Lying down or bending over can also result in heartburn.
Heartburn (acid reflux) - causes, treatment
Many people obtain relief by standing upright or by taking an antacid that clears acid out of the esophagus. Heartburn pain is sometimes mistaken for the pain associated with heart disease or a heart attack , but there are differences. Exercise may aggravate pain resulting from heart disease , and rest may relieve the pain. Heartburn pain is less likely to be associated with physical activity. More than 60 million American adults experience heartburn at least once a month, and more than 15 million adults suffer daily from heartburn.
Many pregnant women experience daily heartburn. Recent studies show that GERD in infants and children is more common than previously recognized and may produce recurrent vomiting , coughing , and other respiratory problems.
Doctors recommend lifestyle and dietary changes for most people needing treatment for GERD. Treatment aims at decreasing the amount of reflux or reducing damage to the lining of the esophagus from refluxed materials. Avoiding foods and beverages that can relax the LES is often recommended. These foods include chocolate , peppermint, fatty foods, caffeine, and alcoholic beverages. Foods and beverages that can irritate a damaged esophageal lining, such as citrus fruits and juices, tomato products, and pepper, should also be avoided if they cause symptoms.
Decreasing the size of portions at mealtime may also help control symptoms. Eating meals at least 2 to 3 hours before bedtime may lessen reflux by allowing the acid in the stomach to decrease and the stomach to empty partially. In addition, being overweight often worsens symptoms. Many overweight people find relief when they lose weight.
Cigarette smoking weakens the LES. Stopping smoking is important to reduce GERD symptoms. Elevating the head of the bed on 6-inch blocks or sleeping on a specially designed wedge reduces heartburn by allowing gravity to minimize reflux of stomach contents into the esophagus. Do not use pillows to prop yourself up; that only increases pressure on the stomach. Along with lifestyle and diet changes, your doctor may recommend over-the-counter or prescription treatments.
Antacids can help neutralize acid in the esophagus and stomach and stop heartburn. Many people find that nonprescription antacids provide temporary or partial relief.
Combat your acid reflux and GERD the natural way with these remedies to soothe your stomach.
An antacid combined with a foaming agent helps some people. These compounds are believed to form a foam barrier on top of the stomach that prevents acid reflux from occurring. Long-term use of antacids, however, can result in side effects, including diarrhea , altered calcium metabolism a change in the way the body breaks down and uses calcium , and buildup of magnesium in the body.
Too much magnesium can be serious for patients with kidney disease. If antacids are needed for more than 2 weeks, a doctor should be consulted. For chronic reflux and heartburn, the doctor may recommend medications to reduce acid in the stomach.
These medicines include H2 blockers, which inhibit acid secretion in the stomach. It also occurs in children. Although common, the disease often is unrecognized — its symptoms misunderstood. This is unfortunate because GERD is generally a treatable disease, though serious complications can result if it is not treated properly.
Heartburn is the most frequent — but not the only — symptom of GERD. The disease may be present even without apparent symptoms. Heartburn is not specific to GERD and can result from other disorders that occur inside and outside the esophagus. All too often, GERD is either self-treated or mistreated. GERD is a chronic disease. Treatment usually must be maintained on a long-term basis, even after symptoms have been brought under control.
Issues of daily living and compliance with long-term use of medication need to be addressed as well. The acid perfusion Bernstein test is used to determine if chest pain is caused by acid reflux. For the acid perfusion test, a thin tube is passed through one nostril, down the back of the throat, and into the middle of the esophagus. A dilute, acid solution and a physiologic salt solution similar to the fluid that bathes the body's cells are alternately poured perfused through the catheter and into the esophagus.
The patient is unaware of which solution is being infused. If the perfusion with acid provokes the patient's usual pain and perfusion of the salt solution produces no pain, it is likely that the patient's pain is caused by acid reflux. The acid perfusion test, however, is used only rarely. A better test for correlating pain and acid reflux is a hour esophageal pH or pH capsule study during which patients note when they are having pain. It then can be determined from the pH recording if there was an episode of acid reflux at the time of the pain.
This is the preferable way of deciding if acid reflux is causing a patient's pain.
GERD & Acid Reflux
It does not work well, however, for patients who have infrequent pain, for example every two to three days, which may be missed by a one or two day pH study. In these cases, an acid perfusion test may be reasonable.
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How is GERD acid reflux treated? One of the simplest treatments for GERD is referred to as life-style changes, a combination of several changes in habit, particularly related to eating. Lifestyle changes and GERD acid reflux diet. As discussed above, reflux of acid is more injurious at night than during the day. At night, when individuals are lying down, it is easier for reflux to occur. The reason that it is easier is because gravity is not opposing the reflux, as it does in the upright position during the day. In addition, the lack of an effect of gravity allows the refluxed liquid to travel further up the esophagus and remain in the esophagus longer.
These problems can be overcome partially by elevating the upper body in bed. The elevation is accomplished either by putting blocks under the bed's feet at the head of the bed or, more conveniently, by sleeping with the upper body on a foam rubber wedge. These maneuvers raise the esophagus above the stomach and partially restore the effects of gravity.
Heartburn and acid reflux - NHS
It is important that the upper body and not just the head be elevated. Elevating only the head does not raise the esophagus and fails to restore the effects of gravity. Elevation of the upper body at night generally is recommended for all patients with GERD. Nevertheless, most patients with GERD have reflux only during the day and elevation at night is of little benefit for them.
How do you control GER and GERD?
It is not possible to know for certain which patients will benefit from elevation at night unless acid testing clearly demonstrates night reflux. However, patients who have heartburn, regurgitation, or other symptoms of GERD at night are probably experiencing reflux at night and definitely should elevate their upper body when sleeping. Reflux also occurs less frequently when patients lie on their left rather than their right sides. Several changes in eating habits can be beneficial in treating GERD.
Reflux is worse following meals.