What Is Acid Reflux?
Acid reflux occurs when the acid normally in the stomach backs up into the esophagus, the tube that carries food from the mouth to the stomach.
When acid reflux occurs more than twice weekly, is long-lasting, or causes uncomfortable symptoms or damage, it is referred to as gastroesophageal reflux disease (GERD).
What Are Symptoms of Acid Reflux?
Symptoms of acid reflux include:
- Heartburn, which is burning pain or discomfort in the chest, stomach, abdomen, or throat
- Regurgitation, which is when acid and undigested food back up into the throat or mouth
- Stomach pain
- Chest pain
- Trouble swallowing
- Feeling as if food is stuck in the throat
- Sore throat
- Unexplained dry cough
- Vomiting (may be bloody)
- Bloody or black stools
- Unexplained weight loss
- Bad breath
- Respiratory problems
- Tooth erosion
What Causes Acid Reflux?
Acid reflux and gastroesophageal reflux disease (GERD) occur when the lower esophageal sphincter becomes weak or relaxes, causing stomach contents to back up into the esophagus.
Causes of lower esophageal sphincter weakness or relaxation include:
- Overweight or obesity, which puts increased pressure on the abdomen
- Pregnancy, which also puts increased pressure on the abdomen
- Hiatal hernia
- Smoking or inhaling secondhand smoke
- Certain medicines
- Asthma medications
- Calcium channel blockers
How Is Acid Reflux Diagnosed?
After a history and physical examination, tests used to diagnose acid reflux and gastroesophageal reflux disease (GERD) include:
- Upper gastrointestinal (GI) endoscopy and biopsy
- Upper GI series
- Esophageal pH and impedance monitoring
- Esophageal manometry
What Is the Treatment for Acid Reflux?
Some people can manage acid reflux on their own with lifestyle changes or by taking non-prescription medicines.
Home remedies to relieve acid reflux include:
- Lose weight if you are overweight or obese
- Raise the head of the bed 6 to 8 inches using blocks of wood or rubber under 2 legs of the bed or a foam wedge under the mattress
- Avoid foods that worsen symptoms
- Fatty or greasy foods
- Spicy foods
- Don’t smoke
- Don’t overeat
- Don’t eat 2 to 3 hours before bed
- Lying down with a full stomach can make reflux worse
- Wear loose clothing around the stomach area
If lifestyle changes do not relieve symptoms of acid reflux, medications used to treat the condition include:
- Best for mild symptoms
- Only work for a short time
- Available without a prescription
- Examples include aluminum hydroxide and magnesium hydroxide (Maalox), calcium carbonate and magnesium hydroxide (Rolaids), sucrose and calcium carbonate (Tums), and simethicone (Mylanta)
- Histamine blockers
- Stronger and longer-lasting than antacids
- Many available without a prescription
- Examples include cimetidine (Tagamet HB), famotidine (Pepcid AC), and nizatidine (Axid AR)
- Proton pump inhibitors (PPIs)
- Used for frequent and more severe symptoms
- Some are available over-the-counter (OTC) and some require a prescription
- Examples include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole (Protonix), and rabeprazole (AcipHex)
- Used to help the stomach empty faster
- Examples include bethanechol (Urecholine) and metoclopramide (Reglan)
- Can help the stomach empty faster
- Erythromycin has fewer side effects than prokinetics
In severe cases of gastroesophageal reflux disease (GERD) when symptoms do not improve with lifestyle changes or medications, surgery may be recommended. Types of surgery to treat gastroesophageal reflux disease (GERD) include:
- A laparoscopic procedure in which a thin tube with a tiny video camera and the top part of the stomach is sewn around the esophagus to reduce reflux
- Endoscopic techniques
- Endoscopic sewing uses small stitches to tighten the sphincter muscle
- Radiofrequency creates heat lesions, or sores, to help tighten the sphincter muscle
- Results for endoscopic techniques are not as good as those for fundoplication
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