Causes
· Weakening of the lower esophageal sphincter which prevents reflux of the gastric acids.
· Eating a large meal or eating late at night
· Lying down immediately after a meal
· Obesity
· Smoking or second hand smoking
· Alcohol
· Fatty foods or spicy foods
· Carbonate drinks and caffeinated drinks
· Pregnancy
· Hiatus hernia
· Certain medications
Symptoms
· Burning in the chest
· Chest pain
· Sour taste in the mouth (reflux)
· Sore throat
· Belching
· Bad breath
· Shortness of breath
· Bloating
· Nausea
Complications
· Esophagitis – inflammation of the esophageal mucosa leading to bleeding and ulcer formation.
· Esophageal stricture – narrowing of the esophagus due to scar tissue causing difficulty in swallowing.
· Barrett’s Esophagus – precancerous changes in the lining of the esophagus due to chronic damage from the stomach acid.
· Chronic cough or asthma
Diagnosis
· Physical history of aggravating or alleviating factors
· Tests:
o Endoscopy – a camera that is place down your esophagus to check for damage to the tissue or any abnormal growth.
o Esophageal manometry to check the rhythm of your esophageal muscles as your swallow.
o Esophageal pH study – a test that checks when and how long acid stays in your esophagus.
o Barium swallow – helps to detect if your esophagus is becoming narrow.
Treatment
· Lifestyle changes:
o Avoid aggravating foods
o Taking a light diet
o Don’t lie down for 3 hours after meals
o Avoid smoking and alcohol
o Avoid obesity
o Elevate your head while sleeping
· Medications – various types of antacids.
· Surgery – if medical and lifestyle management fail.
o Surgery includes Nissen fundoplication in which the surgeon wraps the top of your stomach around your lower esophageal sphincter to re-create the similar mechanism.
