GASTRO-ESOPHAGEAL REFLUX DISORDER {ACID REFLUX}

DEFINATION:-

Gastro-esophageal reflux disorder is a common condition that features a burning pain in the gastric tract or lower chest area, this is also known as Acid reflux and heart burn.  

Heart Burns or Acid reflux occurs when the sphincter muscle of the esophagus (food pipe) at the lower end are relaxes at the wrong time, that causes stomach acid to back up into the esophagus (food pipe). This cause Acid reflux or heartburn, pain, Irritations and other signs and symptoms in the stomach. Constant and frequent Acid reflux can lead to gastro-esophageal reflux disorder (GERD).

In other words the liquid content of the stomach regurgitates (backs up or refluxes) into the esophagus (food pipe). The liquid can damage or inflame the esophagitis (lining) these are the visible signs of inflammation that occur in many patients. The Stomach juices mainly contains acid and pepsin named enzymes that are produced by the stomach. Pepsin is an enzyme that helps in the digestion of proteins in the stomach. The refluxed stomach juice (liquid) may also contain bile that has backed-up into the stomach from the duodenum (first part of small intestine). So the Acid is most injurious component of the refluxed liquid. The bile and Pepsin enzymes may also injure the esophagus, they also causes inflammation and damage in the esophageal. 

SYMPTOMS OF GASTRO-ESOPHAGIAL REFLUX DISORDERS

• Pain and burning sensation in the chest area, throat and stomach
• Heart burn
• Gas or Flatulence 
• Chest Pain
• Regurgitation
• Indigestion
• Bad Breathing
• Constipation
• Nausea or vomiting
• Heaviness in the abdomen after eating
• Frequent burps
• Mimic heart pain (angina)
• Regurgitation of undigested food coming back into mouth
• Over-eating
• Eating at odd times
• Skipping meals
• Unhealthy eating habits such as having too much tea, coffee, cold- drinks, spicy, junk, and oily food
• Pain may extend to the back in many patients 
• Stomach ailments like ulcers 
• A bad lifestyle such as taking too much stress, sleeping less, drinking alcohol, and smoking etc.
• In many patients with GERD are awakened from sleep due to heart burn or pain
• Prolonged regurgitation of acidity can cause acid-induced erosions of teeth.
• Acidity can cause inflammation into the esophageal blood vessels 
• Prolonged acidity can cause bleeding into the esophagus
• The bleeding may severe due to acidity
• Due to acid reflux swallowed food may get stuck into the esophagus, causes severe narrowing 
• The refluxed acidic liquid can cause coughing 
• Narrowing of the breathing tubes may resulting in an attack of asthma.
• Recurrent acidity can cause Inflammation of the larynx and throat 
• The severe acidity resulting inflammation this can lead to a sore throat and hoarseness of voice 
• The refluxed acidic liquid can cause infections and inflammation of the lungs
• The refluxed acidic liquid also cause aspiration that may lead to infection of the lungs and result in pneumonia. This type of pneumonia can cause Pulmonary fibrosis

CAUSES OF GASTRO-ESOPHAGIAL REFLUX DISORDERS

There are four common factors that contribute to GERD, these are following:-

1. Lower Esophageal Sphincter Abnormalities
2. Hiatal Hernias
3. Abnormal Esophageal Contractions
4. Prolonged or Slow emptying of the stomach.

• Lower esophageal sphincter (LES)

The functions of the lower esophageal sphincter is the most important mechanism (factor) for preventing the acid reflux. The esophagus is a muscular, it is a tube like structure which extends from the lower throat to the stomach. The LES is a ring of muscle which surrounds the lower-most end of the esophagus and it joins to the stomach. When there is contracting and closing off the passage from esophagus to the stomach. So the closing of the passage helps to prevent the reflux. When saliva and food is swallowed, to allow the food or saliva the LES relaxes for a few seconds, this happens to pass the saliva and food from the esophagus into the stomach, and then it is closed again after all these process.

In the patients with GERD there are several different abnormalities are found. There are two factors that causes GERD. The first abnormality is, weak contraction of the LES, which reduces the ability to prevent reflux. The second abnormality is LES relaxations. These prolonged relaxations allow reflux to happen more easily. 

