Acidic digestive matter refluxes from the stomach to the pharynx or mouth, which can be very unpleasant …… Many people treat “acid reflux” as a physiological phenomenon, but in fact, they may be suffering from an extremely common disease – gastroesophageal reflux disease. This disease is not uncommon, according to a questionnaire survey in Beijing and Shanghai, about 1 in 20 people suffer from this disease.
What is this disease?
Gastroesophageal reflux disease, as the name suggests, is a disease in which half of the food digested in the stomach flows back into the esophagus and even into the mouth.
The most common symptoms of the disease are: heartburn and acid reflux.
Heartburn: A burning sensation behind the sternum, often occurring about an hour after a meal.
Acid reflux: Patients with acid reflux will feel a hot current coming from the bottom up to the middle of the chest, with a burning and tingling sensation.
Some patients may also experience chest pain, difficulty swallowing, or non-digestive symptoms such as coughing, throat discomfort, and chest tightness and panic.
Clinically, people often go to cardiovascular medicine for chest pain, chest tightness, and panic, and are eventually referred back to gastroenterology for a confirmed diagnosis of GERD.
Why does this happen?
Under normal circumstances, the esophagus works like this: it peristalsis slowly delivers swallowed food to the lower esophagus, where the lower esophageal sphincter relaxes and allows food to enter the stomach; when the food enters the stomach, the lower esophageal sphincter regains its tension and holds the entrance, preventing food from flowing back into the esophagus from the stomach.
This muscle under the esophagus is like a gate, and after the food passes, the gate should close. If it does not close tightly, plus sometimes there is too much pressure in the gate, it can cause food to return to the esophagus and cause discomfort.
Therefore, when the lower esophageal sphincter that “holds the gate” is relaxed for some reason, with or without increased intra-stomach pressure (overeating, delayed gastric emptying, etc.) or increased intra-abdominal pressure (pregnancy, ascites, weight-bearing labor, etc.), it can cause the appearance of reflux symptoms.
In addition, abnormalities in esophageal peristalsis and salivary secretion, as well as damage to the mucosa of the digestive tract, can also lead to the development of the disease.
How is it diagnosed?
The doctor will make a comprehensive analysis based on the symptoms and the results of tests such as gastroscopy and pH monitoring. Experimental treatment with acid-suppressing medications may also help to confirm the diagnosis if the symptoms are significantly relieved.
It should be emphasized that early stage esophageal cancer may also be manifested by heartburn and reflux, which are typical symptoms of GERD. Therefore, if you have these symptoms, don’t put up with them, but go to gastroenterology department in time and listen to the doctor’s advice.
What should I do if I have heartburn and acid reflux?
After the diagnosis of GERD, most patients need systematic medication. Doctors will choose to take medication for long term, short term or during symptomatic episodes depending on individual circumstances.
Do lifestyle changes also help?
Yes! Data show that about 20% of patients can improve their symptoms through lifestyle modifications alone. For example, avoid lying down immediately after meals or exercising or working out immediately; avoid eating 3 hours before bedtime; elevate the head of the bed 15-20 cm to enhance acid removal by gravity and reduce reflux during sleep; avoid high abdominal pressure conditions such as constipation, obesity, and tight pants; control the intake of tea, coffee, chocolate, high-fat foods, and spicy and acidic foods, which can lead to a decrease in muscle tone in the lower esophagus; and stop smoking. Avoid high abdominal pressure, such as constipation, obesity, tight pants; control the intake of tea, coffee, chocolate, high-fat food, spicy and sour food, because these foods can lead to a decrease in muscle tone of the lower esophagus; quit smoking and alcohol, because tobacco and alcohol can lead to recurrent GERD through various mechanisms; regulate psychological balance, because stress is also a causative factor of GERD.