What is Acid Reflux?Acid Reflux Disease is chronic symptoms or mucosal damage caused by stomach acid coming up from the stomach into the esophagus. A typical symptom is heartburn. Acid Reflux is usually caused by changes in the barrier between the stomach and the esophagus, including abnormal relaxation of the lower esophageal sphincter, which normally holds the top of the stomach closed; impaired expulsion of gastric reflux from the esophagus, or a hiatal hernia.
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Causes and Effects
Acid Reflux is caused by a failure of the cardia. In healthy patients, the "Angle of His" - the angle at which the esophagus enters the stomach - creates a valve that prevents duodenal bile, enzymes, and stomach acid from traveling back into the esophagus where they can cause burning and inflammation of sensitive esophageal tissue.[1]
Factors that can contribute to Acid Reflux:
- Hiatal Hernia, which increases the likelihood of Acid Reflux due to mechanical and motility factors
- Obesity, increasing body mass index is associated with more severe Acid Reflux
- Zollinger-Ellison Syndrome, which can be present with increased gastric acidity due to gastrin production
- Hypercalcemia, which can increase gastrin production, leading to increased acidity
- Scleroderma and systemic sclerosis, which can feature esophageal dysmotlity
- The use of medicines such as Prednisolone
- Visceroptosis Syndrome, in which the stomach has sunk in the abdomen upsetting the motility and acid secretion [1]
Symptoms
The most-common symptoms of Acid Reflux are:
- Heartburn
- Regurgitation
- Trouble swallowing
Less-common symptoms include:
- Pain with swallowing
- Excessive salivation is common during heartburn, as saliva is generally slightly alkaline and is the body's natural response to heartburn, acting similarly to an antacid.
- Nausea
- Chest Pain
Acid Reflux sometimes causes injury of the esophagus. These injuries include:
- Reflux Esophagitis, necrosis of esophageal epithelium causing ulcers near the junction of the stomach and esophagus
- Esophageal Strictures, the persistent narrowing of the esophagus caused by reflux-induced inflammation
- Barrett's Esophagus, intestinal metaplasia (changes of the epithelial cells from squamous to intestinal columnar epithelium) of the distal esophagus
- Esophageal Adenocarcinoma, a rare form of cancer
Several other atypical symptoms are associated with Acid Reflux, but there is good evidence for the causation only when they are accompanied by esophageal injury. These symptoms include:
- Chronic cough
- Laryngitis
- Asthma
- Erosion of dental enamel
- Dentine hypersensitivity
- Sinusitis and damaged teeth
- Pharyngitis [1]