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Acid Reflux

Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common digestive disorder characterised by the backflow of stomach acid and sometimes stomach contents into the esophagus.

The esophagus is the tube that connects the mouth to the stomach, and its lower part contains a ring of muscles called the lower esophageal sphincter (LES).

The LES acts as a valve, opening to allow food and liquid to enter the stomach and closing to prevent the backflow of stomach contents.

In people with acid reflux, the LES may not function properly, or it may relax abnormally, allowing stomach acid to flow back into the esophagus.

RISK FACTORS FOR ACID REFLUX:

Several factors can increase the risk of developing acid reflux or gastroesophageal reflux disease (GERD). Understanding these risk factors can help individuals take preventive measures and make lifestyle changes to reduce their chances of experiencing acid reflux symptoms.

Some common risk factors for acid reflux include:

  • Hiatal Hernia: A hiatal hernia is a condition in which part of the stomach protrudes into the chest through the diaphragm, weakening the barrier between the stomach and the esophagus, making acid reflux more likely.

  • Obesity or Excess Weight: Excess body weight can increase pressure on the abdomen and push stomach contents upward into the esophagus, contributing to acid reflux.

  • Dietary Habits: Certain foods and beverages can trigger or worsen acid reflux symptoms. Consuming high-fat foods, spicy foods, acidic foods (e.g., citrus fruits, tomatoes), caffeine, alcohol, and carbonated beverages can be risk factors.

  • Smoking: Smoking can relax the lower esophageal sphincter (LES), allowing stomach acid to flow back into the esophagus more easily.

  • Pregnancy: Hormonal changes and increased pressure on the abdomen during pregnancy can lead to acid reflux symptoms in some women.

  • Certain Medications: Some medications can weaken the LES or irritate the esophagus, increasing the risk of acid reflux. These medications may include certain painkillers (e.g., aspirin or NSAIDs), muscle relaxants, and some blood pressure medications.

  • Delayed Stomach Emptying: Conditions that slow down the emptying of the stomach, such as gastroparesis or certain neurological disorders, can increase the likelihood of acid reflux.

  • Connective Tissue Disorders: Conditions like scleroderma that affect the connective tissues of the esophagus can lead to dysfunction of the LES and promote acid reflux.

  • Alcohol Consumption: Excessive alcohol consumption can relax the LES and contribute to acid reflux symptoms.

  • Lying Down After Meals: Eating a large meal and then lying down or bending over can increase the risk of acid reflux, as it allows stomach contents to flow back into the esophagus more easily.

  • Age: Acid reflux can occur at any age, but it becomes more common with age, possibly due to changes in the esophagus and LES function.

 

  • Stress and Anxiety: While stress itself may not directly cause acid reflux, it can worsen symptoms in individuals who already have GERD.

COMPLICATIONS​

If left untreated or poorly managed, acid reflux (GERD) can lead to complications such as esophagitis, esophageal stricture, Barrett's esophagus, respiratory issues, dental problems, laryngitis, chronic cough, pulmonary fibrosis, worsening asthma, and disrupted sleep, affecting overall quality of life.

The symptoms of acid reflux, also known as gastroesophageal reflux disease (GERD), can vary from person to person, and some individuals may experience more severe or frequent symptoms than others.

The most common symptoms of acid reflux include:

  • Heartburn: A burning sensation in the chest that may radiate to the throat. Heartburn is often described as a discomfort or pain behind the breastbone and is typically felt after eating or lying down.r or lying flat.

  • Regurgitation: The sensation of stomach contents or sour-tasting fluid rising back into the throat or mouth. This can occur along with or separately from heartburn.

  • Dysphagia: Difficulty swallowing or a feeling of food getting stuck in the throat. This symptom can be especially concerning and may be associated with narrowing of the esophagus (stricture) due to chronic acid irritation.

  • Chronic Cough: A persistent cough, especially when lying down or at night. This cough may be dry or produce mucus.

  • Hoarseness or Sore Throat: Irritation of the throat caused by the backflow of stomach acid.

  • Laryngitis: resulting in a hoarse or raspy voice.

  • Worsening Asthma Symptoms

  • Chest Pain: Chest pain that can be mistaken for heart-related issues.

  • Excessive Salivation: Some people with acid reflux may experience increased saliva production.

CONVENTIONAL TREATMENT OPTIONS:

  • Over-the-Counter Antacids and H2 Blockers:

    • Antacids: These can provide quick relief by neutralising stomach acid.

    • H2 Blockers: These medications reduce the production of stomach acid, providing longer-lasting relief than antacids.

