Acid Reflux

Acid reflux disease

• In adults and children, irritating acidic juices may back up from the stomach into the oesophagus and throat
• This is frequently called gastro oesophageal reflux disease or GORD
• This may occur at any time but happens more often when lying down
• Hiatus hernia is a common medical condition that predisposes people to acid reflux
• The most commonly recognised symptom of acid reflux is “heartburn” due to irritation of the lining of the oesophagus

Laryngopharyngeal reflux

• Most people do not know that acid reflux can also cause problems in the larynx (voice box) or the pharynx (throat)
• This can happen to someone even if they are not aware of any heartburn, and is sometimes called silent reflux or laryngopharyngeal reflux

Symptoms of acid reflux

• Hoarseness
• Excessive mucous or phlegm
• Throat clearing – acid reflux throat
• A sensation of a lump in the throat
• Sore throat
• Choking episodes
• Wheezing
• A sense of post-nasal drip

Reflux symptoms in children

• In children the symptoms can be a little different and may include:
  • persistent vomiting
  • bleeding from the oesophagus
  • respiratory problems
  • choking episodes
  • recurrent pneumonia
  • asthma
  • problems with eating and drinking
  • anaemia
• In some children unexplained fussiness and crying is due to acid reflux

Complications of acid reflux

• In a small percentage of people, more serious problems are associated with reflux, including pneumonia, ulcers of the larynx, vocal cord scarring, or a pouch of the upper oesophagus
• There is also a small chance of developing cancer in the oesophagus or throat due to long-term reflux that is not managed effectively

Acid reflux remedies

• This information is intended to help you understand acid reflux and the steps you can take to address this problem
• It is important to realise, however, that the healing of the irritated larynx, pharynx and oesophagus will take time

Acid reflux diet

• Dietary factors often contribute to acid reflux
• Certain foods are acids or irritants themselves, others will bring on acid production by the stomach
• The following list contains types of foods that are known to be especially troublesome:
  • Caffeinated beverages, Coffee, Tea
  • Chocolate
  • Carbonated beverages
  • Alcoholic beverages
  • Citrus drinks
  • Highly spiced foods

Acid reflux cause

• Being overweight contributes to acid reflux – if you are overweight it would help to lose weight
• Large meals at one time are troublesome, so three or four smaller meals are preferable to one or two large meals
• It is preferable to not eat for two or three hours before bedtime and it is advisable not to lie down right after eating

Behavioural and other factors

• As mentioned body weight is a significant factor in promoting the reflux of stomach acid and weight reduction is helpful
• Pregnancy will markedly increase the reflux symptoms of heartburn and sometimes throat symptoms – this is partly due to pressure on the stomach by the space taken up by the growing infant
• It is preferable to avoid clothing that fits tightly across the midsection of the body
• Good posture can make a difference – avoid slumping when sitting down and avoid bending or stooping
• For many people reflux occurs most often at night and sets up the irritation that continues to bother during the daytime – one of the most important things you can do is to sleep on a bed that is elevated at the head end

Avoid medications that worsen acid reflux

• Several different medications that you might be taking for medical problems may actually increase stomach acid
• These include:
  • progesterone (Provera and other birth control pills)
  • anticholinergics (Scopolamine, Probanthine and others)
  • beta-blockers (Atenolol, Metoprolol, Propranolol and others)
  • dopamine
  • calcium channel blockers (Cardizem, Diltiazem and others)
  • Aspirin or aspirin-containing compounds and other drugs used for pain – especially non-steroidal anti-inflammatory drugs or NSAIDs are especially prone to aggravating this problem
  • Vitamin C is also an acid and can cause reflux and stomach problems

Medications to treat reflux

In addition to dietary and behavioural adjustments, medications are often part of an anti-reflux program. Some are available without a prescription, while others require a prescription.

• Antacids are commonly used and work by neutralising stomach acid
• Other medications work to decrease stomach acid secretion before it happens and are more effective at controlling symptoms
• Medications to treat reflux should be discussed with your doctor and will be prescribed as appropriate

Surgery

• In some patients with severe symptoms or complications of acid reflux, surgery can be performed for treatment
• If appropriate your doctor will discuss this option with you