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BREAKING NEWS
Source: Thailand Medical News  Jul 06, 2019
Understanding Acid Reflux and Managing It The Right Way
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Understanding Acid Reflux and Managing It The Right Way
Source: Thailand Medical News  Jul 06, 2019
Acid reflux (or acid regurgitation ) is a common condition affecting million worldwide and is most often related to diet in which stomach acid flows backward up the esophagus, causing acid reflux symptoms such as a burning feeling in the chest (heartburn) and a bitter or sour taste in the mouth. These acid reflux symptoms last a few hours after a meal and then go away. Most people experience acid reflux from time to time, usually after eating certain foods. Acid reflux that occurs more than twice a week is called GERD (Gastroesophageal reflux disease). Left untreated, this serious disease can lead to problems such as inflammation of the esophagus (esophagitis) and a precancerous condition called Barrett’s esophagus. GERD can also worsen asthma, cause chronic cough, insomnia, and pulmonary fibrosis.



Acid reflux and GERD can occur in people of all ages, including children. It is most common in people who are overweight, smoke, and eat poor diets, as well as in pregnant women.

Causes Of Acid Reflux
Acid reflux usually occurs when a ring of muscle at the bottom of esophagus called the lower esophageal sphincter (LES) does not function properly. Normally, the LES keeps stomach contents in the stomach and prevents the backflow of acid by tightening up after swallowing. However for  people with acid reflux, the LES becomes weak and relaxes, allowing acid and stomach contents to flow back up the esophagus. Several factors have been shown to contribute to and worsen acid reflux including:
  • Smoking , Alcohol or caffeine consumption
  • Eating large meals and eating before bedtime
  • Medications such as antihistamines, calcium channel blockers, theophylline, and nitrates
  • Fatty, fried, and spicy foods; tomato-based foods; citrus fruits; chocolate; mint; garlic; and onions
  • Pregnancy
  • Hiatal hernia, a condition in which the top of your stomach protrudes above the diaphragm muscle in your chest
  • Obesity
Acid Reflux Symptoms
Heartburn is the most common of the acid reflux symptoms. Other symptoms include:a) Bitter or sour taste in the mouth, b) Chronic dry cough, c) Trouble swallowing, d) Wheezing and e) Hoarseness

Diagnosis
Acid reflux that occurs more than twice a week could be GERD and should be checked by a doctor, especially if one have been taking antacids or over-the-counter (OTC) reflux medications for more than two weeks.

Testing for GERD involves a physician performing a test called an upper GI series.The patient drinks a type of contrast or dye called liquid barium, which highlights the upper digestive tract. As the barium flows down the esophagus and into the stomach, the physician will take X-ray pictures of the process. The physician may also recommend an endoscopic examination or endoscopy procedure which involves passing a small, flexible tube with a tiny camera at the tip into the mouth and esophagus while the patient is sedated. Any abnormalities in the esophagus can be viewed via the camera.

Traditional Treatments
Healthcare professionals usually recommend lifestyle changes and OTC medications as the first line of treatment for acid reflux. If symptoms aren’t resolved, the patient may be prescribed medication as a treatment for acid reflux. The healthcare professional will also consider the medications(such as NSAIDs) the patient already takes and discuss alternatives to those that may trigger reflux.

Lifestyle Modifications Recommended:
Typical suggestions by healthcare professionals will include:Stop smoking, Avoiding foods and beverages that trigger or worsen symptoms, Eating small but frequent meals, Not to lie down within three hours after eating, Losing weight and to avoid wearing tight clothing, especially around the  midsection.

Antacids:
These OTC drugs (Alka-Seltzer, Maalox, Mylanta, Rolaids, Kreamsil,Eno,Antacil, Gaviscon ) use different combinations of either magnesium, calcium, or aluminum and hydroxide or bicarbonate ions to help neutralize stomach acid and temporarily relieve symptoms. Some might cause diarrhea or constipation.

H2 Blockers:
Available both OTC and by prescription, these drugs (Tagamet, Pepcid, Zantac, Axid) provide short-term relief of GERD by preventing production of stomach acid.Long term usage is not advisable.

Proton Pump Inhibitors (PPIs):
Available by prescription and OTC in Thailand, PPIs (Prilosec, Prevacid, Protonix, Nexium,Miracid) block stomach acid production more effectively than H2 blockers. However, they can cause “rebound” reflux: If the patient uses them, then stops taking them, the stomach acid may return worse than before. However , recent emerging studies show that PPI usage has been found to be associated with lots of negative health conditions, some even dangerous and fatal.

Health Tips By Thailand Medical News
  • Use solid supports such as blocks, or boards to tilt the head of your bed a few inches above your feet. Avoid raising your head by sleeping on two pillows, which can make reflux worse  due to none proper body postures.
  • Practice  relaxation strategies such as calm music, yoga, meditation etc. Stress and anxiety can worsen reflux symptoms.
  • Exercise regularly including activities such as jogging or swimming.
  • Keep a food diary to monitor the foods and beverages that make your symptoms worse. Different people are triggered by different foods.
  • Eat a diet rich in fiber, at least 120 grams a day, including fruits, vegetables and whole grains.
  • Avoid drinking alcohol. Keep alcohol to a minimum if you do drink, and drink only with meals.
  • Drink plenty of water to keep yourself hydrated.
  • Avoid Caffeinated beverages, coffee and tea (including decaffeinated coffee), tobacco and other stimulants as they can irritate the gastrointestinal tract.
  • Take deglycyrrhizinated licorice (DGL).  Slowly chew two tablets or take a half-teaspoon of the powder before or between meals and at bedtime. Taper your dose down as your symptoms improve.
  • Slippery Elm supplements are also good to heal irriated digestive tracts.