ACID REFLUX
What is Acid Reflux?
Acid reflux is properly termed Gastro-oesophageal Reflux Disease or GORD in the medical profession. It refers to the condition where gastric juices, which are very acidic, are pushed backwards up into the gullet (or oesophagus) causing a burning sensation or pain. This pain is usually in the epigastric area of the upper abdomen and the burning sensation may spread upwards to the chest and the throat if acid travels that far. Some people also have a bitter or sour taste in their mouth or sometimes have a feeling of fluid regurgitating back into their mouth. This is sometimes called 'water brash'.
Why does it happen?
A mild degree of acid reflux can occur in most people and can be associated with: eating a big meal and lying down too soon afterwards, drinking lots of carbonated drinks (which is a mild acid), eating spicy or sour food and being stressed, all of which can stimulate acid production from the stomach.
Some people also have a weak sphincter at the lower end of the gullet which allows acid to go backwards too often and these are the people in whom the reflux is worse and who may come to need surgery. In more severe cases, the acid may flow backwards (reflux) up into the throat and spill over into the larynx and the lungs.
How is reflux usually treated?
Most people who have reflux don't need to have surgery and are very well treated with modification of their eating habits, their lifestyle and also a range of medicines.
Lifestyle and Eating Habits
In the first instance, people who suffer from acid reflux should make some changes to their lifestyle and eating which can sometimes cure the problem. Regular meals which are eaten slowly and not rushed, and avoiding a large heavy meal late at night or just before lying down to sleep are important. They should avoid having any form of fizzy or carbonated drinks (these contain carbonic acid) and also avoid oranges, lemons, limes and grapefruits and their juices (these contain citric acid).
Where possible they should stop smoking and decrease as much as possible the sources of stress in their lives. Most people with reflux find that their symptoms improve when they are on holidays and this is because they are often less stressed and eat better and more regularly.
They should also avoid wearing tight clothing or belt around their abdomen which may push on the stomach.
Medications
Acid reflux is usually treated successfully with several groups of medications and most people do not need surgery.
These medicines include:
Medicines which protect the lining of the oesophagus or neutralize the acid (antacids)- Gaviscon, Rennies,
Medicines which turn off some of the acid production (H2 antagonists) - Zantac, Cimetidine
Medicines which specifically turn off most of the acid production (proton pump inhibitors) - Nexium, Losec, Zoton
Medicines which encourage the stomach to propel food the correct way forward - Prepulsid
Some of these medicines are available over the counter and some by prescription but you should always consult your doctor or pharmacist before starting on any medicines you haven't had before.
When do you need surgery for Acid Reflux?
If you have reflux but it is not too bad and well controlled either with a change in lifestyle or more care and attention paid to your eating, then you do not need to have surgical treatment.
Those people who might need to or want to consider surgery:
will have quite severe symptoms with daily burning pain with eating
will suffer from regurgitation when they lie down or bend over - and the sensation is not controlled with medication
have to take daily medicine to keep the reflux under control and do not want to have long term drug use
have symptoms which are not well controlled on the medicines
are unable to tolerate the medicines or are allergic to them
