What is gastroesophageal reflux?

When experiencing gastroesophageal reflux, many individuals will encounter symptoms such as belching, bloating, and may hesitate to eat anything further.

Gastroesophageal reflux disease (GERD) is a chronic disorder of the lower esophageal sphincter that allows stomach contents, including food, digestive enzymes, and gas, to flow back into the esophagus, causing inflammation and damage in the upper digestive and respiratory tracts.

GERD is characterized by the backward flow of acid from the stomach into the esophagus. This condition can lead to symptoms such as heartburn, bloating, indigestion, and abdominal discomfort. The underlying cause often stems from the lower esophageal sphincter’s spasms, which weaken or damage the esophagus internally.

The disease can result in esophagitis, esophageal strictures, esophageal adenocarcinoma, asthma, chronic laryngitis, dental caries, chronic sinusitis, and recurrent otitis media, among other complications.

When experiencing this condition, the food you consume can produce a significant amount of acid.

Meanwhile, the lower esophagus serves as a barrier preventing food in the stomach from moving back into the esophagus. When experiencing this condition, the food you consume can trigger a considerable amount of acid. To minimize the risk of exacerbating the condition, it is important to follow certain dietary guidelines and choose foods suitable for individuals with gastroesophageal reflux.

Two important dietary principles for those with gastroesophageal reflux:

Limit the intake of foods high in acid and those that can irritate the lower esophagus, such as citrus fruits (lemons, oranges, tangerines), carbonated beverages, spicy foods, and highly seasoned dishes.
Select foods that can neutralize acid, such as bread, oatmeal, and easily digestible proteins. These foods can help prevent the erosion caused by stomach acid and reduce the risk of lower esophageal spasms.

Effects of Gastroesophageal Reflux Disease

The stomach is responsible for storing and partially digesting food. To carry out digestion, the stomach secretes a powerful acid, hydrochloric acid (HCl), which activates pepsin, an enzyme that plays a key role in protein digestion. Consequently, the stomach has a strong barrier that prevents acids and enzymes from “eroding” it. However, other organs lack this protective mechanism. Therefore, when exposed to stomach contents, the mucosa can quickly become damaged, eroded, and subsequently lead to swelling, inflammation, scarring, and in severe cases, cancer. Specifically:

Esophageal ulcers: These ulcers can bleed, cause pain, and make swallowing difficult.
Esophageal strictures and scarring: When damage heals, it can leave scarring that causes strictures, obstructing the passage of food.
Barrett’s esophagus: This condition involves the transformation of the squamous tissue in the lower esophagus into columnar tissue resembling that of the intestines (intestinal metaplasia). This process results from continuous damage to the esophageal lining, with gastroesophageal reflux being the most common cause. These altered cells may carry a risk of becoming cancerous. Therefore, individuals with Barrett’s esophagus are advised to undergo regular endoscopies to monitor for early warning signs of cancer.
Esophageal cancer: There are two main types of esophageal cancer: adenocarcinoma and squamous cell carcinoma. Barrett’s esophagus is a significant risk factor for esophageal cancer. It is estimated that 1 in 10 to 20 individuals with Barrett’s esophagus may develop esophageal cancer within 10 to 20 years.
Extraesophageal manifestations: These include pharyngitis, laryngitis, recurrent otitis media, exacerbation of asthma, dental erosion, and aspiration of acid into the lungs, which can lead to pulmonary fibrosis.

Treatment Options for Gastroesophageal Reflux Disease

Medications

Proton pump inhibitors (PPIs) are the primary medication used to reduce stomach acid secretion. PPI treatment regimens typically start with a loading dose for 4 to 8 weeks, followed by a maintenance dose that is gradually reduced. Additionally, doctors may prescribe other medications such as H2 receptor antagonists, alginates, and prokinetic agents like Domperidone and Metoclopramide.

Surgery

If medical treatment fails and complications arise, surgery may be indicated by the physician.

Traditional Medicine

Depending on the patient’s condition, herbalists may utilize various herbs that help regulate qi, relieve stress, harmonize the stomach, and strengthen the spleen according to the specific symptoms presented. Commonly used formulations include Xiao Yao San and Ban Xia Hou Po Tang.

Individuals with gastroesophageal reflux disease often experience a burning sensation that spreads along the throat. (Photo: Medical News Today).

Acupuncture

There are various treatment methods such as acupuncture, auricular acupuncture, and needle embedding. Commonly used acupoints include Zhongwan, Danzhong, Neiguan, Zusanli, Taixi, Gongzong, San Yin Jiao, Shenmen, Sympathetic, Spleen, and Stomach…

Wellness Practices

Patients can relax and reduce stress through breathing exercises and wellness practices.

Lifestyle Modifications

Patients should lose weight if obese, avoid smoking, refrain from late-night meals (eat at least 2-3 hours before sleeping), avoid lying down immediately after eating, and elevate the head of the bed while sleeping. They should limit spicy and acidic foods, fried foods, chocolate, alcohol, and carbonated beverages, and avoid drinking water during meals. Relaxation and stress reduction are crucial factors in managing the condition.

According to Dr. Nhi, gastroesophageal reflux disease requires careful examination by a physician to create a treatment plan combined with lifestyle adjustments to prevent recurrence. If symptoms such as difficulty swallowing, painful swallowing, hoarseness, vomiting blood, choking, or difficulty breathing at night occur, it is essential to seek immediate medical attention for diagnosis and clinical tests.

Home Remedies for Gastroesophageal Reflux

Avoid Lying Down After Eating

When you eat a meal and then lie down immediately, the contents in your stomach can easily be pushed upward due to pressure on the lower esophageal sphincter. However, if the patient remains sitting or standing, gravity can help reduce the reflux of food.

Adjust Sleep Position

Nocturnal gastroesophageal reflux can be particularly dangerous. If frequent nocturnal reflux occurs, the risk of complications increases.

However, there are simple remedies for nighttime gastroesophageal reflux.

Lying flat can force the contents and food in the stomach against the lower esophageal sphincter. Using a higher pillow can help reduce pressure in the stomach due to gravity.

Elevating the entire head of the bed by placing bricks or wooden blocks under the bed’s legs can also help the patient avoid reflux symptoms while sleeping.

Choose Appropriate Clothing

Avoid tight waistbands, skinny jeans, and tight clothing, as these can help prevent irritation of the lower esophageal sphincter.

Foods Suitable for Individuals with Gastroesophageal Reflux

Egg Whites

People with gastroesophageal reflux should only consume egg whites and avoid the yolks. The yolk contains high levels of fat, which can easily stimulate the stomach to produce more acid, leading to gastroesophageal reflux.

Bread and Oatmeal

These whole grains are rich in fiber. They can absorb stomach acid and alleviate reflux symptoms from within.

Legumes

Peas, mung beans, and red beans are high in fiber and can significantly help reduce the risk of gastroesophageal reflux occurrences.

Lean Meats

Lean meats such as chicken and fish are low in fat, which helps reduce the risk of gastroesophageal reflux. However, it is advisable to use baking or boiling methods instead of frying to avoid stimulating excessive acid production in the stomach.