Acid reflux or Gastroesophageal reflux disease (GERD) is a chronic digestive disease that occurs when stomach acid or, occasionally, bile flows back (refluxes) into your food pipe (esophagus). The backwash of acid irritates the lining of your esophagus and causes GERD signs and symptoms.Most people can manage the discomfort of heartburn with lifestyle changes and over-the-counter medications. But for people with GERD, these remedies may offer only temporary relief. People with GERD may need stronger medications, even surgery, to reduce symptoms.
GERD signs and symptoms include:
- A burning sensation in your chest (heartburn), sometimes spreading to the throat, along with a sour taste in your mouth
- Chest pain
- Difficulty swallowing (dysphagia)
- Dry cough
- Hoarseness or sore throat
- Regurgitation of food or sour liquid (acid reflux)
- Sensation of a lump in the throat
- Hiccups that don’t let up
GERD is caused by frequent acid reflux — the backup of stomach acid or bile into the esophagus.
When you swallow, the lower esophageal sphincter — a circular band of muscle around the bottom part of your esophagus — relaxes to allow food and liquid to flow down into your stomach. Then it closes again.
However, if this valve relaxes abnormally or weakens, stomach acid can flow back up into your esophagus, causing frequent heartburn and disrupting your daily life. This constant backwash of acid can irritate the lining of your esophagus, causing it to become inflamed (esophagitis). Over time, the inflammation can erode the esophagus, causing complications such as bleeding or breathing problems.
These are other common risk factors for acid reflux disease:
- Eating large meals or lying down right after a meal
- Being overweight or obese
- Eating a heavy meal and lying on your back or bending over at the waist
- Snacking close to bedtime
- Eating certain foods, such as citrus, tomato, chocolate, mint, garlic, onions, or spicy or fatty foods
- Drinking certain beverages, such as alcohol, carbonated drinks, coffee, or tea
- Being pregnant
- Taking aspirin, ibuprofen, certain muscle relaxers, or blood pressure medications .
Over time, chronic inflammation in your esophagus can lead to complications, including:
- Narrowing of the esophagus (esophageal stricture). Damage to cells in the lower esophagus from acid exposure leads to formation of scar tissue. The scar tissue narrows the food pathway, causing difficulty swallowing.
- An open sore in the esophagus (esophageal ulcer). Stomach acid can severely erode tissues in the esophagus, causing an open sore to form. The esophageal ulcer may bleed, cause pain and make swallowing difficult.
- Precancerous changes to the esophagus (Barrett’s esophagus). In Barrett’s esophagus, the color and composition of the tissue lining the lower esophagus change. These changes are associated with an increased risk of esophageal cancer. The risk of cancer is low, but your doctor will likely recommend regular endoscopy exams to look for early warning signs of esophageal cancer.
Lifestyle and home remedies
Lifestyle changes may help reduce the frequency of heartburn. Consider trying to:
- Maintain a healthy weight.
- Avoid foods and drinks that trigger heartburn. Everyone has specific triggers. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse. Avoid foods you know will trigger your heartburn.
- Eat smaller meals. Avoid overeating by eating smaller meals.
- Don’t lie down after a meal. Wait at least three hours after eating before lying down or going to bed.
- Elevate the head of your bed
- Don’t smoke. Smoking decreases the lower esophageal sphincter’s ability to function properly.
DIET & REFLUX
There are a couple reasons why some foods cause heartburn:
- When the lower esophageal sphincter (LES) – the valve between your esophagus and your stomach – relaxes when it shouldn’t;
- When the stomach produces too much acid.
When the LES is the culprit, food and stomach acid come back up into your esophagus. Some of the foods that can relax the LES include:
- Fried (greasy) foods
- High-fat meats
- Butter and margarine
- Creamy sauces
- Salad dressings
- Whole-milk dairy products
- Caffeinated beverages (e.g., soft drinks, coffee, tea, cocoa)
Foods that may stimulate acid production and increase heartburn include:
- Caffeinated beverages
- Carbonated beverages
- Spicy foods
- Citrus fruit and juices (e.g., orange, grapefruit)
- Tomato-based products
Other possible connections between heartburn and food are when you eat and how much you eat. Eating too close to bedtime or eating too large of a meal later at night can contribute to nighttime heartburn. For more information, read about preventing nighttime heartburn.
It is important to remember that everyone is different, so keeping a heartburn diary will be helpful in determining which specific foods are problems for you.
Learning Which Foods Are Better
As mentioned above, everyone is different. What may be a problematic food for others may not cause you anydistress, and what may be a safe food for others may cause you heartburn every time you eat it. Again, this is why keeping a heartburn diary is important.
Some “safe” foods include:
- Fresh juice and fruit juices (not citrus)
- Vegetables (e.g., baked potatoes, carrots, green beans, peas)
- Lean meat, chicken breast, fish
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