What is gastric reflux?

Gastric reflux, also referred to as heartburn, is a burning sensation and pain in the stomach and/or chest, behind the breastbone. It often occurs when hydrochloric acid backs up into the oesophagus causing senstiive tissues to become irritated.

Gastric reflux is a back flow of acid into the oesophagus. The oesophagus is the tube which all food passes down after being swallowed. This tube connects the throat to the stomach. A valve between the stomach and oesophagus usually prevents backflow of stomach contents. In certain individuals this valve may be weak, or there may be increased pressure within the stomach forcing acid upwards.

Gastric reflux is often associated with obesity, pregnancy, overeating, bending, lifting, lying down too soon after eating and smoking. Gastric reflux may also be brought on by acidic food or drink (tomatoes, orange juice and cola) and by alcohol, especially fortified wines and spirits. Hiatus hernia may also cause Gastric reflux.

Gastric reflux occurs to some degree in all people but is usually cleared by contractions of the oesophagus and neutralised by swallowed saliva. A dull, gnawing, steady, mild to moderately severe pain is characteristic of peptic ulcers. See your Doctor if you have any of these symptoms. Other complications of chronic gastric reflux include inflammation of the oesophagus, an increased risk of oesophageal cancer, anaemia and ulceration of the oesophagus.

How to prevent gastric reflux?

Research demonstrates that eating too quickly and not chewing food thoroughly increased the incidence and severity of gastric reflux.

Signs and symptoms of gastric reflux

Gastric reflux is generally experienced as a burning sensation around the stomach, in the centre of the chest or radiating up behind the breastbone. Terms such as indigestion, dyspepsia, heartburn or sour stomach are often used to describe the symptoms.

The symptoms of gastric reflux can be similar to the symptoms of heart attack, especially if prolonged and unrelieved by antacids. Always consult your doctor for diagnosis and advice. In no way is this information intended to replace the advice of a medical practitioner.

Treatment options for gastric reflux

As with all conditions your doctor should be consulted to diagnose and treat this condition. Ask your Doctor about the latest advice for this ailment. Your doctor will decide whether the symptoms are a sign of a more serious condition or if the gastric reflux is a result of prescribed medication. An antacid or H2-receptor antagonist may be prescribed.

Pharmacist's advice for gastric reflux

Ask your pharmacist for advice.

1) Follow the diet hints . Eat smaller meals more often. Avoid carbonated drinks, chewing gum and sucking lollies as these may increase the intragastric pressure.

2) Consider an antacid to help with the acidity. Ask your pharmacist for the best brand suitable for you. There are a class of drugs now available without a prescription called H2 receptor antagonists e.g. Tagamet which may be taken to reduce gastric acid and pepsin output. These drugs help to improve the symptoms of gastric reflux, decrease patient's use of antacids and aid in the healing of gastric damage to the oesophagus. Ask your Pharmacist for advice.

3) Never undertake exercise or lie down immediately after a meal as this may hinder digestion. Wait at least 2 hours to allow the food to digest.

4) Avoid smoking, tea, coffee, alcohol, chocolate, peppermint and spearmint which all relax the oesophageal sphincter. If you need help to stop smoking ask your pharmacist about the Quit Programme.

5) Avoid stressful situations, especially around meal-times.

6) Sometimes sedatives and other medications may decrease the body's ability to swallow properly. This can lead to heartburn. Ask your Pharmacist for advice. As a general rule, prescribed drugs should be taken with ample fluid and the patient should stand or sit for a period afterwards.

7) Some drugs may aggravate reflux. For example, theophylline (prescribed for asthma), calcium channel blockers (prescribed for heart disease), anticholinergics (prescribed for depression and other illnesses), aspirin and other non-steroidal anti-inflammatory drugs may be the cause of Gastric Reflux. Ask your Pharmacist about any side effects of prescribed medications.

8) Raise the bed head; avoid wearing tight clothes around the abdomen. If necessary sleep propped up on a few pillows to reduce the likelihood of Gastric Reflux during the night.

9) Lose weight if necessary. Being overweight is associated with an increased incidence of gastric reflux.

10) If the diet is inadequate consider the nutritional supplements suggested in this topic.

Diet hints for gastric reflux

• Avoid eating within three hours of bedtime.
• Eat several small meals during the day. Large meals are associated with Gastric Reflux. Try to avoid physical exertion directly after eating, especially bending over and heavy lifting.
• Try to eat foods which are easily digested e.g., salads, chicken, fish and some wholemeal bread. Concentrate on lightly cooked greens and avoid roasts and fatty red meats that are hard to digest.
• Hot spicy food or food containing possible irritants, such as garlic and onion should be avoided. Citrus fruit juices and tomato products are also possible irritants.
• Avoid alcohol and citrus juices which stimulate gastric juices and acid in the stomach.
• Avoid drinking before meals and drink sparingly during the meal. Stomach acid (the aid to digestion) can be diluted with too much fluid. Excess fluid intake with meals may also overfill the stomach.
• It is advisable to avoid caffeine, fried foods, fatty foods such as chocolate, peppermint and spearmint which all relax the oesophageal sphincter.

Vitamins, minerals and herbs for gastric reflux

• Slippery elm reduces inflammation and hyperacidity and improves digestion.
• Acidophilus helps rebalance gastrointestinal bacterial levels and improve digestion.
• Digestive enzymes help digestion and the breakdown of food.
• Glutamine is an amino acid thought to help reduce hyperacidity and inflammation of the stomach lining.