptoms to treatment is commonly called a therapeutic trial.

    There are problems with this approach. For instance, patients who have conditions that can mimic GERD, specifically duodenal or gastric ulcers, also can actually respond to such treatment. In this situation, if the physician assumes that the problem is GERD, the cause of the ulcer disease would be missed such as a type of infection called Helicobacter pylori , or nonsteroidal anti-inflammatory drugs or NSAIDS , can also cause ulcers and these conditions would be treated differently from GERD.


    Upper gastrointestinal endoscopy is a common way of diagnosing GERD. EGD is a procedure in which a tube containing an optical system for visualization is swallowed. As the tube progresses down the gastrointestinal tract, the lining of the esophagus, stomach, and duodenum can be examined.

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