There is a circular band of muscle (a ‘sphincter’) at the junction between the esophagus and stomach. This relaxes to allow food down, but then normally tightens up and stops food and acid leaking back up (refluxing) into the esophagus. In effect, the sphincter acts like a valve. The lining of the esophagus can cope with a certain amount of acid. However, some people have a lot of reflux without developing gastritis/esophagitis or symptoms.
What are the symptoms of acid reflux and esophagitis?
- Heartburn is the main symptom. (It is confusing as it has nothing to do with the heart!)
- Other common symptoms include: pain in the upper abdomen and chest, feeling sick, an acid taste in the mouth, bloating, belching, and a burning pain when you swallow hot drinks.
- Some uncommon symptoms may occur. This makes the diagnosis difficult in some cases as the symptoms can mimic other conditions. For example:
- A persistent cough, particularly at night. This is due to the refluxed acid irritating the windpipe. Hoarseness or asthma symptoms can sometimes be due to acid reflux.
- Severe chest pain develops in some cases (and may be mistaken for a heart attack).
What can I do to help with symptoms?
The following are commonly advised. However, there has been little research to prove how well these ‘lifestyle’ changes help to ease reflux.
- Smoking. The chemicals from cigarettes relax the sphincter muscle and make acid reflux more likely. Symptoms may ease if you are a smoker and stop smoking.
- Some foods and drinks These include: peppermint, tomatoes, chocolate, spicy foods, hot drinks, coffee and alcoholic drinks.
- Some medicines may make symptoms worse. The most common culprits are anti-inflammatory painkillers (such as ibuprofen or aspirin).
- Weight. If you are overweight it puts extra pressure on the stomach and encourages acid reflux. Losing some weight may ease the symptoms.
- Posture. Lying down or bending forward a lot during the day encourages reflux. Sitting hunched or wearing tight belts may put extra pressure on the stomach which may make any reflux worse.
- Bedtime. If symptoms recur most nights, it may help to go to bed with an empty, dry stomach.
What are the treatments for acid reflux and esophagitis?
This is an option if medicines fail to prevent symptoms, or if you need medication every day to control symptoms. An operation can ‘tighten’ the lower esophagus to prevent acid leaking up from the stomach. It can be done by ‘keyhole’ surgery, and has a good success rate.