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Acid Reflux

What is acid reflux?
Acid reflux is a very common condition characterized by a burning pain (heartburn) felt internally around the lower chest area. This is a condition in which the acid produced in the stomach moves upwards from the stomach into the food pipe(esophagus)and can reach the throat which causes irritation to the tissues. The acid moves upwards if the valve found at the junction of the food pipe and stomach becomes loose 

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What causes reflux disease? 
Acid reflux can affect people of any age. The following are some of the causes of acid reflux to occur
Hiatal Hernia: When a small portion of the stomach migrates into the chest it becomes easy for reflux to happen. Pregnancy: Due to changes in the hormonal balance the lower esophageal sphincter(valve) gets loose during pregnancy. Smoking: Smoking can be a cause of acid reflux. Excessive smoking causes increased acid secretion, reduced esophageal valve muscle function, damaged mucous membranes, and reduced salivation. These conditions can further cause acid reflux.
Larg meals: Overeating can contribute to acid reflux. Overloaded stomach places excessive pressure on the diaphragm which causes the acid to reflux upward.
Obesity:
One of the major causes of reflux is excess body weight.The increased pressure in the abdomen due to fat accumulation can cause acid to reflux.
What are the symptoms of reflux disease?
Heartburn is considered as an initial symptom of acid reflux. Heartburn is a burning sensation or slight discomfort in the chest or abdomen which can move up to the throat. Other symptoms of acid reflux are:

  • Regurgitation: It is a bitter-tasting acid backing up into your throat or mouth.
  • Bloating
  • Nausea
  • Bloody or black stools
  • Dry cough
  • Wheezing
  • Upper abdominal pain
  • Repeated Sore throat
  • Bad breath
  • Difficult in swallowing food

Can reflux cause any serious complication?

Yes.Long-standing severe reflux can cause some serious trouble.

Esophagitis – This is a condition in which the lining of the esophagus is inflamed which causes ulceration and bleeding.
Barrett's esophagus – This is a serious complication which causes the cells and tissues lining the esophagus to develop cancer
How do we diagnose reflux?
Diagnosis of acid reflux is done by analyzing the symptoms and confirmed using an upper GI endoscopy. Esophageal manometry, biopsy, and PH monitoring are also done to diagnose acid reflux.
How to cure reflux disease?
One of the most effective ways to avoid acid reflux is by avoiding food items which trigger the symptoms.Stopping smoking and alcohol, weight reduction, avoidance of caffeine also help reduce reflux., For mild cases of reflux, acid-suppressing medications are helpful.For severe cases and in patients with a hiatal hernia the problem is effectively treated by performing a laparoscopic fundoplication.
Laparoscopic fundoplication
This is a procedure where the lower esophageal valve is tightened using the stomach as a wrap around it.This is done through a keyhole technique these days thereby avoiding a major scar or pain.The patient usually goes home the next day following the operation.This operation has gained popularity in the recent years due to its effectiveness and early pain-free recovery.

Authored By Dr G Parthasarathy - Surgical Gastroenterologist, Hyderabad