Do you sometimes feel a burning sensation in the middle of your chest after eating a heavy meal? Or do you feel a sour taste in your throat after a while? Many people in Sri Lanka call this "gastritis". But this is not always gastritis. This is something different, and it may be a condition that we should definitely be aware of. Today we are talking about Acid Reflux and GERD, which is a serious condition.
Simply put, what is Acid Reflux?
It's very simple. Our stomach contains many types of acids that help digest food. Normally, this food and acid should go down from the stomach, that is, towards the intestines. That is the right way. However, when this stomach acid flows back up, that is, along the tube through which we swallow food (the esophagus) and towards the throat, we call it Acid Reflux.
Think about how strong the acid in your stomach is. The walls of your stomach have a special coating that can withstand that acid. But our throat and esophagus don't have that special coating. So when that strong acid comes up, it burns the delicate tissues in those places and causes inflammation. This is what we call "heartburn." It can be normal to feel this way from time to time. But this is not a disease.
So what is GERD?
GERD is an abbreviation for Gastroesophageal Reflux Disease . In Sinhala, it means gastroesophageal reflux disease. Although the name is a bit complicated, it is very easy to understand.
Acid reflux from time to time is not a problem. But if this condition persists, meaning if you experience this burning sensation in your chest and throat for more than twice a week, we call it GERD. This is a medical condition.
Simply put, GERD is a condition called chronic acid reflux. What happens here is that there is a weakness in the mechanism that prevents the contents of the stomach from coming up.
What are the symptoms of Acid Reflux and GERD?
Many people may have one or more of these symptoms at the same time. Let's look at the main ones.
| Symptom | A simple explanation |
|---|---|
| Regurgitation | A feeling of food, liquid, or acid coming back up from the stomach into the throat shortly after eating. A sour taste in the mouth. |
| Feeling of burning | Heartburn is the main symptom. Some people may also experience it as a burning sensation in the upper part of the stomach (acid indigestion). |
| Chest pain that is not heart disease | For some people, this may not feel like a burning sensation, but rather like a tightening in the chest. Some people are afraid because this pain is similar to the pain of a heart attack. |
| Nausea and anorexia | Stomach acid can come up, causing nausea and loss of appetite. Even after a long time, you may still feel full. |
| Sore throat and difficulty swallowing | If acid gets into your throat, it can cause a sore throat. It can feel like something is stuck in your throat, like a lump. It can also be difficult to swallow. This often happens at night. |
| Asthma-like symptoms | GERD can cause asthma-like symptoms, such as persistent coughing, wheezing, and wheezing. |
When do these symptoms increase?
- When you lie down to sleep at night.
- After eating a large meal with too much oil and chili.
- When you lean forward.
- When smoking or drinking alcohol.
Do small babies get GERD?
Yes. It is normal for babies to spit up a little after drinking milk. It is not a big problem. But GERD is a more serious condition. It can cause discomfort and refusal to eat. Babies who are born prematurely or with some problem in the esophagus are more likely to develop GERD.
Symptoms of GERD in a young baby may include:
- Constant crying for no reason, restlessness.
- Difficulty sleeping.
- Refusal to drink milk.
- Frequent vomiting.
- Wheezing or hoarseness of voice when breathing.
- Bad breath.
Why do we get acid reflux like this?
The main reason for this is the weakening of a muscle that acts like a valve at the end of our esophagus (food pipe), where it connects to the stomach. In medical terms, this is called the Lower Esophageal Sphincter (LES) .
This LES is like a door. When we swallow food, this door opens, and when the food goes into the stomach, it closes again. When it closes, the contents of the stomach cannot come back up. But if this LES door becomes weak for some reason, if it doesn't close properly, then the acid in the stomach leaks up.
| The main causes of LES weakness | |
|---|---|
| Hiatal Hernia | This is when the upper part of the stomach pushes up into the chest. This is more common as we age. This changes the pressure on the LES and weakens it. |
| Pregnancy | During pregnancy, the pressure of the growing belly and hormonal changes can cause the LES to relax. This condition often goes away after the baby is born. |
| Obesity | As you gain weight, your belly fat increases, which increases the pressure inside your stomach. This pressure pushes the LES up, making it more likely for acid to come up. |
| Smoking | The chemicals in tobacco cause the LES to relax. Smoking also slows down digestion and increases stomach acid production. |
In addition to these main causes, certain medications (e.g., some high blood pressure medications, painkillers), certain foods (chocolate, coffee, mint, fatty foods), and alcohol can also affect this.
