Keeping it down: acid reflux disease and how to treat it

Oct 12, 2014

For many of us, the burning sensation associated with acid reflux disease or GERD (Gastroesophageal reflux disease) is a familiar yet fortunately infrequent experience. However, recurring symptoms of the disease can lead to reduced quality of life and an increased risk for serious health conditions.

This week on “Take Care,” Dr. Rajeev Jain discusses the symptoms of acid reflux and the treatments for the disease. Jain is chief of gastroenterology at Texas Health Dallas and a partner at Texas Digestive Disease Consultants.

Stomach acid is an essential part of the digestive system. It kills parasites, breaks down protein, and helps with the absorption of vitamin B12. A common misunderstanding is that acid reflux results from an overproduction of acid. 

“It’s not an overproduction of acid. The real defect in acid reflux is this muscle between the esophagus and the stomach called the esophageal sphincter,” Jain says.

When the esophageal sphincter relaxes for too long or too often, acid and food can be pushed out of the stomach and into the esophagus.

Jain says that the two classic symptoms of the disease are heartburn and regurgitation, which do not necessarily go together. 

“There’s both acid and non-acid reflux.”

The treatment for either form is the same. Doctors first recommend that the patient identifies certain food triggers such as chocolate or caffeine and eliminate them from their diet. Those who are overweight can reduce symptoms by losing weight.

Lying on your left side after eating can help because the position leaves the stomach lower than the esophagus. Raising the head of your bed for sleeping can also reduce symptoms.

For patients who need more aggressive treatment, medications called Proton Pump Inhibitors or PPIs can be used to cut off acid production in the stomach. PPIs come in both over-the-counter and prescription forms. 

“I try to limit the use of these medications,” Jain says.

The reason Jain gives for controlling the amount of prescriptions he gives for PPIs is the potential side effects of the drugs, including osteoporosis, reduced absorption of vitamin B12, and colon infection. 

“There is no medication that we use that has zero side effects.”

Surgery is a final option for more severe cases. The surgery that is typically used is called fundoplication and involves wrapping the top part of the stomach around the lower esophagus to strengthen the esophageal sphincter.

If you have recurring acid reflux, Jain recommends that you seek treatment even if it does not cause discomfort.

“I think it is important for those patients who have very symptomatic acid reflux that they get [it] under control because the studies show that if you have long-standing acid reflux or poorly controlled acid reflux, your risk of developing esophageal cancer goes up.”