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Acid Reflux Heartburn and GERD

What is Acid reflux Heartburn and GERD ?

Acid reflux

In the upper part of GIT at the junction of the esophagus and stomach, there is a circular muscle called “lower esophageal sphincter.” Its main function is to involuntary regulate the passage of food and liquid to the stomach. 

But if that muscle doesn’t work properly due to any pathology or weakness then the undigested acidic food can backflow into the esophagus. This phenomenon is known as acid reflux. Acid reflux occurs when acid in stomach regurgitates (backflow) in the esophagus resulting in the irritation of esophageal epithelium.

Heartburn

On the other hand, heartburn is a case of acidic indigestion. Heartburn is a symptom of acid reflux because there is a burning sensation felt around the region of the heart, despite the fact that it has nothing to do with the heart. It is felt so, because the esophagus is anatomically positioned just behind the heart. 

GERD or (gastro-oesophageal reflux disease) is a chronic condition of acid reflux. It is an advanced and most feared form of chronic acidity. It is diagnosed when a patient complains of two or more cases of acid reflux within a week. It can also be associated with inflammation of the esophagus. Long term GERD can also lead to cancer. The pain associated with GERD is intense and may not be relieved with mild antacids or other over the counter drugs. Often painkillers are prescribed to the patient.

Various symptoms that indicate to GERD are:-

  • Foul breath despite brushing teeth regularly
  • Damaged tooth enamel despite maintaining proper dental hygiene.
  • Frequent heartburn
  • Feeling of regurgitating stomach contents into the mouth
  • Chest pain
  • Asthma
  • Difficulty in swallowing

The main difference between GERD and acid reflux is that symptoms associated with acid reflux are temporary and subside in a short time. But symptoms of GERD are chronic and can only be relieved after proper medication.

There are many complications that can arise due to GERD like:-

  • Esophageal stricture– it is a condition of narrowing of the esophagus due to the formation of a large amount of scar tissue. Continuous damage to esophageal tissue by frequent regurgitation of acid forms a large amount of scar tissue. This leads to problems associated with the swallowing of food.
  • Esophageal ulcer:- frequently regurgitation of the acidic content into the esophagus can wear away esophageal epithelium leading to the formation of open sores. Which further develops into an esophageal ulcer. These ulcers can bleed and cause pain.
  • Barrett esophagus:- it is a pre-malignant conversion of the epithelium of the lower esophagus, due to continuous damage. Despite of the fact that it is a nonproblematic state but in future can lead to major complications like cancer

What are the dissimilarities between acid reflux heartburn?

As heartburn is mainly a symptom of acidic reflux. It is associated with a very uncomfortable burning feeling of pain and discomfort around the chest. A person may also feel a sour or bitter taste in his mouth & throat.

This phenomenon is also associated with GERD. But it’s not a guarantee that a person suffering from GERD will definitely have heartburn. During acidic reflux, there is bitter taste in throat and in mouth , sometimes it is also associated with churning motion of stomach, nausea, and belching. This involuntary motion in the stomach can also add to increased discomfort and stomach pain. Bloating of upper abdomen wheezing hoarseness of voice, irritation in throat is also common. Feeling of fullness, tightness of abdomen and vomiting can also be seen in some people.

Symptoms of acid reflux heartburn

Acidic reflux heartburn are commonly associated with these symptoms:- 

  • Metallic taste in  mouth and throat
  • A warm feeling inside the throat and region around the heart
  • Temporary tonsillitis associated with a sore throat
  • Irregular churning movement in the stomach
  • Frequent belching
  • The feeling of nausea associated with fullness
  • Bloating
  •  Difficulty in swallowing 
  • Feeling that something is stuck in the throat

note : Acid reflux heartburn can also cause chest pain, especially after eating and lying down. If symptoms of chest pain are severe, then one should immediately rush to nearby hospital and seek medical help. Severe chest pain may indicate serious health condition like heart attack.

Common causes of acid reflux heartburn

Acid reflux and heartburn can be caused by a variety of reasons that can be either due to physiological or pathological causes. Some of the common causes are

  • Alcohol consumption
  • Cigarette smoking
  • Obesity
  • Eating hefty meals
  • Frequent eating
  • Eating just before when you are going to sleep
  • Insomnia or poor sleep
  • Pregnancy
  • Diabetic condition
  • Stress
  • Tumors of stomach

A pre-existing acidity can also be aggravated by eating various food some of them are:

  • Deep-fried and oily foods
  • Dark chocolates and cocoa powder
  • Caffeine
  • Carbonated drinks
  • Fermented beverages
  • Citrus fruits like lemon orange-pineapple etc
  • Hot sauce and spicy food

How to diagnose acid reflux heartburn?

A person with the above signs and symptoms needs to see a gastroenterologist, who is a medical professional that specializes in the pathology of the gastrointestinal tract.

Doctors diagnose G E R D (gastro-oesophageal reflux disease) by doing a provisional diagnosis. It includes taking a detailed history of patients about various signs and symptoms associated with the disease. 

In chronic cases of acid reflux, an Upper GI series is often prescribed to the patient. It is a series of X-rays along various sections of the esophagus, stomach, and other parts of the upper git. It is very helpful in ruling out other complications that can be associated with the disease. 

The doctor often advises upper GIT endoscopy to patients who have a past history of chronic and frequent acidic reflux.

Endoscopy provides a clear view of the extent and severity of the condition. It also helps to rule out other conditions like ulcer gastritis, tumors of GIT, etc.

Treatment of acid reflux  heartburn

Various kinds of medications are prescribed by doctor fruit rate acidic reflux and hard words such as:-

  • Coating agents (eg sucralfate) prevents overproduction of acid in the stomach.
  • Proton pump inhibitors (eg: pantoprazole rabeprazole, esomeprazole, etc) reduces the amount of acid secretion by suppressing the acid-producing cells present on the wall of the stomach.
  • True motility drugs (eg: metoclopramide, carbachol, and bethanechol ) reduces the mortality of the stomach which prevents acidic regurgitation.

How to prevent acid reflux  heartburn ?

For many person changes in diet and lifestyle can be very helpful in the prevention of acid reflux. Some of them are:-

  • one should avoid eating just before bedtime
  • Don’t go to bed just after your dinner
  • Eat light and well-timed meals, rather than having one or two hefty meals
  • One should avoid taking spicy caffeinated citrus acidic and deep-fried foods.
  • Limiting your alcohol content
  • Quit smoking
  • If you are obese then try to lose weight
  • Maintain good posture while sitting and sleeping
  •  You should immediately consult your doctor if you are on any medication that causes symptoms of acid reflux and heartburn.
  • Avoid taking and prescribed over the counter antacids and H2 blockers. As this may trigger and acid reflux as a side effect.
  • A person suffering from frequent acid reflex should also avoid sleeping on the right side as it increases the tendency of the acid content of your stomach to regurgitate into your esophagus.
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