Ayurveda

Severe Gastric Reflux

Gastric Reflux is a chronic condition in which the lower esophageal sphincter, a valve, allows gastric acids to flow back into the esophagus. This disorder causes acid indigestion, heartburn and sometimes injury to esophageal lining.

The esophagus is a muscular food pipe connecting the mouth to the stomach. The food pipe gets injured from the acidic content of the stomach when the valve becomes weak and allows back the flow of acid from the stomach. The severity of the gastroesophageal valve disease depends on the symptoms ranging from mild to severe.

Symptoms Of Severe Gastric Reflux

Severe heartburn
As the disease progresses, it gives severe heartburn from the acidic content of the stomach. This causes painful, warm, burning sensation in the chest radiating upwards.

Chest pain
Severe chest pain behind the breast bone. The pain is called as a non cardiac chest pain and is so severe and sometimes misdiagnosed with heart attack symptoms.

Regurgitation
In severe conditions, the acid reflux causes stomach acids and undigested foods to be regurgitated up into the esophagus. This occurs after a short meal. Regurgitated fluids can sometimes enter windpipe and cause wheezing and asthma like symptoms.

Dysphagia
Prolonged exposure to stomach acids causes scarring and inflammation of the esophageal lining. This narrows the esophagus and causes difficulty in swallowing.

Throat damage
Gastric acids can damage throat and larynx and result in sore throat, wheezing, chronic coughing and nocturnal choking. It also causes laryngitis and hoarseness.

Tooth erosion
The gastric acids from the stomach when enters into mouth, it causes enamel softening and erosion. This exposes the tooth’s inner dentin layer. This erosion causes heat and cold sensitivity, teeth discoloration and even tooth loss.

Laryngitis
Hoarseness of voice can occur when acid reaches the mouth and throat causing laryngitis.

Night time coughing
Night-time coughing- when stomach contents enter windpipe and lungs.

Asthma attacks
People with asthma experience shortness of breath due to acid reflux.

Hematemesis
Vomiting of blood. This is a rare symptom due to tears in the esophagus.

Side Effects Of Gastric Reflux

  • Increased incidence of gastric reflux causes increased weight.
  • Prolonged exposure to acids causes oesophagitis, which is inflammation of oesophagus.
  • It can also cause narrowing in the affected part of oesophagus.

Causes Of Acid Reflux

Some of the causes of acid reflux are as follows:

  • Pregnancy
  • Large meals before going to bed.
  • Overweight
  • Bending forward also causes acid reflux, especially just after meals.
  • Peptic ulcers and lack of digestive enzymes- causes acid reflux as it slows down the digestion. It causes accumulated gastric acids back into the esophagus.
  • Eating some acidic foods citrus fruits, tomato, mint, chocolate, onion, garlic.
  • Eating fatty and spicy foods.
  • Smoking.
  • Alcohol consumption.
  • Certain medicines as ibuprofen, aspirin, some muscle relaxers and blood pressure medicines.
  • Tobacco causes acid reflux as it prevents the proper working of sphincter. It increases acid production in the stomach.
  • Constipation increases the pressure inside the stomach and causes the valve to relax and allow the reflux of the acid into the esophagus.

Treatment For Gastric Reflux

The treatment depends on the severity of symptoms. Some people may see changes with change in lifestyle, others may need medications.

Lifestyle changes

  • Aoiding alcohol
  • Quitting smoking
  • Losing weight would ease extra pressure on stomach and relieve the condition
  • Eating small meals
  • Avoiding carbonated beverages
  • Avoid chocolate and peppermint
  • Wearing loose-fitting clothes would ease the symptom and tight belts would put extra pressure on stomach and make reflux worse.
  • Posture as in bending forward and lying down after meals encourages reflux. So these should be avoided.
  • Eat meals before three hours and avoid drinking in the last two hours of going to bed. Raise the head of bed by 10-20 cms. This helps acid from refluxing into the esophagus.

Antacid treatment

  • Antacids based on Calcium carbonate actually increase the acid in stomach. All antacids reduce acidity in lower esophagus only, but in stomach it remains the same.

    Medication

    • A doctor advices acid-suppressing drugs. The 2 groups of drugs are proton pump inhibitors (PPIs) and histamine receptor blockers (H2 blockers). Both reduces the amount of acid the stomach makes.
    • PPIs include pantoprazole, lansoprazole, omeprazole, rabeprazole and esomeprazole.
    • H2 blockers include famotidine, nizatidine, cimetidine and ranitidine.

    Surgery

    The surgery is advised in the following conditions:

    • Symptoms do not get better with medications or return when medication is stopped.
    • Lifelong medication is required.
    • Patient is unwilling to take medicines for a prolonged time.
    • Severe damage to esophagus due to acid reflux.
    • The most effective surgery is Laparoscopic anti-reflux surgery. The surgery is also called Intraluminal Endoscopic surgery and Laparoscopic Nissen Fundoplication.

    Fundoplication Surgery

    Esophageal valve tightening

    • The surgery involves tightening of the esophagal valves, hence increasing the pressure near lower esophageal valve.
      By increasing the pressure at the point between stomach and esophagus, the surgery prevents stomach content to move up into esophagus.
    • 5 small abdominal incisions are done for fundoplication, which is 0.5 to 1 centimeter long.
    • The operation is effective and 90% patients leave the hospital the next day after surgery.

    Intraluminal Endoscopic Acid Reflux Surgery

    • This is done through means of an endoscope.
    • This is a quick method of surgery with minimal risk and post operatory treatment.

    Home Remedies

    • Simple home remedies can cure most of the people and control the problem. The best home remedy to control the disease is to eat a healthy diet.
    • A healthy diet minimizes the stomach acid production. Maintain a food log for a few weeks and follow a routine religiously.
      There are some food which causes more acid reflux symptoms. So it is better to avoid those foods. These include citrus fruits, spicy foods, some spices, fatty foods and caffeine.
    • A glass of milk at the initial sign. It immediately calms the symptoms and coats the inner stomach.
    • Papaya is a fruit rich in the enzyme papain. This enzyme is good for the digestive system and acts as an anti-inflammatory agent.
      Chamomile tea. It is the most calming tea and is mostly used for bowel irritation and upset stomach.
    • Apple cider vinegar. One tablespoon mixed with water just before or with meals works best to get relieve form acid reflux. It helps in digesting the food easily.
    • Fruits like apples, banana, pineapple, fig, carrots and papaya.
    • Herbs like cardamom, cinnamon, nutmeg, mace and slippery elm.
    • Ginger is a natural stomach soother. Ginger bread, sushi ginger and ginger ale can all cure acid reflux symptoms.
    • Chewing gum is also a good remedy for acid reflux. It increases saliva production and that is body’s natural antacids. Excess saliva settles the stomach and decreases the amount of acid production.
    • If you stick to lots of fresh vegetables and fruits, you could soon get relieve from acid reflux. Symptoms. A healthy and balanced diet can also prevent future acid reflux symptoms.
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