2007年12月18日星期二

Acid reflux - Symptoms, Prevention and Treatment

Symptoms

Almost everyone has occasional heartburn. But if these symptoms occur two or more days a week for at least three months, you may have acid reflux. Acid reflux occurs when the lower esophageal sphincter, the valve separating the esophagus and stomach, does not close properly, allowing acid to back up into the esophagus.

Heartburn is in most cases harmless, even if you are not comfortable with it. It is common during pregnancy and is not dangerous.

Many also get a feeling of sickness, have a hollow feeling in the stomach and diffuse pain in the stomach or the chest combined with the heartburn. The acid reflux may cause you to cough during nighttime.

If the heartburn comes back often and you wake up with acid refluxes you should see this as a warning signal. You should watch your habits, for example what and how often you eat and drink.

Pregnancy and heartburn

It is common with heartburn during pregnancy, do not worry. Some day its more, other days less. The reason for heartburn during pregnancy is that the pregnancy hormones make the uterus softer and easier to stretch out. The stomach, the upper part of the stomach, and the bowels are effected in the same way.

Acidity of the stomach can then come up in esophagus and cause heartburn. When uterus grows it will also push on the stomach. If you have serious problems, talk to your midwife.

What can You do - Prevention

Avoid bigger meals and much drinking late on the evening.
Avoid strong, spicy food and also fat food.
Quit smoking and be cautious with alcohol.
Try to avoid stress.
Eat on specific times and add something between meals.
Check your coffee- and tee-drinking.
Try to avoid heavy lifting and forward bending.

Medical examinations

If your doctor suspects that your problems are caused by a disease your doctor will do an endoscopy which can be performed in a hospital or the doctors office. The doctor will spray your throat to numb it and slide down a thin, flexible plastic tube, the endoscope. A tiny camera in the endoscope allows the doctor to see the surface of the esophagus and to search for abnormalities.
With the endoscope one can also take a specimen.

Treatment

Some treatment is easy to say but perhaps not so easy to stick to.
- raise the head of your bed by six inches to allow gravity to help keep the stomach's contents in the stomach
- eat meals at least three to four hours before lying down and avoid bedtime snacks - eat smaller meals
- limit your consumption of fat foods, chocolate, peppermint, coffee, tea, colas, and alcohol and also, avoid tomatoes and citrus fruits or juices, which contribute additional acid that can irritate the esophagus
- quit smoking
- wear loose belts and clothing
- try to find your own way to raise your pH. Milk is good for some but not proved to work for everyone.

Your doctor may recommend over-the-counter antacids, which you can buy without a prescription. The doctor can also prescribe medications that stop acid production or help the muscles that empty your stomach.

Surgery is also an option when medicine and lifestyle changes do not work. It may also be a reasonable alternative to a lifetime of drugs and discomfort.