Heartburn and Reflux

Heartburn and Acid Reflux

What is heartburn and acid reflux?

Heartburn and acid reflux are often used interchangeably to refer to symptoms like burning or discomfort in the chest, throat, or mouth caused by stomach acid travelling back into the oesophagus. Heartburn is usually most noticeable at night when you lie down; sometimes, it can wake you up with a harsh burning sensation.

Also called acid indigestion, acid reflux is a condition that happens when stomach contents that contain acid move backwards into the oesophagus. The oesophagus lining is not made to withstand the stomach’s harsh acidic environment, so acid reflux may cause inflammation, which leads to pain and discomfort.

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What causes heartburn and acid reflux?

The LES (lower esophageal sphincter) is located at the junction between your stomach and oesophagus, where food flows out of your stomach into your oesophagus. Normally this valve remains closed so that acidic stomach contents do not flow back into the oesophagus.

The process of acid moving back up the oesophagus is called reflux. Reflux happens when the LES isn’t working properly. When reflux occurs, so does acid, and this leads to heartburn and other symptoms associated with acid reflux. The causes of heartburn can vary, including eating certain foods, being overweight, smoking cigarettes, etc.

What are the symptoms that accompany heartburn and acid reflux?

The main symptom of acid reflux or heartburn is a burning sensation in your chest area, which sometimes travels up to your neck, throat, or even mouth. Sometimes you may also experience pain when swallowing food and belching. Other symptoms that may accompany acid reflux include:

  • Discomfort or pain in the lower chest area
  • Hoarseness or sore throat due to laryngopharyngeal reflux (LPR) caused by stomach acid travelling up your oesophagus and causing irritation of your vocal cords and throat. This can make your voice hoarse or raspy
  • Regurgitation
  • Heartburn
  • Bad breath
  • Sour taste in the mouth
  • Difficulty swallowing
  • Frequent gagging, coughing, or choking while eating food because food goes down the wrong way. The other name for this condition is globus sensation
  • Asthma-like symptoms such as wheezing and shortness of breath
  • Dry cough
  • Persistent dry hacking cough that doesn’t improve after a number of weeks

Certain foods tend to worsen the condition, so it is best to avoid them if possible. The foods you may want to avoid in this case include; fatty foods, chocolate, caffeine products (coffee, tea, cola), citrus fruits like oranges and lemon, tomato-based products (sauce, juice), and many others.

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What are the risk factors for heartburn and acid reflux?

The causes of acid reflux are not completely understood, but some factors may increase the risk of developing it, like:

 Having excess body fat around the abdomen influences the development of acid reflux. It is believed that the pressure that extra weight places on the stomach can cause acid reflux and worsen existing acid reflux by increasing pressure on your stomach

Smoking increases the risk of developing heartburn because smoking narrows blood vessels which reduces blood supply to various organs, including the oesophagus

Eating large meals and lying down after eating can worsen acid reflux. It is recommended to eat smaller, more frequent meals and not lie down for at least three hours after eating

Certain food items like chocolate, caffeine products (coffee, tea, cola), citrus fruits like oranges and lemons, spicy or greasy foods may trigger heartburn

Drinking alcohol increases the risk of developing acid reflux because it decreases pressure on the stomach which allows contents there to flow back into the oesophagus

During pregnancy, some women experience severe heartburn that is worsened by bending over or during activities that increase the pressure on the stomach, such as climbing stairs

Taking medication like certain blood pressure medications, aspirin, ibuprofen can trigger heartburn in certain people

What is the treatment for heartburn and acid reflux?

The main treatment of acid reflux or heartburn is lifestyle changes, diet changes, and medication.

The lifestyle changes include:

  • Practising healthy eating habits, which are avoidance of foods that may worsen your condition
  • Avoiding late-night snacks before bedtime
  • Losing weight which would most likely be recommended if you are obese or overweight
  • Quitting smoking 

Other preventative measure includes not drinking alcohol with meals because it relaxes the LES allowing contents to travel back into the oesophagus, sleeping on an incline by raising your head end of the bed 6 inches with blocks under feet end of the bed with 10-degree inclined angle, wearing loose clothing and avoiding tight waistbands because they exert pressure onto stomach and bowel which can contribute to acid reflux.

The diet changes include eating smaller, more frequent meals; avoid high-fat foods such as cream sauces, chocolate, fried or greasy food items, smoked meat or fish, certain cheeses like blue cheese that can trigger heartburn symptoms in some people.

Another treatment of acid reflux that may be recommended for you is over-the-counter medication like antacids, H2 blockers (cimetidine-Tagamet), proton pump inhibitors ( lansoprazole -Prevacid), natural remedies such as aloe vera juice, slippery elm, fennel tea, caraway seeds.

Conventional medicine for the treatment of acid reflux includes proton pump inhibitors such as omeprazole (Prilosec), pantoprazole (Protonix), and esomeprazole (Nexium). All these drugs work by blocking the H+/K+-ATPase enzyme, which reduces the amount of acid is produced in your stomach. 

Another medication is called H 2 receptor blockers which reduce acid production in your stomach by inhibiting histamine type-2 receptors; examples include cimetidine (Tagamet), ranitidine (Zantac). If needed, the natural treatment may be accompanied by medications, like aloe vera juice with ranitidine (Zantac).

We provide extensive evaluation before recommending any treatment for acid reflux in Singapore. If you experience the symptoms above and they aren’t improving or are only getting worse, chances are there you’re dealing with something more complicated. Get in touch with us now to schedule your medical exams and treatments if necessary.