Heartburn & Acid Reflux in Houston
Heartburn is the most common symptom of Acid Reflux. Most people describe heartburn as a burning discomfort behind the breastbone. The stomach produces a very strong acid solution to digest food. In normal digestion, the sphincter, or Valve, between the esophagus and stomach opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus. The sphincter also relaxes when the stomach is distended with gas allowing it to vent (a belch). When the sphincter between the esophagus and stomach is weak acid flows back into the esophagus. This results in heartburn and chest pain as well as a variety of other symptoms. For a majority of people, heartburn symptoms are an occasional annoyance. However, if symptoms persist you are at risk for serious long-term side effects.
Common Symptoms Associated With Acid Reflux
- Chest or stomach pain
- Difficulty swallowing
- Food regurgitation or vomiting
- Coughing or wheezing, made worse by lying down especially at night.
- Frequent throat clearing
Common Causes of Acid Reflux
There are several factors that weaken the muscle sphincter between the esophagus and stomach leading to Acid Reflux Disease.
Obesity and smoking are leading causes of acid reflux. Spicy foods, chocolate, coffee, tea, mint, and alcohol also relax the lower esophageal sphincter and increase acid reflux.
One of the most common causes of Acid Reflux is an abnormality of the diaphragm, breathing muscle, called a hiatal hernia. In this case, the muscle sphincter between the esophagus and stomach is not attached to the diaphragm anymore. Rather, it has moved into the chest above the diaphragm. In this position, stomach acid easily flows back into the esophagus.
There is a potential for long-term consequences of acid reflux if left untreated. Stomach acid injures the lining of the esophagus. This leads to esophagitis, inflammation of the esophagus. In the long run, inflammation can cause bleeding, ulcers, and narrowing of the esophagus. Narrowing of the esophagus can lead to difficulty swallowing, food impaction, and vomiting.
A very small percentage of people will suffer from Barrett’s Esophagus. Barrett’s Esophagus is when the damaged cells of the esophagus are replaced by new abnormal cells that have the potential to turn cancerous.
Solutions for Acid Reflux
For most people, heartburn is easily controlled with simple solutions or over-the-counter antacids. There are multiple solutions to reduce symptoms of acid reflux.
- Eat dinner at least three hours or more prior to going to bed.
- Consume small quantities of food to avoid over-filling your stomach.
- Reduce stress in your daily life. Stress is a major contributor to acid reflux.
- Raise the top half of your mattress.
- Avoid certain food items that increase acid reflux.
- Stop smoking.
- Reduce alcohol intake.
- Lose weight, including considering weight loss surgery when medical means are not effective.
When to See an Acid Reflux Specialist
If your acid reflux symptoms are becoming frequent, persistent or severe you should see an acid reflux specialist. An acid reflux specialist will diagnose your symptoms and provide options for successful treatment.
Acid Reflux Tests
A variety of tests can be performed to evaluate and diagnose acid reflux disease:
- Barium Swallow: This test is done using X-ray imagery. It visualizes the esophagus and stomach anatomy. It checks for the presence of a hiatal hernia and the backflow of contrast into the esophagus.
- Esophageal Manometry: This test measures the strength of your esophageal contractions. It checks for the ability of the esophagus to move food down into the stomach.
- 24 hour pH Monitoring: pH testing can check for the level of acid in your esophagus. It is performed over a period of 24 hours and it detects each reflux occurrence from the stomach.
- Endoscopy: Our acid specialists insert a flexible, lighted tube into the esophagus and stomach to visualize the inner lining of this area. The test can detect inflammation, erosion, abnormal growths, and hiatal hernias.
- Gastric Emptying Study: This study evaluates the emptying function of your stomach. It involves eating a scrambled egg mixed with a radio-labeled substance. A special machine then measures how fast your stomach is emptying the consumed meal.
When Is Surgery Considered
While surgery is not required for most patients with reflux disease, it is an option for many. The surgical procedure performed is called Hiatal Hermia repair and Nissen fundoplication. The procedure is performed through tiny incisions. It is considered in the following cases:
- Failure to control reflux symptoms by lifestyle changes and medications
- Patients who have complications from reflux disease, such as esophagitis, difficulty swallowing, Barrett’s Esophagus, or aspiration.
- Patients who are young and prefer to avoid a lifetime of medical treatment.
- Patients with a large or complicated hiatal hernia
If you are experiencing frequent heartburn or chest pain near Houston, it is possible that you may have a hiatal hernia. Some people with hiatal hernias never experience any symptoms or complications, while others live in a great deal of discomfort until the cause of the symptoms is recognized and addressed. Here’s what you need to know about hiatal hernias:
What Is a Hiatal Hernia?
A hiatal hernia occurs when a portion of the stomach enters into the hiatal opening: the opening that allows the esophagus to pass through the diaphragm and into the stomach. The cause of hiatal hernias is not exactly known, but many experts believe it may be due to a larger than normal hiatus and/or increased pressure on the area such as occurs with obesity, pregnancy, straining, and heavy prolonged coughing.
What Are the Types of Hiatal Hernias?
A hernia is classified as a sliding hiatal hernia when the stomach, along with the bottom portion of the esophagus that connects to the stomach, move up into the chest cavity. When the stomach and esophagus remain in their proper locations but a portion of the stomach protrudes through the hiatus to lie alongside the esophagus, it is classified as a paraesophageal hernia. Sliding hiatal hernias are the most common, while paraesophageal hernias are more dangerous.
What Are the Symptoms of a Hiatal Hernia?
Hiatal hernias can produce GERD symptoms such as heartburn or acid reflux. They can also cause chest pain due to the increased pressure in the area. In fact, hiatal hernia symptoms can easily be mistaken for a heart attack. Hiatal hernias do not cause GERD, nor vice versa, but it is possible to have both conditions simultaneously, or one without the other.
What Is the Treatment for a Hiatal Hernia?
Hiatal hernias that cause no symptoms usually do not require treatment. In cases where the stomach is in danger of having its blood supply cut off, or during any weight loss surgery, hiatal hernia repair surgery may be necessary to put everything back where it belongs and decrease the size of the hiatus. Otherwise, most treatments will involve simply managing any reflux or GERD symptoms caused by the condition.
With over 15 years experience, Dr. Mirza is highly skilled, trained, and experienced in the treatment of a reflux and hiatal hernia.
Please give us a call if you would like to know more, and start treating your heartburn and acid reflux effectively.
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