• Hiatal hernia

Hiatal hernias can cause reflux, in many patients with GERD have hiatal hernias. If there is a hiatal hernia, a small part of the upper stomach which attached to the esophagus pushes up through the diaphragm. As a result, a small part of the stomach and the lower esophageal sphincter come to lie in the chest, and the lower esophageal sphincter is no longer at the level of the diaphragm. It appears when the diaphragm that surrounds the lower esophageal sphincter is important in preventing reflux.

• Esophageal contractions

The swallows are very important in eliminating the acid in the esophagus. Swallowing can causes a ring-like wave of contraction of the esophageal muscles, which narrows the inner cavity (lumen) of the esophagus. The contraction, can cause peristalsis, that peristalsis begins in the upper esophagus and moves to the lower esophagus. It pushes the food, and saliva from the esophagus into the stomach.

In patients with Gastro-esophageal reflux disorders, several abnormalities of contraction are occurred such as waves of contraction may not occurs after each swallow or the waves of contraction may die out before they come to the stomach. The pressure also generated by the contractions, that may be too weak to push the acid back into the stomach. Smoking can also cause GERD in many patients.

• Gastro paresis (Emptying of the stomach)

Most reflux can occurs after meals. This reflux may be due to transient lower esophageal reflux relaxations that are caused by distention of the stomach with meal. The slower emptying of the stomach causes prolongation of the distention of the stomach after meals with food. 

HOME REMEDIES FOR GASTRO-INTESTINAL REFLUX DISORDER:-

• Saunf or Fennel seeds:-  

One teaspoon of fennel seeds powder mix in a glass of warm water relieves acidity, heartburn, bloating and its symptoms. This also improves digestion.

• Black Cumin Seeds:-

Take one tablespoon of cumin seeds Chew directly or those in a glass of water and its drink relieve acidity. Black cumin seeds are gastro-protective remedy. These are very effective in preventing acidity and reducing pain. This also helps to reduce the symptoms like heartburn, bloating, constipation, pain, and nausea, etc. 

• Health Benefits of Sabja Seeds:-

Take one tablespoon of sabja Seeds, mix it into water and its drink gave good relief in acidity

• Cloves:-

Take a piece of clove, it gave relief in acidity and its symptoms like indigestion, nausea, flatulence, and gastric irritability etc. 

• Lukewarm Water:-

During empty stomach or before going to sleep at night drink a glass of lukewarm water it provides relief from acidity.

• Watermelon Juice:-

A glass of watermelon juice is very effective remedy in relieving acidity and it is also good for digestion. 

• Cardamom:-

Chewing one cardamom pod every day that helps to prevent acidity, improves digestion, and flatulence also. 

• Buttermilk:-

The Lactic acid present in the buttermilk normalizes the acidity in the stomach and gives a good result. A glass of buttermilk topped with coriander and black pepper helps in instantly easing the symptoms of acidity.  

• Ginger:-

Drinking ginger tea or chewing raw ginger is very helpful to prevent acidity and its symptoms. 

• Banana:-

Taking banana neutralizes the acidity and gives relief from heartburn. A mixture of banana and milk helps to suppress excess acid secretion.

• Papaya:-

Papaya helps to reduces gastric acid secretion and gives relief from acidity. This is due to enzyme papain, present in papaya.

• Ajwain:-

Intake of ajwain gives relief from flatulence and acidity. It is very effective anti-acidic agent for digestion and good for digestion.  

• Cold Milk:-

Drinking of one glass of cold (chilled) milk instantly relieves acidity.  

• Baking Soda:-

Intake 1/2 teaspoon of baking soda and mixed this in 1/2 cup of water gives quick relief from heartburn and acidity.

• Turmeric:-

Adding turmeric into your daily diet relieves heartburn and acidity. 

LIFESTYLE CHANGES CAN HELP TO PREVENT ACIDITY

1. Stay active and engage in exercise, like swimming, cycling, dancing or your favorite sport etc. 
2. Eat smaller meals, four to five times in a day
3. Have your dinner early, at least  two hours before you go to the bed
4. Do not overeat and chew your food during eating
5. Do not sleep immediately after a meal
6. Lose weight if you are obese or overweight  
7. Raise the head end of your bed during lying down
8. Avoid drinking alcohol and smoking 

AVOID FOODS THAT TRIGGER ACIDITY

1. Very spicy and oily food
2. Tea, coffee, and cold drinks
3. Raw onions, and garlic
4. Citrus fruits like lemons, oranges, and kiwis
5. Tomatoes
6. Junk food