What is Acid Reflux?
Acid reflux is a digestive condition where a person experiences an uncomfortable (sometimes painful) burning sensation in the lower chest area, at the top of the stomach, sometimes lasting for several hours. This usually occurs after eating or becomes more intense after eating.
What Causes Acid Reflux?
The burning sensation from acid reflux occurs when stomach acid travels back up through the opening of the stomach (called the gastroesophageal sphincter) into the esophagus.
Stomach acid (called gastric acid) contains enzymes, potassium chloride, sodium chloride, and hydrochloric acid, important compounds that break down food after it enters your stomach. The strength of gastric acid on the pH scale ranges from 1 to 3, which puts it just below the strength of battery acid (pH 0)! A healthy stomach lining is specially equipped with a mucus lining that neutralizes acid to protect it from damage. The burning sensation experienced with acid reflux comes from the powerful gastric acid coming in contact with the tissue in your esophagus, which is not meant to withstand the corrosive levels of the substance.
Stomach acid is able to travel up into the esophagus usually due to a relaxation of a ring of muscle called the lower esophageal sphincter which is just before the opening of the stomach. Normally, this muscle relaxes so that food can enter the stomach from the esophagus, and closes back up after food has passed through.
When there is a prolonged relaxation of the lower esophageal sphincter after food has passed through, this causes an opportunity for the stomach acid to move back up into the esophagus, causing symptoms of acid reflux.
Other possible causes of acid reflux include pregnancy and hiatal hernia.
Acid Reflux and Gut Health
Recent study evidence indicates a connection between use of heartburn-type medications such as protein pump inhibitors (PPIs), which decrease stomach acid, and an imbalance of the gut microbiome. While the medications help to decrease the amount of acids secreted into your stomach and ease symptoms of acid reflux, this may also contribute to a change in the balance of microbes in your gut. This dysbiosis may also promote other possible gastrointestinal disorders and conditions (see Are Over-the-Counter Acid Reflux Medicines Safe?).
Acid Reflux Symptoms
Symptoms of acid reflux can include heartburn, regurgitation, bloating, nausea, vomiting, throat soreness, chest pain, erosion of the teeth and bad breath.
Acid Reflux vs. GERD vs. Heartburn
These three terms, sometimes used interchangeably, have different references and meanings.
Where acid reflux is a fairly common condition that can range from mild to severe, GERD (gastroesophageal reflux disease) is when acid reflux moves to a more chronic condition (2 times or more per week) and can lead to other serious digestive disorders. Heartburn is not a condition, but simply a symptom of acid reflux and GERD, and has nothing to do with the heart.
What is the Best Diet for Acid Reflux?
It’s important to eat a healthy diet that is precisely recommended for your current state of health.
There are certain foods that are commonly known to contribute to symptoms including:
Alcohol, especially red wine
Garlic, onions and spicy foods
Acidic juices and fruit such as lemons and oranges
In addition, diets low in dietary fiber are also shown to contribute to acid reflux. An increase in fiber intake is also usually recommended to help with this condition.
Insights and recommendations to improve or support:
Gut Microbiome Health
Immune System Health
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How do you Treat Acid Reflux?
Traditional medical treatments for acid reflux include:
Antacids (chewable tablets that contain calcium carbonate) that neutralizes hydrochloric acid in the stomach
H2 blockers that reduce the amount of acid produced in your stomach (e.g. famotidine)
Proton pump inhibitors (PPIs) that block certain stomach cells from “pumping” acid into the stomach (e.g. omeprazole)
Alginate drugs contain sodium alginate, which creates a gel-like barrier on the top of stomach contents to prevent reflux
More holistic, lifestyle approaches to treating acid reflux can make a difference in your digestion:
If you smoke, quit
Eat smaller meals more frequently instead of 3 large meals
Eat slowly during your meal
Take steps to reduce weight, if you are overweight
Eat at least 2-3 hours before lying down or going to sleep
Eliminate foods that are problematic for you
Is Over-the-Counter Acid Reflux Medicine Safe?
While short-term use of any over-the-counter acid reflux medication seems safe enough, there are label warnings on over-the-counter medications that state when using for longer than two weeks to visit your doctor for further guidance.
General side effects of antacids, PPIs, and H2 blockers can include gas, constipation and diarrhea, dry mouth, headaches, nausea and vomiting.
There are emerging concerns that long-time use of PPIs may have potential side effects including risk of fractures, vitamin B12 deficiency, chronic kidney disease, dementia, as well as infections such as pneumonia and Clostridium difficile diarrhea, which use of PPIs may contribute due to an alteration in gut microbes creating dysbiosis.