Acid Reflux Causes Are Not Always The Same
Millions of men and women suffer from acid reflux every day, and for most of them, the condition is related to diet or other lifestyle issues that can cause or exacerbate heartburn. But for others, acid reflux may indicate an underlying health condition that can only be diagnosed by a physician.
Enzyme and motility insufficiencies are two underlying causes of acid reflux which can usually be successfully treated. Both are directly related to the digestive process. When food enters the stomach, enzymes contained in the stomach acid help break food down into a liquid form, allowing nutrients to be absorbed by the bloodstream. Some individuals do not produce enough of these enzymes for normal, healthy digestion. In these men and women, additional stomach acid may be produced, which can result in an excess of fluid being released backward through the lower esophageal sphincter, where the pain and burning of acid reflux are first felt. In addition, it can take considerably longer for food to digest and pass through the stomach, which means stomach acid remains in the stomach for longer periods of time. This added pressure can cause the lower esophageal sphincter to weaken, allowing acid to reflux. Chronic, unusually prolonged digestion is considered a motility, or movement, problem, and can occur as a result of an enzyme deficiency, or on its own. Digestion is also slowed considerably in individuals who are under stress.
When motility and enzyme issues are not related to another underlying condition, they can usually be treated with medication.
Hiatal hernias are another medical problem that can cause acid reflux to occur. A hiatal hernia occurs when a portion of the upper stomach pushes through the diaphragm, a large, powerful muscle that extends along the lower ribcage and is essential for respiration. The esophagus passes through the diaphragm on its way to the stomach, in an area of the diaphragm known as the hiatus. Hiatal hernias can occur as a result of sudden exertion or heavy lifting, trauma, obesity, pregnancy, prolonged coughing or vomiting, and as a result of aging. In some individuals, defects in the hiatus are present at birth.
Small hiatal hernias usually do not cause acid reflux. But larger hernias may cause heartburn, chest pain, and even trouble swallowing. Many individuals can be successfully treated with antacids, H-2 acid blockers, or proton pump inhibitors; others may benefit from a few changes in lifestyle, such as weight loss or quitting smoking. A very few men and women will require surgery tor repair the herniated area, remove the herniated sac, or repair the weakened area of the diaphragm and esophagus. General surgery may be performed through incisions in the chest or abdomen, while laparoscopic techniques use tiny incisions to repair the area. If you are diagnosed with a hiatal hernia and require surgery, your surgeon will be able to advise you on the method needed to repair the area.
Some individuals with acid reflux also suffer from an underlying condition known as Barrett’s esophagus. This condition has been linked to the development of cancer, and requires immediate attention to prevent progression of the disease. In Barrett’s esophagus, chronic acid reflux causes an abnormal changes to occur in the cells which line the esophagus. To diagnose Barrett’s esophagus, your doctor will perform an endoscopy. In this simple procedure, a lighted, flexible tube is inserted into the lower esophagus, allowing the physician to view changes in the area. In individuals with Barrett’s esophagus, the tissue in the lower area of the esophagus will appear darker pink, or salmon color. Men and women with Barrett’s esophagus need aggressive treatment. Lifestyle changes and use of H-2 acid blockers and proton pump inhibitors may help control the development of Barrett’s, but an increased risk of cancer still exists. Some individuals may require surgery to repair the area, or in rare cases, an esophagectomy, which involves the removal of the entire esophagus.