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Gastric Acid Disease : Symptoms, Causes and Treatment

Gastroesophageal Reflux Disease (GERD) is a condition characterized by heartburn or a burning sensation in the chest due to increased stomach acid to the esophagus. the esophagus is the part of the digestive tract that connects the mouth and stomach. Gastric acid is a health problem that is quite common in the community.

Gastric Acid Disease

Symptoms of Stomach Acid Disease

When stomach acid rises, the tissue of the esophagus and mouth wall will be irritated by stomach acid. The following are the most common symptoms experienced by people with gastric acid:

  • Gastric acid reflux or regurgitation. The acid in the stomach will return to the esophagus and also the mouth so that it appears sour and bitter.
  • Burning sensation in the chest or heartburn. This condition is felt in the sternum due to stomach acid which rises to the esophagus. The pain will feel stronger after eating and when bending.

In addition to the above symptoms, there are also several other symptoms that may be experienced, including:

  • Feel as if something is blocking in the esophagus when swallowing.
  • Laryngitis (inflammation of the larynx or vocal cords that causes the throat to hurt and the voice becomes hoarse).
  • Dry cough without stopping, especially at night.
  • Chest pain.
  • Wheezing.
  • Difficulties and pain when swallowing.
  • The teeth become damaged.
  • Bloating and belching.
  • Bad breath.
  • Sudden increase in the amount of saliva.

Mild stomach acid that occurs once or twice a month usually does not require doctor intervention. This can be overcome by changing the diet and consuming over-the-counter drugs when the symptoms appear. But for more severe and frequent symptoms, it is recommended to see a doctor and ask about more appropriate medication or treatment. Take the medication according to the dosage and rules of use.

Causes of Stomach Acid Disease

Gastric acid is generally caused by a lower esophageal sphinchter (LES) that does not function properly. LES is a circle of muscles in the lower part of the esophagus that functions as a 'gatekeeper'. When eating, LES muscles will relax and allow food to enter the stomach. After food passes, LES muscles will become tense and close to stomach acid and food does not rise again from the stomach to the esophagus or esophagus.

In patients with gastric acid, LES experiences weakness. As a result, stomach acid can escape and rise again to the esophagus. Patients will feel heartburn or a burning sensation in the chest and abdomen that feels bad.




Although it is not yet known why LES is weakening, there are several risk factors that are thought to be related to this condition. The first is being overweight or obese. People who are obese have a higher pressure in their stomach compared to people who have ideal body weight. This high pressure is thought to weaken the LES muscle.

The second factor is eating too much fatty food. Fatty foods require a longer digestive time in the stomach so that more stomach acid is produced and the risk of rising back into the esophagus is also higher.

The third factor is consuming too much coffee, chocolate, or alcohol, and likes to smoke. These elements make LES muscles relax so that stomach acid can rise into the esophagus.

The fourth factor is pregnancy. People who are pregnant will experience hormonal changes, this can weaken LES. In addition there will be an increase in pressure on the abdomen.

Then the fifth factor is suffering from a hiatal hernia. This is a condition when a portion of the stomach is pushed through the diaphragm. LES is weaker in patients with hiatus hernias. Stress factors also play a role in making LES weak.

In addition, diabetics are also more at risk of suffering from stomach acid disease. High sugar levels damage the nerves that control the abdominal muscles. As a result, food stays in the stomach longer before continuing into the small intestine. This condition gives stomach acid the chance to rise into the esophagus.

In addition to the above factors, drugs can also have an impact on the weakening of LES muscles. For people with high blood pressure or hypertension, calcium-channel blockers can be a step in treatment. This drug can weaken the LES work system. In addition, nitrates used to treat angina can also weaken LES.

Read Also : Hernia : Causes, Symptoms and Treatment

Diagnosis of Stomach Acid Disease

To make a diagnosis of gastric acid or GERD, the doctor simply asks about the symptoms you are experiencing. Further research to ensure the diagnosis can be done through endoscopic procedures.

The endoscope itself uses a device called an endoscope, a long flexible tube with lights and a camera at the end. This tool will be inserted through the mouth to see the cause of acid reflux and if there is a wound in the esophageal wall.

To find out if you suffer from stomach acid or GERD, the doctor simply asks about the symptoms that are experienced and he can determine the diagnosis.

Further testing is only recommended if you feel pain or difficulty in swallowing, and if the symptoms do not subside after taking the drug. Further tests are carried out to make sure the symptoms that occur are not due to other diseases such as irritable bowel syndrome or IBS.

The following are some advanced tests that your doctor may recommend to examine stomach acid or GERD.

  • This test is done to check LES muscle function.
  • Examination uses an endoscope to confirm the diagnosis of GERD and also to see if there is an esophageal wall damaged by acid.
  • Monitoring acidity in the esophagus. Measurement of pH or acidity in the esophagus needs to be done if the endoscopic results cannot confirm the presence of GERD disease. A diagnosis of GERD can be ascertained if the pH in the esophagus has been shown to rise dramatically after meals.
  • Blood test. Sometimes a blood test will be performed by a doctor to check for the appearance of an anemia condition which is a sign of internal bleeding.
  • Barium test. This test aims to check if there are obstacles or problems when swallowing food or drinks. This test can show if there is a problem with the digestive tract muscle while swallowing. Barium is a safe and non-toxic chemical that can be clearly seen by X-rays. A barium solution will be taken, then an X-ray scan will be performed to find out the problem.

