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Treating reflux as a disease may be necessary

A chronic digestive disease occurs with severe acid reflux conditions and can affect millions of people in the U.S., according to a Texas AgriLife Extension Service specialist.

The illness, know to doctors as gastroesophageal reflux disease, occurs when stomach acid or other digestive juices flow back into the esophagus, said Andy Crocker, AgriLife Extension program specialist for gerontology health.

Crocker said while acid reflux and gastroesophageal reflux disease are closely related, they are not necessarily the same disorder. When acid reflux occurs more than twice each week or interferes with daily life, a health provider may diagnose the problem as the disease.

He explained that when a person swallows, a small muscle near the bottom of the esophagus, called the lower esophageal sphincter, opens to allow food and liquid to flow down into the stomach and then closes again.

"However, if this muscle relaxes abnormally or weakens, stomach acid can flow back up into your esophagus, causing heartburn," Crocker said. "This acid may irritate the lining of your esophagus and cause it to become inflamed. Over time, the inflammation can erode the esophagus, causing bleeding, trouble breathing and other serious problems."

In addition to acid reflux, other symptoms may include but are not limited to: heartburn spreading to the throat with a sour taste in the mouth, chest pain, difficulty swallowing, dry cough, hoarseness or sore throat, and the sensation of a lump in the throat.

"Make an appointment with your health provider if you experience severe or frequent symptoms or if you turn to over-the-counter medications for heartburn more than twice per week," Crocker said.

While a person may start by seeing a family health provider, he or she may refer the patient to a gastroenterologist (a specialist in digestive disorders). Tests and procedures may be used to diagnose the disease, such as an X-ray of the upper digestive system, an endoscopy and a test to monitor the amount of acid in the esophagus.

Conditions that may increase the risk of the disease development include: obesity, hiatal hernia, pregnancy, smoking, dry mouth, asthma and diabetes.

"Seek immediate medical attention if you experience chest pain, especially when accompanied by symptoms such as shortness of breath or jaw or arm pain," Crocker warned. "These may be signs of a heart attack."

Treatment for heartburn and other signs and symptoms of the disease usually begins with over-the-counter medications that control acid:

--Antacids that neutralize stomach acid. Overuse of some antacids can cause side effects such as diarrhea or constipation.

--Medications to reduce acid production. These may not act as quickly as antacids but may provide longer relief.

--Medications that block acid production and heal the esophagus. By blocking the acid production, these allow time for the esophagus to heal.

Crocker said if the symptoms are not relieved by these medications after a few weeks, the person should talk to their health provider, who may recommend prescription-strength medications or combine medications to increase effectiveness.

Though most gastroesophageal reflux disease can be controlled through medications, there may be instances where medications are not effective, he said. In these instances, the health provider may recommend additional treatment options.

Lifestyle changes may also help control the symptoms. The American College of Gastroenterology recommends:

--Maintain a healthy weight. Excess weight puts pressure on the stomach, causing acid to back up into the esophagus.

--Avoid tight-fitting clothing. Clothes that fit tightly around the waist put pressure on the abdomen and lower esophageal sphincter.

--Avoid foods that trigger heartburn. Common triggers may include fatty or fried foods, alcohol, chocolate, mint, garlic, onion and caffeine.

--Do not lie down after a meal. Wait at least two to three hours after eating before lying down or going to bed.

--Elevate the head of the bed. An elevation of about six to nine inches may reduce acid flow into the esophagus.

--Do not smoke. In addition to other health detriments, smoking decreases the lower esophageal sphincter's ability to function properly.

Access additional information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the National Institutes of Health: http://www.niddk.nih.gov.

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