Esophageal reflux

Acid Reflux Disease or Gastro Esophageal Reflux Disease (GERD) afflicts millions worldwide and dietary restrictions can form the first line of treatment and in most mild cases a change in diet can bring significant relief. Certain food items can precipitate or aggravate Acid Reflex disease - like for instance - Whole Milk can trigger GERD for people who have lactose intolerance which affects most people of almost all ethnic origins except Caucasians.

You might feel an upper abdominal pain or discomfort on consumption of a heavy meal or when bending to lift an object. Acid reflux symptoms tend to make an appearance at night, when you are lying on your back. This may result in nausea after eating or stomach bloating and burping. Women tend to suffer more from acid reflux symptoms during pregnancy due to the pressure from the growing fetus and the increased hormone levels.

Tackling GERD - Gastro Esophageal Reflux Disease

• Eat frequent small meals during the day. Avoid big meals.
  
• Include complex carbohydrates in each meal.
  
• Limit the consumption of alcohol, chocolate and caffeinated drink.
  
• Do not lie down on a full stomach. Instead sit in an upright position for about 45 minutes after each meal.
  
• Stay clear of high-fat meals as they will trigger an acid attack on the stomach.
  
• Smoking can weaken the lower esophageal muscles. Tobacco aggravates the condition of Acid Reflux disease.
  
• Maintain healthy body weight. Shed excess weight to curb acid reflux symptoms.
  
• Chewing gum or sucking on candy can cause swallowing of air, thereby worsening acid reflux and belching.
  
• Avoid tight clothing, especially around the abdomen.
  
• Do not drink water during mealtimes but instead drink a glass or two of water about half an hour before a meal.
  

Persons suffering from acid reflux disease would do well to maintain a diary of foods consumed daily. This can help identify any potential triggers so that you can eliminate them from your diet.

Antacids

One of the common stomach disorders encountered is gastro esophageal reflux also known as heartburn. The stomach contains hydrochloric acid which helps in digestion of the food and subsequently killing ingested microorganisms. The acidity of the gastric HCl is 2M and any increase in the acidity leads to reflux, in which the gastric HCl travels through the cardiac sphincter muscle to the esophagus causing burning sensation and discomfort. Antacids are common choice of drugs which are administered in these conditions as they reduce the acid reflux and peptic ulcer.

Antacids act locally in the stomach region to neutralize the effect of the gastric HCl in order to prevent the onset of peptic ulcer. Most antacids are not absorbed and they are easily excreted in the stool. The predominant forms of chemicals used in the preparation of antacids include sodium bicarbonate, potassium bicarbonate, aluminum hydroxide, aluminum carbonate, magnesium carbonate, magnesium oxide and calcium carbonate. The natural forms of antacids include ginger, bananas, aloe vera, chamomile (used along with tea), carrots and turmeric. The action of antacids on the stomach is carried out throughout the wall to prevent ulcer formation.

Types of antacids

Antacids are recommended depending upon the intensity of the gastric disorder. In normal or mild conditions of acidity, non systemic antacids are recommended as they do not cause much damage. Prolonged administration of systemic antacids may lead to a condition called alkalosis in which the PH of the blood is raised leading to renal failure. Some of the common types of antacids used in the treatment of reflux and peptic ulcers are:

Sodium bicarbonate: It is recommended by many doctors to treat acid reflux and also reduce the acidity of urine and blood. Antacids which contain sodium bicarbonate also contain baking soda and hence it is not recommended for patients having congestive heart failure, hypertension, kidney disorders and gastrointestinal bleeding. Antacids containing sodium bicarbonate should be taken only after meals on a partially full stomach. The side effects include nausea, flatulence, weakness, increased thirst, black stools and irritability.

Aluminum hydroxide: Aluminum hydroxide is widely used as a non-systemic antacid and in most cases is available without prescription. The side effects of aluminum hydroxide include constipation and abdominal discomfort. In order to avoid constipation and abdominal stress, aluminum hydroxide is given in combination with magnesium hydroxide which has laxative properties along with antacid effects The combination of two such compatible antacids helps in sustained action in relieving peptic ulcers and protecting the wall of the stomach.

Calcium Carbonate: These antacids are mainly used in the treatment of indigestion, flatulence along with acidity and more commonly used as it is less expensive than other types of antacids. They are mostly recommended for children below the age of 12. In patients who have a previous history of osteoporosis or any other type of calcium deficiencies, the intake of calcium carbonate in case of acidity also helps in balancing the calcium requirement. If patients have a history of renal calculi or any other allergic reaction, calcium carbonate antacids should be avoided. The major side effect of this antacid is that it interacts with cardiac drugs. Calcium carbonate based antacids usually disintegrate and dissolute in forty minutes.

Drug side effects

Antacids react with many medications; digoxin, isoniazid, quinidine, pseudoephedrine and tetracycline. The potency and absorption of the drug reduces when the antacids interact with the corresponding drugs.

Barium Swallow

Barium Swallow or Upper GI series is a radiological test that allows visual examination of the esophagus, stomach, duodenum and small intestine. Nothing should be eaten for about 6 hours prior to the test. Typically, double contrast barium swallow is used. The patient is made to swallow a barium drink after swallowing an effervescent agent. The barium creates a temporary coating on the lining of the upper GI tract. Then he is asked to stand and lie in different positions to spread the liquid. An x-ray machine then takes pictures. Fluoroscopy is often used during a barium swallow.

After this test, patients are asked to drink extra fluids and water to relieve the bowels of the barium. Constipation or fecal impaction may occur if the barium isn't completely eliminated from the body. This diagnostic test is used for detecting dysphagia, hernia, peptic ulcer disease, GERD (Gastro Esophageal Reflux Disease), achalasia, generalized epigastric pain and suspected perforation.