What happens if we dismiss this as just inflammation? (Complications)
This is where we need to pay the most attention. If we don't treat it as "just a little gastritis," it can lead to serious problems in the long run.
- Esophagitis: The lining of the esophagus can become inflamed and sore due to continued acid reflux . This can cause ongoing pain and difficulty swallowing.
- Barrett's esophagus: This is a more serious condition. Due to prolonged exposure to acid, the cells in the lower part of the esophagus begin to change. This is a precancerous condition that has the potential to develop into cancer .
- Esophageal stricture: As the injury continues to heal, scar tissue can form in the esophagus, narrowing the area. This can make it very difficult to swallow food.
- Throat and respiratory problems: If acid reaches the throat and enters the respiratory tract, it can cause conditions such as persistent coughing, hoarseness, and asthma, or worsen existing asthma.
How does a doctor diagnose GERD?
After listening to your symptoms, your doctor may recommend several tests to confirm the diagnosis and determine its severity.
- Upper endoscopy: In this, a thin tube with a camera at the end is inserted through the mouth and the inside of the esophagus and stomach is examined. This can clearly see if there are any lesions or changes.
- pH test: This measures how long and how much acid is present in the esophagus.
- Esophageal manometry: This test measures the pressure and function of the muscles in the LES and esophagus.
What are the treatments for this?
Treatments for GERD can be divided into three main categories. Often, one or more of these methods are used together.
1. Changes in lifestyle and eating habits
Even before resorting to medication, this condition can be controlled to a great extent by making small changes in our lifestyle.
- Losing weight: If you are overweight, losing weight is a must.
- Meal control: Instead of eating one big meal at a time, eat several small meals throughout the day.
- Avoid spicy, oily foods:Reduce your intake of spicy foods, oils, fried foods, chocolate, coffee, and mint.
- Lying down after eating: Do not lie down for at least 2-3 hours after eating at night.
- Sleeping position: When sleeping, sleep with your head slightly elevated. It would be better if you could raise the bed a little by placing two pieces of wood on the legs at the head of the bed.
- Smoking and alcohol: It is very important to stop both of these completely.
2. Medicines (types of medicines)
If lifestyle changes alone are not enough to control your symptoms, your doctor may prescribe medication.
- Antacids: These work by quickly reducing the acidity of the stomach acid. They are good for occasional heartburn, but they are not a long-term solution.
- H2 blockers: These reduce the production of stomach acid.
- Proton pump inhibitors (PPIs): These are the most powerful acid-reducing drugs available. They largely stop acid production and help heal ulcers in the esophagus.
The most important thing: Any of these medications should only be used under the advice of your doctor. Taking them at the pharmacy as you please will only worsen the condition and cause internal complications.
3. Surgery
For those with very severe GERD that doesn't respond to medication, or those with a condition like a hiatal hernia, surgery may be recommended. This involves strengthening the weakened LES.
What should you do if you suddenly get chest pain?
- Stand up straight: If you are lying down, get up and sit or stand up straight. Gravity will help the acid go down.
- Drink some water: Not a lot, just a few sips of water can help wash away the acid and go down.
- Loosen your clothes: If you are wearing tight clothes or a belt, loosen it.
- An antacid: If you have an antacid that a doctor has prescribed, use it.
Take-Home Message
- While occasional heartburn is normal, if you experience these symptoms more than twice a week, it is a medical condition (GERD).
- Don't just ignore it, thinking it's "gastritis." If you have these symptoms, definitely see a doctor and get an accurate diagnosis.
- This disease can be largely controlled with simple changes in lifestyle and dietary habits.
- If GERD is not treated properly, it can lead to serious complications such as esophageal cancer.
- Do not take acid-reducing medications for as long as you want without consulting a doctor.
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