What you should know about acid reflux

A spicy dish. A refreshing Margarita, garnished with salt and lime. A plate of crispy, fried calamari. All these foods can trigger a very common condition called acid reflux.

Acid reflux occurs when stomach contents flow backward into the esophagus, the tube that carries food from the mouth to the stomach. When reflux happens repeatedly or causes ongoing symptoms or complications, it may be diagnosed as gastroesophageal reflux disease, which is commonly known as GERD.

Heartburn—a burning sensation behind the breastbone—is the best-known symptom, but it is not the only one. Acid reflux can also cause a sour taste, regurgitation, nausea, upper abdominal or chest pain, difficulty swallowing, hoarseness or a chronic cough, experts say.

Occasional reflux is common, however.

“Acid reflux is such a common condition and that’s why there are aisles at the pharmacy full of over-the-counter medicine to treat it,” says  Morgan Sendzischew Shane, associate professor of clinical medicine at the University of Miami Miller School of Medicine. She is a gastroenterologist who is a specialist in motility.

Shane shared the following information about acid reflux:

Q: Why should people not ignore acid reflux?

A: I don’t think you should ignore any symptoms that go on for too long without seeking a medical professional. The first person you should see is your primary care physician because this is such a common symptom. That person can decide whether the symptom may need the attention of a specialist.

Q: What kind of symptoms merit seeing a specialist such as a gastroenterologist?

A: Any difficulty swallowing or significant changes in your appetite that lead to unintentionally losing weight. We get more worried as a person ages because cancer becomes more common in older individuals. However, it is important to note that only about 60 percent of people with esophageal cancer had symptoms of typical acid reflux.But if the symptoms begin to start to negatively affect the quality of life, that is a sign that you should seek care.

Q: Can continued acid reflux damage the esophagus, and what can be the consequences?

A: This is a bit tricky because heartburn and acid reflux are not the same. Heartburn is a sensation of burning, but everyone who has acid reflux may not feel the burning. Many people who have acid reflux may not have any symptoms. Conversely, there are many people that have many symptoms, and when you go in to do an endoscopy—a procedure to examine the upper gastrointestinal tract—you find that they have a perfect esophagus and no signs of inflammation. This does not mean their symptoms should be ignored.However, some untreated severe acid reflux can lead to some esophagitis, which is inflammation of the bottom of the esophagus. There is something called Barrett’s esophagus, in which the body responds to the inflammation and acid exposure that makes the esophagus have changes that can progress to being precancerous. But there is an entire spectrum of risk with that disease, and it does require surveillance. Those patients who do not show precancerous conditions (no dysplasia) can get an endoscopy every three to five years.

Q: Is there a correlation between acid reflux and organs that can affect the respiratory tract?

A: Your esophagus is a tube that connects your mouth to the stomach. In front of your esophagus is your airway, the tube that connects your mouth to your lungs. They share an opening in the mouth. So, when any material is coming all the way up from your stomach, it can cause something called microaspirations, which means that particles from the mouth can go down the bronchus into your lungs. This can aggravate the lungs and lead to conditions like asthma and bronchiectasis.

Q: What kind of lifestyle changes and treatments can help relieve acid reflux?

A: Watching what you eat would be a good way to start. People tend to eat foods that can trigger symptoms. When we eat a diet that is not healthy for us, it can trigger more symptoms.Some lifestyle changes would be:

• Avoid fatty and fried foods.
• Avoid foods that are acidic, such as citrus fruits (lemons, oranges, grapefruits).
• Limit alcohol.
• Avoid tomato sauce.
• Avoid carbonated beverages.
• Do not eat late (the body needs at least three hours to fully digest a meal). Lying down before food is fully digested increases the chance of acid reflux or heartburn.
• Monitor your weight and maintain it at a healthy level.
• Be aware that some medications, such as GLP1 and some medications for Parkinson’s can slow down digestion.

Source: University of Miami