ACID REFLUX/ HEARTBURN

 Acid reflux and heartburn are often used interchangeably. Acid reflux is the movement, the action of stomach acids going up the wrong way, while heartburn refers to the burning sensation. 
Acid reflux is such a common problem you'd think it would be simple to spot and treat. But sometimes acid reflux symptoms are less than obvious or easy to mistake for something else. If left untreated, heartburn can lead to Barrett's esophagus, which is a precursor to cancer, says Timothy Pfanner, MD, assistant professor of internal medicine at Texas A&M Health Science Center College of Medicine, in College Station.
 



Here are some symptoms—both common and unusual—that could mean you have acid reflux.
 
CHEST PAIN; 
Chest pain, which occurs because stomach acid is splashing into the esophagus, is a classic acid reflux symptom. But the pain can last longer and be more intense than expected. Many people mistake heartburn for a heart attack. You can never ignore chest pain, especially if it gets worse when you exercise or exert yourself.

If you're having chest pain, check with your doctor to make sure you're not having a heart attack, says Walter J. Coyle, MD, gastroenterologist with Scripps Clinic Torrey Pines in La Jolla, Calif.

 
PAIN WORSEN AT NIGHT;

The acid that is supposed to stay in your stomach is more likely to escape into your esophagus when you lie down or bend over, causing heartburn.If you're sitting up straight, gravity helps keep food in the stomach," says Dr. Coyle. "If you lose the gravity, you're more prone to reflux." That's why people with chronic heartburn raise the head of their bed, and why they shouldn't eat big meals right before bedtime.

POST-MEAL PAIN;

Pain that sets in right after a meal—especially a big meal—often means the stomach is overloaded and its contents have nowhere to go but up. But you may be able to prevent this without taking medication.

"I would stress not eating big, fatty meals and watching [your intake of alcohol and tobacco]," says Dr. Coyle, who is a spokesman for the American College of Gastroenterology.

Sore throat; 
A sore throat is another classic cold or flu symptom that might actually be caused by digestive problems. If your throat tends to ache only after meals, you may have heartburn. Unlike with a cold or the flu, however, this type of sore throat can also be chronic. If you don't develop other symptoms, such as sniffling or sneezing, consider acid reflux.

Nausea; 
Nausea is associated with so many things that it can be hard to attribute it to reflux. But, says Dr. Coyle, "in some people, the only manifestation they have of reflux is nausea. If you have nausea and can't figure out why, one of the things [to] think about is reflux." And if the nausea tends to come on right after meals, that's even more of an indication that it might be acid reflux. If so, a regular antacid treatment such as an over-the-counter acid-countering medicine could cut down on your discomfort.

Extra saliva; 
If your mouth all of a sudden starts producing extra saliva, it could be water brash, which is highly suggestive of acid reflux, Dr. Coyle says. It involves the same nerves and reflex as when you vomit. "It is your body trying to wash out an irritant in your esophagus," he says.

Here are some things you can do to avoid the health problems associated with acid reflux.

Pregnancy - more commonly found during the third trimester of a pregnancy. As the growing baby presses on the stomach, contents may back up into the esophagus. Doctors say antacids will not relieve acid reflux caused by pregnancy. Patients find that if they eat smaller meals but eat more meals per day, it helps. In the vast majority of cases the acid reflux will disappear soon after the baby is born.
 
Large meals and eating habits - people who have large meals will usually find that their acid reflux will improve if they cut down portion sizes. Patients who kept a food diary, noting down everything they ate and linking certain foods to incidences of acid reflux, have experienced a reduction in acid reflux.
 
Bending forward - this movement will not usually cause acid reflux unless there is another underlying trigger or problem.
 
Hiatus hernia (hiatal hernia) - a condition where the upper part of the stomach protrudes into the chest through a small opening in the diaphragm. Hiatal hernias are commonly caused by severe coughing, vomiting, straining, sudden physical exertion, pregnancy, and obesity.
 
Peptic ulcers and insufficient digestive enzymes - peptic ulcers and not enough digestive enzymes in the stomach may slow down the digestive process, causing an accumulation of gastric acids that back up into the esophagus.
 
