Gastroesophageal Reflux Disease Causes Food Pipe Irritation
Anatomic cause is loose sphincter. There is a band of circular muscle (sphincter) at the end of the food pipe before stomach begins which acts like a valve preventing backwash of stomach contents into the esophagus.
Gastroesophageal reflux disease (GERD) is one of the most frequently occurring diseases caused by a condition when acid from the stomach back flows into the esophagus causing food pipe irritation. This disease troubles people of all ages with varying degrees at least once a week – usually more.
Symptoms
- Heart burn after a meal usually at night with recumbency
- Chest pain
- Difficulty in swallowing
- Cough
- Laryngitis and voice change
- Regurgitation of sour (acidic) food
- Asthma
- Sleep disturbance
Cause
Anatomic cause is loose sphincter. There is a band of circular muscle (sphincter) at the end of the food pipe before stomach begins which acts like a valve preventing backwash of stomach contents into the esophagus.
Aggravating Factors
- Obesity
- Pregnancy – because of increased abdominal pressure in later stages and muscle relaxing hormones
- Connective tissue disease – collagen abnormalities
- Smoking
- Alcohol
- Hiatal Hernia – gap in the diaphragm separating the chest from the abdomen resulting in stomach sliding in the chest and back wash of the contents into the food pipe
- Large meals
- Lying down soon after meals
- Fried foods, fatty foods, caffeinated beverages, tomatoes, cheese are common culprits
- Medications like aspirin, NSAIDS and muscle relaxers
Also Read: Types of Abdominal Pain and Appropriate Treatments
Complications
- Scarring of the esophagus from constant irritation by stomach acid leading to narrowing
- Acid from the stomach damages the lining of the esophagus giving rise to ulcer
- Barretts esophagus which is a precancerous condition and may lead to cancer of the esophagus
Do you experience food pipe irritation?
Diagnosis
- EGD – Esophagoduedonoscopy. Scope (camera) is passed from the mouth to the stomach. Inflammatory changes are visible.
- Acid Test – like a litmus test. Tester is passed into the food pipe to check for the pH.
- X-ray – barium swallow shows back flow of the barium contrast into the food pipe from the stomach.
Treatment of Food Pipe Irritation
- Lifestyle modification – dietary habits, time of eating, amount consumed, beverages and any other aggravating factors.
- Over the counter medications.
- Antacids provide short lasting relief – Tums and Mylanta are common examples.
- H2 blockers take longer to act but provide longer relief like Pepcid and Zantac.
- PPI – proton pump inhibitors. Prevent acid from forming like Pantoprazole and Omeprazole.
- Same group of medications can be prescribed at higher doses by healthcare providers.
- Surgery/Procedures
- Fundoplication – proximal stomach is wrapped around the esophagus. It is performed both surgically and endoscopically.
- LINX – magnetic beads are placed at the end of the food pipe. The beads stick to each other bringing the esophagus walls closer.
- Transoral Incisionless Fundoplication (TIF) – same as the first one but performed from the mouth.
Also Read: Delay in Seeking Healthcare Leads to Dire Consequences
Lifestyle Modification
- Weight loss
- Tobacco cessation
- Do not sleep immediately after meals
- Lying at least 30 degrees head elevation
- Eat slowly and chew thoroughly
- Avoid alcohol and caffeinated beverages
- Caution with fried and fatty foods
- Wear loose clothing around the abdomen
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