Introduction

The opening of the stomach has a valve called the lower esophageal sphincter (LES) that controls the opening and closing of the stomach when food passes through.

If the LES does not work properly, the stomach acid might move up the esophagus or the food pipe causing a burning pain in the chest called Acid Reflux. Heartburn is the burning pain that occurs in the stomach to the esophagus to the chest and sometimes reaching the throat.

If acid reflux symptoms such as heartburn occur as often as twice per week then this condition is called gastroesophageal reflux diseases (GERD).

Symptoms

Some of the known symptoms for Acid Reflux, Heartburn and GERD are:

• Stomach acid that tastes sour or bitter reaches the mouth
• Bloating
• Black stool sometimes bloody
• Vomiting blood
• Dysphagia or the narrowing of the esophagus
• Nausea
• Weight loss
• Burping
• Hiccups
• Wheezing, dry cough or sore throat

Causes

There are a variety of reasons that can cause acid reflux or GERD, some of these include,

• Hiatal Hernia: is a major cause where a person affected by hiatal hernia will experience the LES, along with the upper part of the stomach, moving above the diaphragm causing the stomach contents to move back and forth.
• Eating large meals
• Lying down right after a meal
• Obesity
• Eating excess of certain food items such as tomatoes, citrus fruits, garlic, onions, chocolate, spicy or fatty foods
• Drinking alcohol, caffeinated drinks, carbonated drinks and sometimes tea
• Smoking tobacco
• Certain medications such as ibuprofen, aspirin, muscle relaxers, and blood pressure medications

Diagnosis

If a patient has frequent heartburn or other symptoms related to it, it is advised to get medical assistance right away. The following are some of the methods used to diagnose acid reflux or GERD,

• Barium Swallow is done in order to check for ulcers or the narrowing of the esophagus by swallowing a liquid that help view structures on an X-ray.
• Esophageal Manometry is performed to check the function of the esophagus and LES
• pH Monitoring is done to check if the esophagus is acidic. In this procedure, a device is inserted into the esophagus for 1-2 days to note the amount of acid present.
• Endoscopy involves inserting a long, flexible tube with a lens at the end through the mouth into the digestive tract to check for issues in the esophagus and the stomach. If a problem is noted, a biopsy may be taken to check for infections or abnormalities.
• Upper GI Series is a diagnostic test performed during the early phase of testing where a special X-ray is done to show the esophagus, stomach, and duodenum. This test will help in ruling out other diagnoses like peptic ulcers etc.

Treatment

Some of the treatment options that doctors recommend are:

• Lifestyle changes that would include avoiding certain foods, certain habits like drinking alcohol and smoking etc.
• Medications such as antacids, H2 blockers, proton pump inhibitors etc. are given to treat GERD
• If the condition persists after medication, in some cases surgery is recommended,
  
  • Fundoplication is a surgical procedure where an artificial valve is created using the top of the stomach to prevent acid reflux and repair the hiatal hernia.
  • Endoscopic Procedures might be performed to make the LES function better.