  • Proton Pump Inhibitors (PPIs):

    • PPIs are potent medications that block the production of stomach acid. They are often used for more severe or persistent cases of acid reflux.

  • Prokinetic Agents: These medications help improve the movement of the digestive system, aiding in faster stomach emptying and reducing reflux episodes.

  • Surgery: In severe cases that don't respond to medications or lifestyle changes, surgical interventions like fundoplication may be considered to strengthen the LES and prevent reflux.

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Acid Reflux & Low Stomach Acid (Hypochlorhydria)

Contrary to what one might expect, low stomach acid can also contribute to acid reflux symptoms. It might seem counterintuitive, as acid reflux is commonly associated with excessive stomach acid, but low stomach acid can create an environment that promotes acid reflux in some individuals.

Here's how low stomach acid can be related to acid reflux:

  • Impaired Digestion: Stomach acid plays a crucial role in breaking down food and facilitating digestion. When stomach acid levels are low, food may not be adequately digested in the stomach, leading to delayed emptying. This can cause food to remain in the stomach for a more extended period, increasing the risk of reflux when the stomach eventually contracts.

  • LES Dysfunction: The lower esophageal sphincter (LES) is a ring of muscles that acts as a valve, preventing stomach contents from flowing back into the esophagus. Low stomach acid can weaken the LES, allowing stomach contents, including undigested food and bile, to reflux into the esophagus more easily.

  • Decreased Pressure: Proper stomach acid levels help maintain adequate pressure in the stomach. When stomach acid is low, the stomach may not contract with enough force, resulting in decreased pressure and a more relaxed LES, which can contribute to reflux.

  • Gastric Motility Disorders: Low stomach acid can be associated with certain gastric motility disorders, such as gastroparesis, where the stomach takes longer to empty its contents. Delayed stomach emptying can increase the likelihood of acid reflux.

  • Reduced Barrier Function: Stomach acid plays a protective role in preventing bacterial overgrowth in the upper gastrointestinal tract. Low stomach acid can lead to bacterial overgrowth, which may contribute to inflammation and reflux symptoms.

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How We Can Help You

Our approach to acid reflux (gastroesophageal reflux disease or GERD) focuses on identifying and addressing the underlying root causes of the condition rather than solely treating the symptoms. This approach aims to promote optimal digestive health and overall well-being.

Here are the key components of a functional medicine approach to acid reflux:

  • Comprehensive Assessment: We beginwith a thorough evaluation of the individual's medical history, diet, lifestyle, stress levels, and other factors that may contribute to acid reflux.

  • Dietary Modifications: We trial an elimination diet or consider food sensitivity testing to identify trigger foods that may worsen acid reflux. Emphasise a whole-foods, nutrient-dense diet rich in vegetables, fruits, lean proteins, and healthy fats.

  • Gut Health: We address gut imbalances and support a healthy gut microbiome. This may include incorporating probiotics and prebiotic-rich foods into the diet to promote beneficial gut bacteria.

  • Hydration and Timing: We ensure adequate hydration and discourage excessive fluid intake with meals, as it can dilute stomach acid and impair digestion.

  • Optimising Stomach Acid Production: In some cases, supporting stomach acid production may be necessary, especially if low stomach acid is suspected. Strategies may include using hydrochloric acid supplements or other natural alternatives.

  • Stress Management: Implement stress-reduction techniques, such as mindfulness practices, yoga, meditation, or breathing exercises, as stress can worsen acid reflux symptoms.

  • Sleep Quality: Encourage good sleep hygiene to promote restful sleep and prevent reflux symptoms during the night.

 

  • Weight Management: If applicable, address and support weight management, as excess weight can contribute to acid reflux.

  • Lifestyle Changes: Advise against lying down or bending over immediately after eating. Elevating the head of the bed and avoiding tight-fitting clothing around the waist can also help prevent reflux.

  • Identifying Underlying Conditions: Investigate the possibility of other underlying conditions that may contribute to acid reflux, such as hiatal hernia or gastric motility disorders.

  • Medication Review: Condiser medications that may exacerbate acid reflux symptoms

  • Monitoring and Follow-Up: Regularly assess the individual's progress and adjust the treatment plan as needed.

If you're feeling overwhelmed and unsure of where to start in addressing your gut symptoms, don't hesitate to reach out to us. Our team is here to help you navigate through the confusion and develop a personalised treatment plan tailored to your specific needs.

We have experience in uncovering the root causes of gut issues and can guide you towards optimal gut health. Contact us today to begin your journey towards better digestive well-being.

"Heal your gut, heal your life."

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