What helps with acid reflux?

Acid reflux is a common digestive condition, that can be a frustrating and disruptive for many individuals. The burning sensation in the chest, the sour taste in the mouth, and the persistent discomfort can impact one’s quality of life. However, with the right knowledge, it is possible to effectively manage and even overcome the challenges caused by this condition.

Understanding acid reflux

What is acid reflux?

Acid reflux, also known as gastroesophageal reflux disease (GERD), is a condition where stomach acid flows back into the esophagus, the tube that connects the stomach to the throat. This can cause a range of symptoms, including heartburn, regurgitation, and difficulty swallowing.

Causes of acid reflux

The main cause of acid reflux is a weakened lower esophageal sphincter (LES), the muscle that acts as a valve between the stomach and the esophagus. When the LES is unable to close properly, stomach acid flows back up into the esophagus.

Risk factors contributing to the weakening or relaxation of the LES, include:

• Hiatal hernia: A condition where a portion of the stomach sticks out through the diaphragm into the chest cavity, disrupting the function of the LES
• Pregnancy: Increased abdominal pressure and hormonal changes can weaken the LES
• Obesity: Excess weight can put additional pressure on the abdomen, leading to a weakened LES
• Certain medications: Antidepressants, blood pressure medications, and pain relievers, can all relax the LES and worsen acid reflux
• Lifestyle factors: Smoking, consuming large meals, and lying down immediately after eating can all add to the development of acid reflux

Symptoms of acid reflux

The primary symptoms of acid reflux include:

• Heartburn: A burning sensation in the chest
• Regurgitation: The backflow of stomach contents into the throat or mouth
• Difficulty swallowing (dysphagia): A feeling of food getting stuck in the throat or chest
• Chronic cough or hoarseness: Acid reflux can irritate the throat and vocal cords
• Nausea and bloating: Caused by excess stomach acid

Diagnosing acid reflux

To accurately diagnose acid reflux, healthcare professionals may utilise a combination of the following techniques:

Medical history and physical examination

An evaluation of your symptoms, medical history, and lifestyle factors can provide insights into the potential causes of your acid reflux.

Endoscopy

During an endoscopy, a healthcare provider uses a flexible, lighted tube with a camera to examine the esophagus and stomach, allowing them to identify any damage or inflammation caused by acid reflux.

pH monitoring

This pH test involves placing a small, flexible tube with a sensor in your esophagus to measure the amount of acid reflux over 24 hours, to provide more understanding of your condition.

Lifestyle changes

One of the most effective ways to manage acid reflux is through lifestyle changes. By changing your habits, you can find significant relief without needing to take medication. Here are some key lifestyle changes to consider:

Dietary changes

• Identify and avoid trigger foods: Spicy, fried, acidic and fatty foods can often make acid reflux worse. Common triggers include citrus fruits, tomatoes, peppermint, chocolate, coffee, and alcohol
• Eat more frequently and smaller meals: Large, heavy meals can put pressure on the stomach and increase the risk of reflux
• Avoid eating close to bedtime: Allow at least 3-4 hours between your last meal and bedtime

Posture and sleep changes

• Elevate the head of your bed: Sleeping with the head of your bed elevated by 6-8 inches can help gravity work in your favour, preventing stomach acid from flowing back into your esophagus
• Avoid lying down after meals: Remain upright for at least 3 hours after eating can help keep acid in the stomach
• Sleep on your left side: Sleeping on your left side can help to keep the esophageal sphincter above the level of stomach acid, reducing the risk of reflux

Weight management

• Maintain a healthy weight: Excess weight can put additional pressure on the abdomen, adding to the weakening of the LES
• Lose weight if overweight

Quit smoking and reduce alcohol consumption

• Smoking can weaken the LES and increase the production of stomach acid
• Alcohol can relax the LES and delay stomach emptying

By incorporating these lifestyle changes into your daily routine, you can achieve substantial relief from acid reflux and prevent the condition from worsening over time. These lifestyle changes can also help with other gastrointestinal conditions.