Asthma - experts still argue about which came first, the asthma or the acid reflux - did the asthma cause the acid reflux or did the acid reflux cause the asthma? Nobody has a definite answer to the relationship between asthma and acid reflux. Some say that the coughing and sneezing brought on by asthmatic attacks can cause changes in the chest which trigger acid reflux. Others blame asthma medications - they are taken to dilate the airways, but might also relax the esophageal sphincter. Most asthma sufferers say that their asthma is worsened by acid reflux because the acid that seeps into the esophagus from the stomach stimulates the nerves along the neck into the chest, causing bronchial constriction and breathing problems.
 
Smoking - research has shown that the saliva of smokers contain lower levels of bicarbonates, which neutralize acids. Cigarette smoking also reduces the production of saliva. Smoking also stimulates the production of stomach acid, weakens the esophageal sphincter, promotes the movement of bile salts from the intestine to the stomach (making the acids more harmful), and slows down digestion (making stomach pressure last longer because it takes more time to empty).
 
Alcohol - patients have commented that quitting alcohol, or cutting down consumption significantly improved their symptoms.
 
Here's How to control acid reflux/heartburn:  
Eat smaller, more frequent meals.

1.  A full stomach can put extra pressure on the lower esophageal sphincter (LES), which will increase the chance that some of this food will reflux into the esophagus.
2. Limit your intake of acid-stimulating foods and beverages.
3. Eat foods that rarely cause heartburn and avoid those foods that will often cause heartburn.
4. Don't eat within two to three hours before bedtime.
5. Lying down with a full stomach can cause stomach contents to press harder against the LES, increasing the chances of refluxed food.
6. Elevate your head a few inches while you sleep.
7. Lying down flat presses the stomach's contents against the LES. With the head higher than the stomach, gravity helps reduce this pressure. You can elevate your head in a couple of ways. You can place bricks, blocks or anything that's sturdy securely under the legs at the head of your bed. You can also use a wedge-shaped pillow, to elevate your head.
8. Maintain a reasonable weight.
9. Obesity increases abdominal pressure, which can then push stomach contents up into the esophagus. According to some statistics, approximately 35 of overweight persons experience heartburn. The good news is that for many people, as little as a 10 percent decreaee in weight will improve their heartburn symptoms.
10. Don't wear belts or clothes that are tight fitting around the waist.
11. Clothing that fits tightly around the abdomen will squeeze the stomach, forcing food up against the LES, and cause food to reflux into the esophagus. Clothing that can cause problems include tight-fitting belts and slenderizing undergarments.
12. Don't smoke.
13. Nicotine relaxes the esophageal sphincter. Smoking also stimulates the production of stomach acid. Read to learn other ways smoking can worsen heartburn.
14. Don't drink alcohol. Relax.
15. While stress hasn't been linked directly to heartburn, it is known that it can lead to behaviors that can trigger heartburn.
16. Keep a heartburn record.
17. Record what triggered your acid reflux episodes, the severity of each episode, how your body reacts, and what gives you relief. The next step is to take this information to your doctor so the both of you can determine what lifestyle changes you will need to make and what treatments will give you maximum relief.

What is the treatment for acid reflux?
Diet
The vast majority of people with acid reflux will get better if they make some changes to their diet. Some foods are safe for heartburn sufferers, while others are major triggers of it.

It would be easy to say that there is a reflux diet. Unfortunately, we all react differently to different foods.

Below is a list of foods/drinks that commonly cause irritation and/or heartburn:

• Alcohol
• Black pepper
• Chili and chili powder
• Citrus fruit, pineapple
• Coffee
• Garlic
• Spicy food
• Tea
• Tomatoes, tomato sauce, tomato juice, ketchup
• Vinegar

Some patients with acid reflux say these gassy foods cause discomfort:

Beans
Broccoli
Cabbage
Cauliflower
Fizzy drinks (sodas)
 
Medications
Acid suppressant - these have been shown to be effective, such as histamine2-receptor antagonists (blockers). Histamines are good at reducing inflammation. An inflamed stomach produces more acid - blocking this extra production of acid helps prevent the acids from building up and seeping upwards.
Proton pump inhibitors - these reduce the production of acid in the stomach. They act on cells in the stomach wall which produce stomach acids.
Prokinetic agents - these promote the emptying of the stomach, stopping it from becoming overfull.
Antiacids - commonly used to treat mild acid-related symptoms, such as heartburn or indigestion. They neutralize the acids in the stomach. These are not recommended for frequent heartburn for patients with GERD.

#stayhealthy

Wednesday, May 01, 2013