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What Is Acid Reflux Disease?

By Annie Stuart
 Medically Reviewed by Jennifer Robinson, MD on April 25, 2020

At the entrance to your stomach is a valve, which is a ring

of muscle called the lower esophageal sphincter (LES).
Normally, the LES closes as soon as food passes through
it. If the LES doesn't close all the way or if it opens too
often, acid produced by your stomach can move up
into your esophagus. This can cause symptoms such as a
burning chest discomfort called heartburn. If acid reflux
symptoms happen more than twice a week, you may
have acid reflux disease, also known as gastroesophageal
reflux disease (GERD).

What Causes Acid Reflux Disease?

One common cause of acid reflux disease is a stomach
abnormality called a hiatal hernia. This occurs when the
upper part of the stomach and LES move above the
diaphragm, a muscle that separates your stomach from
your chest. Normally, the diaphragm helps keep acid in
our stomach. But if you have a hiatal hernia, acid can
move up into your esophagus and cause symptoms of
acid reflux disease.

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These are other common risk factors for acid reflux

disease:

Eating large meals or lying down right after a meal

Being overweight or obese

Eating a heavy meal and lying on your back or

bending over at the waist

Snacking close to bedtime

Eating certain foods, such as citrus, tomato,

chocolate, mint, garlic, onions, or spicy or fatty
foods

Drinking certain beverages, such as alcohol,

carbonated drinks, coffee, or tea

Smoking

Being pregnant

Taking aspirin, ibuprofen, certain muscle relaxers,

or blood pressure medications

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What Are the Symptoms of Acid Reflux

Disease?
Common symptoms of acid reflux are:

Heartburn : a burning pain or discomfort that

may move from your stomach to your abdomen or
chest, or even up into your throat

Regurgitation: a sour or bitter-tasting acid backing

up into your throat or mouth

Other symptoms of acid reflux disease include:

Bloating

Bloody or black stools or bloody vomiting

Burping

Dysphagia -- the sensation of food being stuck in

your throat

Hiccups that don't let up

Nausea

Weight loss for no known reason

Wheezing, dry cough, hoarseness, or chronic sore

throat

How Is Acid Reflux Disease Diagnosed?

It's time to see your doctor if you have acid reflux
symptoms two or more times a week or if medications
don't bring lasting relief. Symptoms such as heartburn
are the key to the diagnosis of acid reflux disease,
especially if lifestyle changes, antacids, or acid-blocking
medications help reduce these symptoms.

If these steps don't help or if you have frequent or severe

symptoms, your doctor may order tests to confirm a
diagnosis and check for other problems. You may need
one or more tests such as these:

Barium swallow (esophagram) can check for

ulcers or a narrowing of the esophagus. You first
swallow a solution to help structures show up on
an X-ray.

Esophageal manometry can check the function

and movement of the esophagus and lower
esophageal sphincter.

pH monitoring can check for acid in your

esophagus. The doctor inserts a device into your
esophagus and leaves it in place for 1 to 2 days to
measure the amount of acid in your esophagus.

Endoscopycan check for problems in your

esophagus or stomach. This test involves inserting
a long, flexible, lighted tube with a camera down
your throat. First, the doctor will spray the back of
your throat with anesthetic and give you a sedative
to make you more comfortable.

A biopsymay be taken during endoscopy to check

samples of tissue under a microscope for infection
or abnormalities.

Can Acid Reflux Disease Be Treated With

Diet and Lifestyle Changes?
One of the most effective ways to treat acid reflux disease
is to avoid the foods and beverages that trigger
symptoms. Here are other steps you can take:

Eat smaller meals more frequently throughout the

day and modify the types of foods you are eating..

Quit smoking.

Put blocks under the head of your bed to raise it at

least 4 inches to 6 inches.

Eat at least 2 to 3 hours before lying down.

Try sleeping in a chair for daytime naps.

Don't wear tight clothes or tight belts.

If you're overweight or obese, take steps to lose

weight with exercise and diet changes.

Also, ask your doctor whether any medication

could be triggering your heartburn or other
symptoms of acid reflux disease.

Can Acid Reflux Disease Be Treated With

Medications?
In many cases, lifestyle changes combined with over-the-
counter medications are all you need to control the
symptoms of acid reflux disease.

Antacids, such as Alka-Seltzer, Maalox, Mylanta, Rolaids,

or Riopan, can neutralize the acid from your stomach. But
they may cause diarrhea or constipation, especially if you
overuse them. It's best to use antacids that contain both
magnesium hydroxide and aluminum hydroxide. When
combined, they may help counteract these
gastrointestinal side effects.

If antacids don't help, your doctor may try other

medications. Some require a prescription. Your doctor
may suggest more than one type or suggest you try a
combination of medications such as these:

Foaming agents (Gaviscon) coat your stomach to

prevent reflux.

H2 blockers (Pepcid, Tagamet) decrease acid

production.

Proton pump inhibitors (Aciphex, Nexium,

Prilosec, Prevacid, Protonix) also reduce the
amount of acid your stomach makes.

Prokinetics (Reglan, Urecholine) can help

strengthen the LES, empty your stomach faster, and
reduce acid reflux.

Don't combine more than one type of antacid or other

medications without your doctor's guidance.

Is Acid Reflux Disease Ever Treated With

Surgery?
If medications don't completely resolve your symptoms
of acid reflux disease and the symptoms are severely
interfering with your life, your doctor could recommend
surgery. There are two types of surgical treatment used to
relieve symptoms of GERD if daily use of medication isn't
effective.

The most recently approved procedure involves

surgically placing a ring known as a LINX device around
the outside of the lower end of the esophagus, the tube
that connects the mouth to the stomach. The ring
consists of magnetic titanium beads held together by
titanium wires. The device helps reflux by preventing
stomach contents from backing up into the esophagus. In
one study, patients were able to stop taking medicine or
cut down the amount they took. You shouldn't get the
LINX device if you're allergic to certain metals, and once
you have a LINX device you shouldn't get any type of MRI
test.

Another surgical procedure called a fundoplication can

help prevent further acid reflux. It creates an artificial
valve using the top of your stomach. The procedure
involves wrapping the upper part of the stomach around
the LES to strengthen it, prevent acid reflux, and repair a
hiatal hernia. Surgeons perform this procedure through
either an open incision in the abdomen or chest or with a
lighted tube inserted through a tiny incision in the
abdomen.

These procedures are done only as a last resort for

treating acid reflux disease after medical treatment has
proven to be inadequate.

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Acid Reflux Causes

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Heartburn / GERD Guide 

1 Overview & Facts

2 Symptoms & Complications

3 Diagnosis & Tests

4 Treatment & Care

5 Living & Managing

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