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Home Disease Index Acid reflux (Gastro-oesophageal reflux)

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Overview

Causes
Symptoms
Risk Factor

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Overview

 

Gastro-oesophageal reflux is a condition where the lower oesophageal sphincter (the muscular ring at the lower end of the oesophagus) is abnormally relaxed and allows the stomach's acidic contents to flow back or 'reflux' into the gullet (oesophagus). It can also cause heartburn.




Causes

 
  • Symptoms typically occur after eating a large or fatty meal or drinking alcohol.
  • Lying down, bending over or bending and lifting can all cause reflux.
  • It is made worse by smoking.
  • Reflux symptoms may have no apparent cause.
  • The frequency with which the symptoms occur varies. For most people, they are rare but weekly and daily episodes of refluxes are not uncommon.

In many cases, the disorder cannot be attributed to any specific cause but the following conditions can contribute to the problem.

Hiatus hernia

The stomach pokes through the diaphragm, preventing the muscle fibres of the diaphragm from closing the lower end of the oesophagus. The oesophagus remains wide open which allows stomach acid to get into the oesophagus.

Overweight

If the person is overweight the excessive fat in the abdominal cavity increases the pressure inside it. This causes the contents of the stomach to travel up into the gullet. Loss of weight reduces stomach acid reflux.

Pregnancy

Because the uterus increases in size during pregnancy, it presses on the stomach, creating higher pressure inside it, which increases the tendency to reflux. In addition, hormonal changes lead to relaxation of the oesophageal sphincter during pregnancy.

Meals

The more the stomach is stretched by food, the higher the tendency to reflux. The tendency is also increased by eating fatty meals as fat delays gastric emptying. Try to avoid large rich meals, particularly in the evening and this will reduce the tendency to reflux.

Foods

Chocolate, peppermint, coffee, fruit juices and alcohol prevent the oesophageal sphincter from working properly.

Tobacco

Tobacco prevents the oesophageal sphincter from working properly, reduces the rate at which the stomach empties and increases stomach acid production.

Constipation

Constipation increases the tendency to reflux by raising pressure inside the stomach cavity.

Lying down

The tendency to reflux increases when you are lying down. This is just due to gravity. A simple way to change that is to use a pillow under the mattress or to raise the head of your bed by 10cm (4 inches) with blocks or a house brick under the bed frame.

 



Symptoms

 
  • A painful or burning sensation in the upper abdomen or chest, sometimes radiating to the back (heartburn).
  • The acid reflux may reach the pharynx (throat) and mouth. It is sour and may burn.
  • A small number of patients have difficulties breathing and suffer from hoarseness because the refluxed fluid irritates the larynx and respiratory tract.
  • Excess belching is common.


Risk Factors

 

It is an unpleasant condition that can have a big influence on your lifestyle.

Many people feel that their quality of life is lowered by the symptoms.

Prolonged exposure to refluxed acid leads to oesophagitis (inflammation of the oesophagus). Long-standing oesophagitis may be complicated by the formation of scar tissue that contracts and results in a narrowing (stricture) in the affected part of the oesophagus. This can make it difficult or even impossible to swallow. It is a serious condition that requires urgent assessment and treatment, but, fortunately, this complication is relatively rare.

It can cause ulceration leading to bleeding and an iron deficiency, which may develop into anaemia due to a chronic blood loss.

  

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