Acid Reflux

Acid reflux is a common digestive issue that can cause a burning sensation in your chest, a sour taste in your mouth, or discomfort after eating. Many people have occasional reflux. When it occurs frequently or starts to impact your daily life, it may be a sign of a more serious condition called gastroesophageal reflux disease, or GERD.

The team at Birmingham Gastroenterology evaluates and treats acid reflux and GERD to help relieve symptoms and protect the health of your esophagus over time.

What Is Acid Reflux?

Acid reflux happens when stomach contents flow backward into the esophagus. The esophagus is the tube that carries food from your mouth to your stomach. At the bottom of the esophagus is a muscle called the lower esophageal sphincter. Its job is to open to let food into the stomach and then close tightly.

If this valve does not close properly or relaxes at the wrong time, stomach acid can move upward into the esophagus. Because the lining of the esophagus is sensitive, this backflow can cause irritation and the familiar burning sensation known as heartburn.

Common Symptoms of Acid Reflux

Acid reflux can show up in different ways. Symptoms may include:

• Burning pain or discomfort in the chest, especially after eating or when lying down
  
• A sour or bitter taste in the mouth or throat
  
• Food or liquid coming back up into the throat
  
• Feeling like something is stuck in the throat
  
• Hoarseness or chronic throat clearing
  
• A persistent cough, especially at night
  
• Sensation of fullness, bloating, or frequent belching
  

Not everyone with reflux has classic heartburn. Some people mainly notice throat symptoms, cough, or chest discomfort. A gastroenterologist can help sort out whether reflux is the cause.

When Acid Reflux Becomes GERD

Almost everyone experiences occasional heartburn, particularly after consuming a large or heavy meal. Acid reflux is considered GERD when:

• Symptoms happen at least a few times a week
  
• Over-the-counter medicines are not enough
  
• Symptoms interfere with sleep, eating, or daily activities
  
• There is evidence of damage to the esophagus
  

Persistent reflux can inflame and injure the lining of the esophagus. Over time, this can lead to problems such as narrowing (strictures), ulcers, or changes in the cells of the esophagus called Barrett’s esophagus. These complications underscore the importance of evaluating ongoing reflux and treating it effectively.

What Causes Acid Reflux?

Many factors can contribute to acid reflux and GERD. These may include:

• A weak or relaxed lower esophageal sphincter
  
• A hiatal hernia, where part of the stomach pushes upward into the chest
  
• Extra pressure in the abdomen from weight, pregnancy, or tight clothing
  
• Large or high-fat meals
  
• Certain foods and drinks, such as spicy foods, citrus, tomato-based foods, chocolate, peppermint, coffee, carbonated beverages, and alcohol
  
• Smoking or use of tobacco
  
• Some medications that relax the lower esophageal sphincter or irritate the esophagus
  

Sometimes more than one factor is involved. Your provider will work with you to identify your personal triggers.

When Should I See a Gastroenterologist?

You should schedule a visit with a gastroenterologist if you:

• Have heartburn or reflux symptoms more than twice a week
  
• Take over-the-counter medicines regularly but still have symptoms
  
• Have trouble swallowing, feel food getting stuck, or have pain with swallowing
  
• Notice unintentional weight loss, nausea, or vomiting
  
• Have chest discomfort you are not sure is heartburn
  
• Have a chronic cough, hoarseness, or sore throat that might be related to reflux
  

Chest pain should always be taken seriously. If you have severe chest pain, pressure, or pain that spreads to your arm, neck, jaw, or back, seek emergency care right away to rule out heart or lung problems.

How Acid Reflux Is Evaluated

At Birmingham Gastroenterology, evaluation for acid reflux starts with a detailed medical history and physical exam. Your provider will ask when your symptoms occur, what seems to trigger them, how often they happen, and how they affect your daily life. They will also review any medicines you are taking and other health conditions that could be contributing.

In many cases, your provider can make an initial diagnosis based on your symptoms and response to treatment. If more information is needed, they may recommend tests such as:

• Upper endoscopy (EGD) to examine the lining of the esophagus and stomach, look for inflammation or complications, and take biopsies if needed
  
• Esophageal pH monitoring to measure how often and how long acid comes into the esophagus over a 24 hour period
  
• Esophageal manometry to evaluate how well the esophageal muscles and lower esophageal sphincter are working
  
• Imaging studies in certain cases, such as to look for a hiatal hernia
  

Your gastroenterologist will explain which tests are appropriate in your situation and what the results mean for your care.

Treatment Options

Treatment for acid reflux and GERD focuses on relieving symptoms, healing the esophagus, and preventing long term complications. Your plan is personalized and often includes a combination of lifestyle changes and medical therapy.

Lifestyle and dietary changes

Simple adjustments can make a big difference in reflux symptoms. Your provider may recommend:

• Eating smaller meals and avoiding large, heavy, or late night meals
  
• Staying upright for at least 2 to 3 hours after eating
  
• Raising the head of the bed to reduce nighttime reflux
  
• Avoiding or limiting trigger foods and drinks
  
• Reaching and maintaining a healthy weight
  
• Avoiding tight belts or clothing that put pressure on the waist
  
• Stopping smoking and avoiding tobacco
  

Medications

Several types of medicines can help control acid reflux:

• Antacids to give quick, short-term relief of heartburn
  
• H2 blockers to reduce acid production
  
• Proton pump inhibitors (PPIs) for stronger and longer-lasting acid control
  
• Other medicines in selected cases to help the stomach empty or reduce sensitivity
  

Your provider will help you find the right medicine and dose, and will discuss how long you may need to take it and how to use it safely.

Procedures and advanced treatments

If lifestyle steps and medicines are not enough, or if there are complications such as strictures or severe inflammation, additional options may be considered. These can include:

• Endoscopic procedures to treat certain complications
  
• Referral for surgical options for GERD in selected patients, such as when a large hiatal hernia is present or when long term medication use is not ideal
  

Your gastroenterologist will review these options with you if they are appropriate and help coordinate your care.

Why Address Acid Reflux Early?

Ignoring frequent reflux can lead to ongoing discomfort and may allow damage to build up over time. Treating reflux early can:

• Reduce symptoms like heartburn, regurgitation, and cough
  
• Improve sleep and daily comfort
  
• Help the esophagus heal
  
• Lower the risk of complications such as strictures, ulcers, and Barrett’s esophagus
  

Care for Acid Reflux at Birmingham Gastroenterology

Living with regular heartburn or reflux is not something you have to accept as usual. The providers at Birmingham Gastroenterology use a thoughtful, step-by-step approach to diagnose the cause of your symptoms and tailor a plan that fits your life.

If you are experiencing frequent heartburn, regurgitation, or other signs of acid reflux, it may be time to talk with a specialist.

Schedule an appointment today to learn what is causing your symptoms and how we can help you feel better and protect your long-term digestive health.