Acid Reflux
Acid reflux is a condition where the flap of the esophagogastric junction fails to work properly or an individual has too much pressure on their stomach due to obesity or pregnancy and allows acid to come up inside the esophagus, causing irritation and erosions of the esophagus.
The esophageal lining is not meant to tolerate acid like the stomach is and when too much acid coats the lining of the esophagus, it brings pain and a burning sensation in the chest so typical of acid reflux.
Symptoms of acid reflux include burning pain in the chest or stomach area, belching, gas, the sensation of fluid coming up into the throat (called waterbrash), sore throat or a hoarse voice. A person can have one or all of these symptoms depending on the severity of the disease. People tend to get heartburn around early middle age but even babies can get it. Acid reflux is a cause of why babies spit up so much and it can be a serious cause of weight loss.
Risk factors for acid reflux include being obese or being pregnant as mentioned above. Smoking can stimulate acid production in the stomach and can contribute to acid reflux. It can also relax the lower esophageal sphincter that keeps acid out of the esophagus. Alcohol does the same thing and makes the esophagus have an increased sensitivity to stomach acid.
Eating certain foods can contribute to acid reflux. Eating fried foods, citrus, fatty foods, tomatoes, coffee, peppermint and pepper can contribute to the formation of acid reflux disease. Those who have a hiatal hernia have a weaker lower esophageal sphincter than normal people that causes the formation of acid and other stomach contents in the area of the esophagus, eroding into it at times. Individuals with a peptic ulcer have a higher rate of gastroesophageal reflux disease. Finally, having gastroparesis, which is a syndrome of delayed stomach emptying can contribute to having acid reflux disease.
There are both surgical and nonsurgical methods of treating acid reflux. The medications used include histamine 2 blockers like Tagamet and Zantac. They prevent the acid from forming, reducing the amount of acid that gets into the esophagus. The state of the art medications for acid reflux include acid pump inhibitors which further reduce the acid made by the stomach. Medications like Prilosec and Aciphex belong in this category and are taken one at bedtime to block stomach acid formation. While fluid still comes up inside the esophagus, it isnt particularly acidic so it doesnt erode or bother the esophageal lining.
The main surgery for acid reflux is the laparoscopic Nissen fundoplication. Doctors use a laparoscope and go in and create a flap for the stomach that makes up for the weak gastroesophageal sphincter and prevents acid from coming up inside the esophagus. The surgery works well but can have complications like abdominal sepsis (if the esophagus is accidentally punctured during the procedure).
Complications of esophageal reflux include Barretts esophagus, which is a precancerous condition of extreme irritation of the esophagus that, if left unchecked, can turn into cancer of the esophagus. Barretts esophagus must be treated aggressively.
