What is acid reflux?
Acid reflux happens when stomach acid leaks up from the stomach into the oesophagus (food pipe). When it happens more than twice a week, it’s known as Gastro-oesophageal reflux disease or GORD. GORD is one of the most common gastrointestinal conditions and it’s thought to affect 10 to 15% of Australians.
Symptoms of GORD
Heartburn is a common symptom of GORD - it’s the burning feeling rising from your stomach or lower chest.
If the stomach acid comes all the way up your oesophagus you may even taste the unpleasant taste it in your mouth.
About one third of people with GORD also have trouble swallowing.
You might also experience other symptoms such as coughing, wheezing, or chest pain.
Causes of GORD
In many cases, the cause of GORD is a problem with the lower muscle at the bottom of the oesophagus (food pipe). It’s known as the lower oesophageal sphincter (LOS). When you swallow food, the LOS opens to let food into the stomach and then closes to stop stomach acid and food contents coming back up. If there is a problem with the LOS, it may not close properly and this means stomach acid can leak out of the stomach and back up the oesophagus.
Weakening of the LOS tends to happen more in people who are overweight, obese or pregnant. People who eat a lot of fatty foods, coffee, chocolate or alcohol also tend to experience GORD more frequently. Smoking also increases your risk as it causes the LOS to relax.
Treating GORD
Treatment for GORD may involve a combination of lifestyle changes and medications.
Lifestyle changes
Losing weight
If you’re overweight or obese, losing weight may well help to reduce the symptoms of GORD. Research has shown that reducing your body mass index results in a reduction in GORD symptoms.
Avoiding eating before bed
It’s best not to eat two to three hours before bed if you have symptoms of GORD at nighttime or early morning upon waking.
Propping up your bed
You might find it helpful to raise the head of the bed or sleep with an extra pillow behind your head if you have symptoms at nighttime.
Eating smaller but more frequent meals
You may find eating smaller but more frequent meals helps to reduce the symptoms of GORD.
Foods to avoid
Healthdirect Australia recommend avoiding the following problem foods:
- coffee
- alcohol
- fatty or spicy foods and pepper
- drinks containing caffeine
- soft drinks
- citrus fruit juices
- chocolate
- peppermint
- battered or fried foods
- pastries, rich cakes and biscuits
Medicines and seeing your doctor
You can get some medications over-the-counter at a pharmacy. If these medications don’t work, it’s best to see your doctor who may prescribe medicines that reduce the amount of acid in the stomach. These are known as proton pump inhibitors or PPI’s and they should be taken 30 to 60 minutes before food. While they are usually effective, it’s best not to go on these medications long term if you don’t need to. You can find out more about the recommendations for taking proton pump inhibitors at Choosing Wisely.
You should also see your doctor if you have symptoms several times a week, if your symptoms are severe, or if you have difficulty swallowing.
Complications of GORD
According to the Better Health Channel Victoria, if you have reflux for a long time the stomach acid can cause damage to your oesophagus. This damage can even lead to ulcers in the oesophagus which can be very painful. It can also cause scarring and narrowing of the oesophagus which makes swallowing food even harder.
If left untreated for many years, GORD can sometimes lead to changes in the cells that line the oesophagus. This is known as Barrett’s oesophagus and it happens to around one in 10 people who have GORD. The symptoms will usually be the same as GORD and, although rare, there’s a chance the cells could become cancerous. If this is detected early, cancer of the oesophagus can usually be treated, however, many people with cancer caused by Barrett’s oesophagus don’t seek treatment until the cancer is too advanced.
More information
Sources
https://www.health.qld.gov.au/news-events/news/what-is-heartburn-acid-reflux-indigestion-prevention-treatment
https://www.healthdirect.gov.au/heartburn
https://www.healthdirect.gov.au/gord-symptoms
https://www.healthdirect.gov.au/gord-and-diet
http://www.choosingwisely.org.au/recommendations/racgp
https://www.nps.org.au/australian-prescriber/articles/the-management-of-gastro-oesophageal-reflux-disease
https://gut.bmj.com/content/63/7/1185
https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/gastro-oesophageal-reflux-disease-gord
All information contained in this article is intended for general information purposes only. The information provided should not be relied upon as medical advice and does not supersede or replace a consultation with a suitably qualified healthcare professional.