Burning feeling in the middle of the chest and at the back of the throat – acidity is not pleasant in any way. Most people get acid reflux now and then. However, if it is recurrent, it can considerably affect one’s overall wellbeing. Let’s try to understand why this happens.
Once the food is chewed, it passes through the food pipe (oesophagus) and lands in the stomach. In the stomach, food is further churned and disintegrated. The acid in the stomach plays a crucial role in the latter. The stomach is protected from the acid because a protective layer of mucus lines it.
A sphincter guards the oesophagal opening to stop churned food and acid return to the oesophagus. However, in acid reflux, due to things such as increased abdominal pressure, stomach constituents with acid get pushed back up into the oesophagus. The oesophagus does not have any shielding layer like the stomach, and this leads to a burning sensation in the chest. This is also known as heartburn. This can also lead to a sour taste in the mouth, cough and hiccups, bad break and bloating. Such symptoms are probably worse after eating, lying down or bending over. These positions increase abdominal pressure or make it easier for stomach constituents to rush back into the food pipe.
Causes
Abdominal obesity is a major cause of frequent acid reflux. When there is a large accumulation of fat in the midsection, it creates more abdominal pressure. Due to the same reason, it is common to have acid reflux issues in pregnancy. Some foods can also trigger acid reflux. This includes spicy and fatty food, alcohol and coffee. They are stronger irritants when they reflux.
Management
The overall management of acid reflux revolves around avoiding its causes.
- Eating smaller meals can help as bigger food portions in the stomach will increase the chance of reflux.
- If overweight or obese, losing weight can help. Often when anyone tries to lose weight, an initial 5-10% weight loss purges sizeable fat deposition around organs. This can drastically reduce intraabdominal pressure.
- Avoiding irritants in excess is essential. Spicy food, lots of coffee, and alcohol should be taken in moderation.
- Do not lie down or sleep immediately after eating, and keep at least a couple of hours of break between your meal and sleep.
- Avoid smoking
- A simple and effective way to suppress acid reflux is by elevating the head of the bed (HOB). This is usually between 15-45 degrees. The elevation reduces exposure of the oesophagus to stomach acids.
References:
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Clarrett et al. Gastroesophageal reflux disease affects millions of people worldwide with significant clinical implications. Mo. Med. 115, 214 (2018).
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Khan et al. Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux. J. Gastroenterol. Hepatol. 27, 1078–1082 (2012).
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Meining et al. The role of diet and lifestyle measures in the pathogenesis and treatment of gastroesophageal reflux disease. Am. J. Gastroenterol. 95, 2692–2697 (2000).
