Acid Reflux - Is It Just Indigestion?
Acid reflux or indigestion. We all get it. Maybe we've eaten too
much or too late in the evening. Maybe we've drunk too much
alcohol at that party the night before. We could have bent down
to do a bit of weeding too soon after a meal and oops, that pain
in the middle of the chest can be quite severe.
What is
acid reflux though?
It is the liquid in the stomach
regurgitating into the oesophagus (gullet). Much of this liquid
is acid produced in the stomach which is harmful to the walls of
the oesophagus. Reflux happens to most people but because we
spend much of our time upright, gravity ensures that the liquid
returns to the stomach unnoticed. In addition, we swallow
frequently which again returns regurgitated liquid to the
stomach and saliva contains bicarbonate which helps to
neutralise the acid in the stomach liquid.
It doesn't do
to ignore repeated instances of painful indigestion though, as
it could be symptomatic of something much more serious. That
refluxing acid can cause lasting damage to the lining of the
oesophagus, which, if left untreated, can lead to other
conditions.
A friend relates that when she was a child,
her father was always chewing on Rennies, a well known antacid
in the UK. He used to say that a good belch would cure the
indigestion. It later turned out that he had a stomach ulcer.
Despite that, when my friend, in turn, started suffering from
frequent indigestion, she too chewed on the Rennies and went
about her business.
Eventually, she realised that the
extent of the indigestion couldn't be normal so she consulted
her doctor who referred her to a specialist for an
endoscopy.
An endoscopy is a procedure whereby an
endoscope, a thin, lighted tube, is inserted down the throat.
The endoscope transmits images of the oesophagus, stomach, and
duodenum, enabling the specialist to identify problem areas and,
if necessary, obtain biopsies. The endoscope is usually inserted
while the patient is under sedation thus avoiding the gagging
reflex.
To return to my friend, a hiatus hernia was
diagnosed. A hiatus hernia occurs when the upper part of the
stomach pushes through the opening in the diaphragm where the
oesophagus connects with the stomach, allowing the acid from the
stomach to reflux. Fortunately, this was a small hiatus hernia,
which could be easily treated with a course of
medication.
A couple of years went by with only minor
instances of indigestion, then my friend started to experience
occasional bouts of very severe heartburn and sickness which she
treated with the usual array of antacid preparations. Suddenly,
one day she woke up with a severe pain in her lower stomach
which didn't respond to the usual remedies and in any event,
didn't resemble any of the normal symptoms of acid
reflux.
A visit to the doctor and my friend found herself
hospitalised for tests which revealed that the original small
hiatus hernia was larger and bleeding and had lead to gastritis
(inflammation of the stomach lining) and duodenitis
(inflammation of the duodenum), both caused by an infection with
the Helicobacter pylori bacteria. This bacteria is extremely
common, thought to infect 70% of the world's population,
although most people do not display any symptoms of the
infection.
The moral of this story is "Don't ignore
persistent acid reflux, it may be much more that just
indigestion".
Watch out for my next article on the
treatment of acid reflux.