Health Break | Published September 4, 2006 | Written by Lois Hassinger, RN

What Is Acid Reflux?

Digestion is the process by which food is converted into substances that can be absorbed and used by the body. This process is accomplished by the digestive system's breakdown of foods into chemical compounds.

Digestion begins as soon as food is put into the mouth and chewing begins. In fact, digestive juices start flowing with just the sight or smell of food. The esophagus carries food from the mouth to the stomach with rhythmic muscular contractions. At the end of the esophagus there is a muscle that acts as a one-way valve, by opening and allowing food to pass into the stomach, then contracting to keep stomach contents from flowing backwards, or refluxing, after swallowing.

As part of the digestive process, the stomach has a great ability to secrete hydrochloric acid. In conjunction with other gastrointestinal secretions, stomach acids aid in the process of breaking food down for absorption.

Acid reflux is the backward flow of acid from the stomach into the esophagus. It occurs because the muscle at the end of the esophagus does not close tightly enough and the valve leaks, or it relaxes at times that it should not.

Although the stomach lining resists acid, the esophagus does not. Acid exposure in the esophagus usually causes pain. This pain is described as "heartburn," or a burning sensation beginning in the upper abdomen and often radiating to the chest.

Prolonged or repeated acid reflux can cause inflammation or irritation of the lower esophagus. This condition is often referred to as gastroesophageal reflux disease, or GERD, which is one of the most common disorders of the gastrointestinal tract, with heartburn being a typical symptom.

Please note that heartburn is often confused with chest pain, and be aware that a physician should evaluate all chest pain.

While all populations are susceptible to acid reflux, it can often be treated with minor lifestyle changes. Reflux can be influenced by a number of factors, such as:

  • Exercise
  • Emotions
  • Pain
  • Body positions (such as bending over)
  • Overeating
  • Smoking
  • Pregnancy

Food products, such as caffeinated beverages; fried, fatty or spicy foods; citrus juices; coffee; milk; and alcohol are also known to cause an increase in acid production.

Some people with persistent acid reflux can develop a form of esophageal inflammation called Barrett's esophagitis. In this condition, the normal lining of the esophagus is replaced by abnormal cells with a small risk of becoming cancerous. For that reason, people with severe, persistent heartburn should see their doctors.

Some helpful guidelines to aid in the reduction of acid reflux include:

  • If you smoke, quit
  • Avoid fatty, fried or spicy foods, as well as onions and tomatoes
  • Eat smaller meals
  • Do not lie down within three hours of eating
  • Avoid tight-fitting clothes
  • Lose excess body weight

Many people with occasional heartburn get relief from over-the-counter medications, such as antacids. If symptoms are severe, prolonged or suggestive of a complication, see a physician.

Together, you and your health care professional can work to decide what lifestyle changes can be made to alleviate symptoms.

In addition, your physician may suggest an upper endoscopy, or EGD (esophagogastroduodenoscopy), which entails using an instrument to look into the esophagus, stomach and the first part of the small intestine for a more definitive diagnosis.

Lois Hassinger is a registered nurse in the Endoscopy Department at Mount Nittany Medical Center.

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