Acid Reflux

Commonly called 'heart burn', acid reflux disease is a condition in which the liquid content of the stomach regurgitates (backs up, or refluxes) into the esophagus. However, when heart burn becomes acid reflux disease or Gastro esophageal reflux disease, commonly referred to as GERD, it is s real problem. That is because with GERD, the acid is stronger and stays in the esophagus longer causing more discomfort.

The main symptoms are:

  • Pain in the chest (behind the breastbone) or throat that can be burning, heavy or sharp — If acid reflux is the cause of esophagitis, the pain may be worse after meals or when you lie flat. Pain from esophagitis may be constant or may come and go.
  • Swallowing problems including worsening of the chest pain when you swallow or a feeling of food sticking in your chest after you swallow
  • Bleeding, seen as blood in vomit or as darkening of the stools

Diagnosis

The diagnosis often is made based on your symptoms. The most accurate way to check for esophagitis is for a gastroenterologist to look directly at the inside of the esophagus with a video camera called an endoscope. The endoscope has a camera at the end of a flexible, plastic-coated tube. This tube is long enough to reach through the stomach to the first portion of the intestine (duodenum), so the procedure is sometimes called esophagogastroduodenoscopy or EGD. Using the endoscope, the gastroenterologist can see evidence of injury from esophagitis, such as areas where the lining of the esophagus has worn away (called erosions or ulcers), blisters or scarred areas. Some infections leave a deposit on the esophagus walls that can be sampled through the endoscope by using a remote-controlled brush. In some cases the doctor will do a biopsy of the esophagus by snipping a small sample of the inside lining through the end of the endoscope. This tissue is examined under a microscope.

Prevention

The most common cause of esophagitis, acid reflux, sometimes can be prevented by some very simple measures:

  • Avoid heavy meals, especially within several hours of bedtime.
  • Cut out cigarettes and alcohol.
  • Avoid large amounts of caffeine, chocolate, peppermint and high-fat foods.
  • Control your weight.
All prescription and nonprescription pills should be taken while you are upright and should be swallowed with water. This is especially important for the medicines that frequently cause esophagitis.

Treatment

Treatment depends on the cause of esophagitis.

  • Acid reflux — Acid-blocking medications, including H2-blockers and proton-pump inhibitors, may be used. For a few difficult cases, a type of stomach surgery can also help prevent reflux.
  • Medications — Drinking a full glass of water after taking a pill can help. For severe esophagitis, it is sometimes better to stop the medicine and find alternative treatment. Since acid can worsen esophagitis caused by medications, your doctor also may prescribe an acid-blocking medication to speed healing.
  • Infections — These are treated with specific antibiotics. Some esophagus infections are difficult to treat with swallowed pills or liquids, so medicines may be given intravenously (into a vein).

While your esophagus is recovering, your doctor can ease your pain symptoms by prescribing pain relievers or a local anesthetic that can be swallowed in a thick liquid form to coat the esophagus lining.

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