Heartburn and Reflux
The point where the esophagus meets the stomach is called the cardio-esophageal junction. This junction is regulated by a valve-like structure called the lower esophageal sphincter, which allows food to pass into the stomach and prevents stomach contents from flowing back up into the esophagus.
In individuals with Gastroesophageal reflux disease (GERD), the lower esophageal sphincter may not close tightly enough, leading to the regurgitation of stomach contents and digestive juices into the lower esophagus.
One of the main symptoms of GERD is heartburn, which is described as a burning sensation or discomfort behind the breastbone, located in the center of the chest. It may also be accompanied by a sour or acidic taste in the mouth due to the reflux of stomach contents.
The most frequent symptoms of Gastroesophageal Reflux Disease (GERD) are heartburn and a sour taste in the mouth. This condition is a digestive disorder that affects the valve at the end of the oesophagus, which is also known as the lower oesophagal sphincter (LES). When the LES fails to close properly, stomach contents can flow back up into the oesophagus and cause discomfort.
Oesophageal Stricture
This is the narrowing of the lower oesophagus which then makes it difficult and painful to eat or drink normally. A narrowed lower oesophagus can make you feel like the food is stuck at the lower part of the chest and can result in vomiting
Oesophageal Ulcer
This is an open sore caused by gastric acid wearing away the tissue in the oesophagus. Recurrent esophageal ulcers can lead on to strictures. Barrett’s Esophaghus is a condition where long term damage from acid reflux causes abnormal changes in the lining. This condition is associated with an increased risk of oesophageal cancer.
Gastro-Esophageal Reflux Disease
Gastroesophageal Reflux Disease (GERD) is characterised by frequent acid reflux that causes a burning sensation that rises from the stomach to the lower chest and neck. This sensation typically occurs after eating and can persist for up to two hours. The symptoms can sometimes mimic chest pain, which can be mistaken for a heart attack. Aside from heartburn, other symptoms may include difficulty in swallowing, nausea, bad breath, breathing difficulties, chronic cough, or vomiting. Several factors can increase the risk of GERD, including obesity, pregnancy, consuming late meals, drinking alcohol, smoking, and hiatal hernia. Hiatal hernia is a condition where the upper part of the stomach moves upwards into the chest through a small opening in the diaphragm. This can make it easier for stomach contents to travel back up into the oesophagus.
Types of Hiatal Hernia
Hiatal hernias are generally not treated surgically. The symptoms of GERD can often be alleviated with anti-acid medications and adjustments to one’s lifestyle. However, if surgery is required to correct both the hiatal hernia and GERD, a combination of corrective procedures will be needed to address both issues appropriately.
Heartburn can sometimes be mistaken for heart pain, but any chest discomfort should not be overlooked. It is important to seek medical advice if one experiences persistent heartburn that does not improve with over-the-counter medication, or if the symptoms change in frequency or intensity. Other signs that warrant medical attention include acid reflux that interferes with daily activities or quality of life, difficulty swallowing, nausea or vomiting, and unexplained weight loss. Typically, symptoms that persist for more than two weeks should be evaluated by a doctor.
Antacids are sometimes effective for managing reflux and heartburn, but your healthcare provider may prescribe proton pump inhibitors or other medications to reduce stomach acid levels. Most cases of GERD can be managed with dietary and lifestyle changes, and long-term medication or surgery is rarely necessary. For instance, avoiding heavy meals close to bedtime or lying down immediately after eating can aid digestion. If certain foods trigger reflux and heartburn, you may need to limit or eliminate them from your diet.
Further investigation may be needed to determine the underlying cause of GERD. A gastroscopy is often recommended for this purpose. In some cases, a 24-hour pH study may be performed to measure the amount of acid in the stomach and oesophagus for persistent symptoms.