Treatment of Stomach Acid Disease

There are various types of gastric or GERD treatment. Starting from the patient's own handling, the use of special medicines, to through the surgical procedure as a final step.

The following are some of the things that sufferers can do to relieve GERD symptoms:

  • Lose weight if needed.
  • Eat small portions but more often.
  • Don't lie down immediately after eating
  • Avoid chocolate, tomatoes, fatty foods, and spicy.
  • Avoid drinking alcohol and coffee.
  • Quit smoking.
  • Sleeping with a pillow that is rather high to prevent acid reflux when lying down.
  • Avoid stress.
  • Avoid wearing clothes that are too tight.

Medications for Overcoming Gastric Acid

1. Antacids

Antacids can be purchased at pharmacies directly. Antacids function to neutralize stomach acid. It is not recommended to take it together with other drugs because it can have an impact on the absorption rate of other drugs. This drug can also relieve pain due to ulcers.

2. Alginate

This medicine is taken right after eating. Alginate functions to protect the abdominal wall and esophagus or esophagus from excessive irritation of stomach acid. This medicine can be purchased directly at a pharmacy without a doctor's prescription.

3. H2 receptor inhibitor or H2-receptor antagonist (H2RA)

This drug reduces stomach acid by inhibiting the effects of histamine. Histamine is needed by the body to produce stomach acid. Examples of H2RA drugs are ranitidine and nizatidine. Purchasing this drug usually requires a doctor's prescription.

4. Proton-pump inhibitors (PPI)

This drug serves to reduce the production of acid in the stomach. This drug rarely has severe side effects. If any, the condition is not too severe and can be constipation, dizziness, or diarrhea. Examples of PPI drugs are omeprazole, lansoprazole and esomeprazole. This medication usually requires a prescription from a doctor.

5. Prokinetic

This drug functions to accelerate the process of emptying the stomach. This means that food and stomach acid will more quickly enter the small intestine thereby reducing the chance of stomach acid to rise to the esophagus. This drug is not recommended for use by people under the age of 20 due to potential side effects. For example, prokinetic drugs are domperidone and bethanecol. This drug generally requires a doctor's prescription.

Handling with Operations

Surgery is the final treatment step for stomach acid or GERD if self-medication and medication do not produce significant results. Other conditions when surgery is an option to do are:

  • Severe inflammation of the esophagus.
  • The occurrence of esophageal narrowing so that food is difficult to get into the stomach.
  • The change in esophageal cells caused by irritation of stomach acid, often referred to as Barrett's esophagus.

Laparoscopic Nissen fundoplication surgery serves to tighten LES to prevent stomach acid from rising into the esophagus. This is done by wrapping the LES with the upper part of the abdomen to form a collar. This operation is usually performed by laparoscopy or 'keyhole' surgery.

Some other surgical techniques that can be done to treat GERD are as follows:

  • Endoscopic injection of bulking agent. Special substances will be injected in the body part between the stomach and esophagus to make it narrower.
  • Endoluminal gastroplication. The fold will be sewn to the bottom of the LES muscle, to limit the width of the muscle opening.
  • Endoscopic augmentation with hydrogel implants. A special gel-filled implant is placed between the stomach and esophagus to make it narrower.
  • Endoscopic radiofrequency ablation. A small balloon will be placed under the esophagus. The small balloon will produce heat to make the esophagus narrower.
  • Laparoscopic insertion of a magnetic bead band (LINX). The magnetic ring is planted around the bottom of the esophagus to strengthen and help it close when not swallowing.

Complications of Stomach Acid Disease

Gastric acid or GERD that lasts for a long time and is not treated can cause complications. Complications that occur are:

  • Injuries to the esophageal wall or esophageal ulcer. Gastric acid can erode the esophageal wall very badly, which causes wounds or ulcers to form. Esophageal ulcers can bleed and cause pain and difficulty swallowing.
  • Esophageal narrowing. The lower wall of the esophagus can be damaged due to irritation of stomach acid continuously. This long-term irritation can cause the formation of ulcer tissue in the esophagus and narrow the channels passed by food.
  • Esophagus Barrett. Changes in cells in the esophageal wall can occur after repeated irritation of stomach acid. This condition is called Barrett's esophagus and can be considered a precancerous condition. Cell changes that occur do not have cancer properties. But later on, these cells can trigger the appearance of cancer cells even though they are rarely.

Esophageal cancer. Apart from the ongoing effects of GERD, there are several things that can increase the risk of esophageal cancer. The risk will increase if the patient is a smoker, alcoholic drinker, or a person who is obese or overweight. The most common symptoms of esophageal cancer are difficulty and pain when swallowing, and weight loss.



References

References

1. Gyawali, C. Fass, R. (2018). Management of Gastroesophageal Reflux Disease. Gastroenterology.

2. AMerican College of Gastroenterology. Acid Reflux.

3. Mayo Clinic (2018). Diseases and Conditions. Gastroesophageal Reflux Disease (GERD).


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Is a health and wellness enthusiast. In him free time, she loves to travel and taste different types of teas.

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