Do I Have Reflux?

acid reflux adel el-ghazzawy mdAcid reflux is caused when the muscular band at the bottom of your esophagus (lower esophageal sphincter) relaxes abnormally, causing stomach acid to flow back up into your esophagus. This lower esophageal pressure is usually accompanied by a hiatal hernia, a gradual enlargement of the opening in the diaphragm that allows the esophagus to pass through the chest into the abdominal cavity. This constant backwash of acid will eventually irritate the sensitive lining of your esophagus, causing irritation, inflammation, and other complications. It’s normal for people to get reflux sometimes, but it’s important to monitor your symptoms. Long-term frequent reflux can lead to serious, long-term complications if left untreated. 

Is It Reflux?

Although acid reflux is common and usually harmless, it can have serious health effects if it occurs often enough. When someone experiences acid reflux more than two times a week, it may be diagnosed as Gastroesophageal Reflux Disease (GERD). There are three procedures by which GERD can be diagnosed:

  1. 24-hour Impedance-Probe Study: Your doctor uses a special tube, or scope, with acid-detecting sensors on the end. The scope is inserted through your nose and into your esophagus to detect whether there’s acid present.
  2. 48-hour Bravo Esophageal pH Test: Your gastroenterologist or surgeon attaches a temporary capsule to the distal esophagus during an upper endoscopy that wirelessly measures and records acid reflux for up to 96 hours. An electronic symptom diary is kept by the patient and a compilation of the measured reflux and symptoms produces a score used to determine the likelihood that the symptoms experienced are due to the acid reflux.
  1. Upper Endoscopy: Your doctor will insert the scope through your mouth and into your stomach and a portion of your small intestine. The scope will help your doctor check and biopsy for tumors, ulcers, inflammation, or otherwise damaged tissue. 

Symptoms

Common sufferers of acid reflux are pregnant women, people with hiatal hernias or connective tissue disorders, overweight people, and those who don’t empty their stomachs as often as necessary. Acid reflux is usually very easy to self-diagnose when you know what to look for. Most symptoms are uncomfortable, but manageable, while others are more serious. Some of the most common symptoms are: 

  • Heartburn, usually after eating. May worsen at night
  • Chest pain
  • Difficulty swallowing
  • Regurgitation of food or sour liquid/Sour taste in mouth/Bad breath
  • Sensation of having a lump in your throat
  • Belching
  • Nausea
  • Upper abdominal discomfort
  • Persistent, dry cough
  • Asthma
  • Disrupted sleep

Symptoms in infants and children may be more difficult to distinguish, due to their inability to speak or communicate how they’re feeling as effectively. Acid reflux in infants is extremely common and will usually improve over time as their bodies grow and strengthen. Some of the symptoms in infants include: 

  • Becoming irritable/inconsolable after feeding
  • Choking
  • Forceful regurgitation with burping
  • Inability to gain weight normally
  • Refusal to eat
  • Persistent spitting up or vomiting
  • Wheezing or breathing difficulties

As children get older and are able to be upright and eat more solid food, the symptoms of acid reflux may change. If your child has any of the following symptoms, talk to their pediatrician.

  • Persistent bad breath
  • Chest discomfort
  • Frequent respiratory infections
  • Heartburn
  • Hoarse voice
  • Abdominal discomfort

The more severe symptoms caused by heartburn are sometimes mistaken for a heart attack. If you experience pain in your chest, jaw or left arm, shortness of breath, or sweating/dizziness, it’s best to call your doctor or seek medical attention immediately to rule out the possibility of a heart attack.

If you begin to experience regular episodes of forceful vomiting, difficulty breathing or swallowing, or if you begin to vomit fluid with bright red blood or a dark “coffee ground”-like substance, you should seek medical attention immediately. These are very serious symptoms and you need to be evaluated for any complications. 

Complications

The tissue lining of the esophagus is much thinner and more sensitive than the lining of the stomach. Because of this, long-term acid reflux can inflict serious damage. The more serious complications which can arise are:

Narrowing of the esophagus (esophageal stricture): The stomach acid causes damage to the healthy tissue in the esophagus. This damage turns the healthy tissue into scar tissue, which narrows your throat, making it more difficult to eat and swallow safely. 

Open sore in esophagus (esophageal ulcer): Tissue is worn away by stomach acid, leaving open ulcers which may bleed and cause pain and difficulty swallowing. 

Precancerous changes (Barrett’s esophagus): Long standing reflux can lead to damage leading to a higher risk of esophageal cancer. 

Damage to teeth: Stomach acid can erode the enamel protecting your teeth over time, leaving you more susceptible to cavities, gingivitis and tooth rot. 

Treatment

There are many choices we make throughout the day which may contribute to the development of acid reflux. Avoiding certain foods and beverages can help to minimize or avoid symptoms. These foods include chocolate, alcohol, coffee, carbonated beverages, greasy/salty foods, peppermint, spicy/acidic foods and tomatoes/tomato products. The symptoms of acid reflux can be easily managed in most cases. Mild heartburn can be treated with over-the-counter antacids or stronger antacids prescribed by your doctor for more intense heartburn. 

Certain lifestyle changes may also help to avoid or treat your acid reflux symptoms. There are simple improvements to your daily routines or health that can make a big difference in your reflux symptoms. These include: not smoking, no tight-fitting clothes, weight loss, exercise, raising the head of your bed, and sitting upright for 3 or more hours after eating. It may also help to switch to eating smaller meals more frequently throughout the day and to avoid any vigorous exercise after eating.