Even babies and young children can suffer from acid reflux, leading to persistent coughs and respiratory problems. The most immediate symptom most adults recognise is the burning sensation in their throat or a sour taste in their mouth. The same burning feeling can be felt when you vomit.
Gastroesophageal reflux disease (GORD) occurs when the amount of gastric juice that refluxes into the oesophagus exceeds the normal limit, causing symptoms. If left untreated for extended periods of time it can cause significant health issues, even ulcers and possibly cell changes that can lead to cancer.
GORD can also be described as a digestive disorder that affects the lower oesophageal sphincter (LOS) - the ring of muscle between the oesophagus and stomach.
Facts about your digestive system:
The oesophagus or food pipe is the muscle tube that carries the food from your mouth to your stomach.
The diaphragm is a dome-shaped muscle that separates the thorax from the abdominal cavity. The oesophagus passes through this to reach the stomach.
The LOS is a ring-like valve at the bottom end of the oesophagus that opens to allow food into the stomach and closes to stop acid and stomach content from going up (reflux) into the oesophagus.
The stomach is the hollow organ where food is broken down and digested by stomach acid.
Stomach acid is composed mainly of hydrochloric acid (HCl) and is produced by the cells lining the stomach. The acid in your stomach is strong enough to dissolve small pieces of metal-like staples.
What causes GORD:
A hiatus hernia: This occurs when the upper portion of the stomach moves up through the diaphragm. The barrier for reflux is therefore weakened.
Certain foods and drinks can act as triggers or aggravate existing reflux disease by weakening of the LOS.
Aggravators and triggers:
Spices; onions; chocolates and peppermints; fried/fatty foods; coffee (decaf and regular); citrus fruits; tomato and tomato juices; caffeine; alcohol.
How to avoid symptoms:
- Improve your diet by avoiding particular foods, eat smaller and more regular meals and decrease your caffeine and alcohol intake.
- Do not eat within three hours of bedtime
- Stop smoking
- Watch your weight. Excess weight causes extra pressure on the stomach and encourages reflux.
- Maintain a good posture.
- Avoid lying down immediately after eating
- Elevate the head of the bed by 10-20cm. Do not prop yourself up on pillows. This will increase the pressure on your stomach and worsen reflux.
Antacids are used for controlling mild symptoms of GORD and works by neutralising stomach acid.
Histamine-2 blockers decrease the amount of acid produced by the stomach.
Proton pump inhibitors (PPIs) are the most potent therapy option available and is more potent than histamine blockers in decreasing stomach acid secretion.
Surgical options are available if GORD persists despite lifestyle changers and the use of medications.
Article compiled by Dr MM Herbst, MBChB (Stell)
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