What is reflux?
The medical name for this condition is gastroesophageal reflux disease (GERD). It is sometimes called acid reflux or heartburn. Reflux occurs when the acid from the food and liquid in your stomach backs up into your throat (esophagus). It can occur at any age, even in babies. Many times, we can determine the triggers for your reflux.
Symptoms of reflux
For many people, the main symptom of reflux is a burning feeling in the back of the throat, in the middle of the chest, or behind the breastbone. You may also have an acid taste in your mouth. Other symptoms can occur without the burning sensation. Those include a dry cough, asthma, and difficulty swallowing. Less common symptoms include having excessive saliva and a sore throat that does not go away.
What causes reflux?
Reflux is caused by a weakened muscle at end of your throat. The muscle does not close properly, which allows acid to back up into your throat. You can be prone to reflux if you are pregnant, overweight, taking certain medicines, or are a smoker.
How is reflux diagnosed?
We will begin by discussing your symptoms. Not everyone who has an episode of reflux has GERD. We may then have you undergo testing to see if you have GERD. Such tests could include:
- Ambulatory acid (pH) probe test: This test measures the acid in your stomach for 24 hours. You will insert a small, thin tube into your nose and down into your throat. The tube is connected to a small computer you strap around your waist. Another version of this involves a small probe placed in your throat. The probe transmits a signal for a period of time. After 2 days, the probe falls off and is passed in your stool.
- X-ray: The X-ray will look at the inside your upper digestive system (throat, stomach, and upper intestine). For this test, you will be given a chalky liquid to swallow. This liquid coats your digestive tract to provide better views of the inside.
- Endoscopy: This is similar to the small, thin tube used for the (pH) test. However, the tube is connected to a small camera at the end. This allows a look inside your upper digestive tract. A sample of the tissue inside your track might need to be taken for further testing.
- Esophageal motility test (manometry): This test measures the movement and pressure of your esophagus. It involves inserting a small, thin tube through your nose and down your throat.
Can reflux be prevented or avoided?
There are many lifestyle changes you can make to reduce or eliminate reflux. These include drinking alcohol, eating too close to bedtime, being overweight, and wearing tight clothing. Some foods also trigger GERD. You may want to cut back on chocolate, caffeine, peppermints, and greasy, spicy, and acidic foods.
If your symptoms are mild, treatment may not be necessary. We may be able to recommend taking medicine to relieve symptoms. Over-the-counter medicine is effective for treating mild cases of reflux. These medicines include:
- Antacids: This is a quick-acting medicine that reduces stomach acid. Unfortunately, antacids alone will not heal the damage stomach acid causes in your esophagus. Sometimes, overusing antacids can cause diarrhea or constipation.
- H-2 receptor blockers: These medicines reduce acid production. They do not work as quickly as antacids. However, they provide longer relief (up to 12 hours). Stronger versions of these medications are available by prescription.
- Proton pump inhibitors: These medicines block acid production and heal the damage in your throat. They are stronger than H-2-receptor blockers.
If these medicines are not providing relief after a few weeks, please contact us. We may give you a prescription version of H-2 receptor blockers or proton pump inhibitors. Additionally, we might need to prescribe medicine to strengthen the lower esophageal sphincter. The medicine may decrease the number of times your muscle relaxes. It often is used for severe reflux. Side effects include fatigue or confusion. Another medicine that we may prescribe helps your stomach empty faster. This will cause the food to move along the digestive tract and not back up into your throat. We may need to combine more than one medicine, depending upon the severity of your reflux.
In some cases, surgery may be required to treat reflux. This is when medicine does not help, or if you want a long-term solution. Types of surgery may include:
- Nissen fundoplication: This surgery reinforces the lower muscle in the esophagus. A surgeon will wrap the very top of the stomach around the outside of the lower esophagus. This reduces reflux by putting pressure on your esophagus. This is laparoscopic surgery. This means the surgeon makes three or four small cuts in the abdomen (stomach region). He or she will insert instruments, including a flexible tube with a tiny camera, through the cuts.
- Linx surgery: This surgery strengthens the muscle in the esophagus. The Linx device is a ring of tiny beads made of titanium. The surgery wraps the ring around the area between the stomach and the esophagus. The magnetic attraction of the beads is strong enough to keep the opening between the two closed. This helps keep acid from backing up into your throat. However, it is weak enough to allow food to pass. The surgery is minimally invasive.
Living with reflux
Living with reflux can be miserable if left untreated. Planning and being aware of the triggers for your reflux can help. Make changes in your diet and lifestyle that can improve your quality of life. For example, if you know eating before bedtime causes your reflux, avoid eating late. If you cannot avoid a trigger, plan to take over-the-counter medications to treat the symptoms of reflux. If you have tried everything (include diet and lifestyle changes), and it doesn’t help, please let us know.
Questions to ask
- Why do certain foods trigger my reflux at times and other times they do not?
- Is reflux hereditary?
- Can the damage to your throat heal over time once you have it under control?
- Does pregnancy increase reflux?
National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases: Acid Reflux in Adults
U.S. National Library of Medicine, Medline Plus: Gastroesophageal Reflux Disease
Last Updated: July 25, 2019
This article was contributed by: familydoctor.org editorial staff and jswords