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Treatment of Reflux
 
 
 
 
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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          About Heartburn and Reflux

Heartburn and Reflux

Everyone has heartburn occasionally.  This occurs when stomach acid flows backward (regurgitates) into the esophagus.  The esophagus is the tube that carries food to the stomach.  People usually feel heartburn as a burning sensation or pain behind the breastbone.  Often, regurgitation of bitter-tasting stomach acid accompanies heartburn.  An antacid or milk temporarily relieves heartburn for most people.

 

Why Does Heartburn Occur?

To understand heartburn, let’s look at the body’s anatomy.  The esophagus carries food and liquid to the stomach.  A sphincter (specialized muscle) is located at the end of the esophagus.  It is known as the lower esophageal sphincter (LES).  This muscle contracts much the same as the anus does to close the opening of the rectum to the outside of the body.  The LES muscle should only open when food or liquid is passed into the stomach.

 

However, the LED muscle does not always work perfectly.  Sometimes it is too weak to stay completely closed, and stomach juices seep back into the esophagus.  This is known as reflux.  There are certain factors that contribute to reflux.  The most common is eating a large meal.  Along with swallowed air, a large meal causes pressure in the stomach to rise, and overpowers the LES muscle.  The following are other factors that reduce the LES pressure and allow reflux:

  • Nicotine (cigarettes)

  • Fried or fatty foods

  •  Chocolate

  • Coffee

  • Citrus fruits and juices

  • Peppermint

  • Pregnancy

  • Lying flat

  • Hiatus hernia

  • Certain prescription medicines

 

Is Heartburn Serious?

Heartburn and reflux are extremely common, with 10 percent of the population experiencing them daily.  Twenty-five percent of pregnant women have heartburn.  Even though heartburn is common, it is rarely life-threatening.  Severe cases, however, can result in injury to the lower esophagus that requires treatment.

 

What Is a Hiatus Hernia?

The diaphragm is a flat horizontal muscle that separates the lungs from the stomach and the rest of the digestive tract.  The esophagus passes through an opening in the diaphragm.  If the opening enlarges, a portion of the stomach can protrude (herniate) through it into the chest.  This is called a hiatus hernia.  A persistent hiatus hernia may produce significant heartburn.  However, many people who experience heartburn do not have a hiatus hernia.  Likewise, many people with a hiatus hernia do not experience heartburn.

 

Diagnosis of Reflux

There are various tests used to diagnose reflux:

  • Upper GI Series - The patient drinks liquid barium, and x-rays are taken of the esophagus and stomach to see how they function.

  • Upper GI Endoscopy - The patient is given a mild sedative.  Then, a thin, lighted, flexible tube, called an endoscope, is inserted into the esophagus to visually inspect it and the stomach.

  • Esophageal Manometry - This test measures the pressures within the esophagus, especially the LES pressure.

Complications of Reflux

In some people, acid in the lower esophagus actually causes tissue damage.  Certain complications can then result:

  • Chronic bleeding and anemia.

  • Scar formation and narrowing of the lower esophagus.  This is called a stricture.  It usually is treated by dilatation, a procedure to widen the area.

  • Barrett’s esophagus can occur when reflux irritates the lower esophagus over a long period of time.  The stomach lining then actually grows into the esophagus.  In these cases, there is a slight, but definite, risk of cancer developing.

  • Lung problems can develop when reflux results in stomach fluid trickling into the breathing tubes.  It often occurs at night when a patient is lying down.  This causes wheezing, bronchitis, and even pneumonia.

The Treatment of Reflux

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