Over-the-counter medications for acid reflux

In addition to lifestyle changes, over-the-counter (OTC) treatment options can provide effective relief for occasional or mild acid reflux. Medications work by either neutralising stomach acid or reducing its production. Some common OTC options include:

Antacids

Antacids, such as Tums, Rolaids, and Maalox, neutralise stomach acid, quickly to relieve heartburn and other acid reflux symptoms. They do not however, address the condition’s underlying cause and are unsuitable for long-term use.

H2 blockers

H2 blockers, like Pepcid AC and Zantac, reduce the amount of acid the stomach makes. They provide longer-lasting relief than antacids, but may take a bit longer to take effect.

Proton pump inhibitors (PPIs)

Proton pump inhibitors, such as Prilosec OTC, Nexium 24HR, and Prevacid 24HR, are stronger acid-reducing medications that can provide more sustained relief for chronic acid reflux. They block the production of stomach acid, allowing the esophageal lining to heal.

While OTC medications can be effective in managing acid reflux, they should not be used as a long-term solution. If your symptoms persist or worsen, consult with a healthcare professional to determine the underlying cause and to develop a treatment plan.

Prescription medications for acid reflux

Healthcare providers may recommend prescription-strength medications for more severe or persistent acid reflux. These include:

Prescription-strength proton pump inhibitors (PPIs)

Prescription PPIs, such as omeprazole, esomeprazole, and lansoprazole, are more potent versions of the OTC varieties. They can provide more effective and long-lasting relief for chronic GERD.

Prescription H2 blockers

Prescription-strength H2 blockers, like ranitidine and famotidine, may be prescribed for people who do not respond well to OTC options or need stronger acid-reducing medication.

Baclofen

Baclofen is a muscle relaxant that can help reduce the frequency of lower esophageal sphincter (LES) relaxation, which contributes to acid reflux. It may be prescribed in combination with other medications.

Alternative and home remedies

Some individuals may explore complementary therapies, but it’s important to note that the effectiveness of these therapies is not as well-established, and to consult a healthcare provider before incorporating them into your management plan.

Herbal remedies

Certain herbs, such as ginger, chamomile, and slippery elm, have been used to alleviate acid reflux symptoms. However, the evidence supporting their use is limited, and to be cautious about potential interactions with medications.

Acupuncture

Acupuncture may help reduce the frequency and severity of acid reflux symptoms. However, the evidence is not conclusive, and more large-scale studies are needed to confirm the effectiveness of this approach.

Probiotics

Some studies have indicated that certain probiotic strains may help improve the function of the lower esophageal sphincter. However, more research is needed to establish the optimal strains and dosages for managing acid reflux.

While these complementary therapies may provide some relief, they should not replace traditional treatments recommended by healthcare professionals. Discuss any potential alternative therapies with your provider to ensure they do not interfere with your treatment plan.

Living with acid reflux

With the right strategies, you can effectively manage your symptoms and improve your quality of life. Here are some tips for living with acid reflux:

Maintaining a reflux-friendly diet

• Keep a food diary to help identify the specific foods or beverages that make your acid reflux worse
• Eat smaller, more frequent meals throughout the day
• Include foods less likely to trigger reflux, such as lean proteins, fruits, and vegetables

Improving sleeping habits

• Elevate the head of your bed by 6-8 inches to prevent acid from flowing back into your esophagus
• Wait at least 3 hours after eating before lying down
• Sleep on your left side to keep the esophageal sphincter above the level of stomach acid, reducing the risk of reflux

Stress management

• Incorporate stress-reducing activities, such as meditation or yoga
• Seek support from friends, family, or a mental health professional

Maintaining a healthy lifestyle

• Excess weight can contribute to acid reflux, so aim for gradual, sustainable weight loss
• Quit smoking and limit alcohol consumption

Managing acid reflux may take some trial and error to find the most effective strategies for your individual needs. Incorporating these techniques and working closely with your healthcare provider can help you take control of your acid reflux and enjoy a more comfortable life.

Conclusion

With the right approach, acid reflux can be effectively managed and even overcome. By understanding the causes, implementing lifestyle changes, utilising over-the-counter and prescription medications, and surgical interventions when necessary, you can find relief and improve your digestive health.

Sources

• Acid Reflux & GERD: Symptoms, What It Is, Causes, Treatment
• Heartburn and acid reflux – NHS
• Gastroesophageal reflux disease (GERD) – Diagnosis and treatment – Mayo Clinic