Acid Reflux Facts

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Young African American woman with indigestion using antacid tabletin glass of water
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What is acid reflux?

Acid reflux occurs when stomach acid backflows up into the esophagus. Acid reflux causes heartburn and other symptoms, such as tasting stomach contents or sour liquid at the back of the throat. Nearly everyone has experienced acid reflux and heartburn on occasion. When it happens frequently and chronically, it is called gastroesophageal reflux disease (GERD). People who have GERD suffer with acid reflux symptoms at least once a week.

Who gets acid reflux?

GERD is common in the United States, affecting up to 20% of the population. In fact, GERD is the most common gastrointestinal (GI) diagnosis in the country. It represents nearly 9 million outpatient visits per year. Acid reflux symptoms are also the most common reason for having an upper endoscopy imaging exam. Here are some additional acid reflux facts:

  • People of all ages have GERD. However, it increases with age and is common in people older than 65. It affects about 8% of men and 15% of women in this group.

  • As BMI (body mass index) increases, GERD becomes more common.

  • Race does not appear to play a role in GERD.

  • More than 75% of people with asthma also have GERD.

  • GERD is also very common in pregnant women.

Can you die from acid reflux?

GERD is the underlying or primary cause of death for about 1,700 Americans. This is a very small number compared to the number of people who have GERD—about 60 million. The most common fatal complication of GERD is hemorrhagic esophagitis. This is severe bleeding resulting from inflammation and rupture of the esophagus. GERD can also become life threatening if it leads to esophageal cancer or aspiration pneumonia.

What are some conditions related to acid reflux?

Conditions with symptoms and characteristics similar to or overlapping with GERD include:

  • Angina—chest pain due to decreased blood flow to the heart muscle

  • Anxiety—a condition that can trigger heartburn

  • Esophageal cancer—a relatively rare cause of heartburn

  • Esophagitis—inflammation of the esophagus causing chest pain, heartburn, and difficulty swallowing

  • Gallstones—hardened particles that can block the bile duct, causing stomach pain after eating

  • Gastroparesis—slow stomach emptying due to nerve damage, which can cause heartburn, nausea and discomfort

  • Hiatal hernia—a condition that pushes the upper part of the stomach up through the diaphragm, causing heartburn, belching and nausea

  • Pleuritis—inflammation of the membrane around the lungs and lining the chest cavity, which causes chest pain and discomfort

  • Stomach ulcer—a condition causing burning, nausea, and stomach pain that can spread to the chest

How does acid reflux affect quality of life?

Health-related quality of life (HRQoL) is a way to measure how a disease or illness affects people with the condition. It can help guide treatment decisions and disease management. HRQoL includes physical, mental and social well-being.

Research consistently shows HRQoL is lower in people with GERD compared to the general population. Several studies have found the impact of GERD to be similar to other chronic conditions, such as heart disease. This reinforces the idea that GERD is more than just heartburn.

With GERD, more disease severity and greater symptom frequency means a larger negative effect on HRQoL. Other trends in HRQoL include:

  • Comorbid conditions, such as anxiety, also contribute to a lower HRQoL in GERD.

  • Having just one GERD symptom episode per week can lower quality of life.

  • People who have daily symptoms are most likely to report negative effects in all areas including physical functioning, mental or emotional health, overall health, bodily pain, vitality, and social functioning.

  • Poor HRQoL in GERD contributes to missed work days and decreased productivity at work.

Fortunately, research has also shown that effectively treating GERD improves HRQoL. There is a strong correlation between symptom reduction and improved functioning. In one study, the number of people reporting problems with eating or drinking, sleeping, vitality, and emotional well-being was cut by more than half after only two weeks of effective treatment.

What causes acid reflux?

GERD happens when stomach acid refluxes into the esophagus due to a faulty lower esophageal sphincter (LES). Normally, the LES closes firmly to keep stomach contents in the stomach. Contents can reflux if the LES is too weak or relaxes when it should not.

Factors that can contribute to problems with the LES include:

  • Being overweight, obese or pregnant, which puts extra pressure on the LES

  • Having a hiatal hernia, asthma, or a connective tissue disorder such as scleroderma

  • Smoking

  • Taking certain medicines, such as antidepressants, aspirin, calcium channel blockers, pain medicines, and sedatives

How are you diagnosed with acid reflux?

Oftentimes, doctors diagnose GERD using symptoms and a physical exam. However, imaging exams can be helpful to confirm the diagnosis or check for GERD-related problems. These exams include:

  • Ambulatory acid (pH) test, which uses a small probe to monitor the amount of acid in the esophagus

  • Esophageal impedance or manometry, which measures how the esophagus functions

  • Upper endoscopy, which involves inserting a thin, flexible scope down the throat to view the esophagus and stomach

  • X-ray of the upper digestive tract, which uses a drinkable barium solution to coat the lining of the digestive tract. This is a barium swallow.

After diagnosis, the first step in treating GERD is often lifestyle changes and over-the-counter (OTC) medicines. Lifestyle changes include:

  • Avoiding or limiting alcohol, caffeine, and foods that trigger symptoms

  • Eating small meals and remaining upright for 2 to 3 hours afterwards

  • Losing weight if necessary and maintaining a healthy body weight

  • Stopping smoking

Another acid reflux remedy involves elevating the head of the bed 6 to 8 inches. Techniques include using blocks under the feet, a wedge between the mattress and box springs, or an adjustable bed. If symptoms continue despite these changes, prescription-strength medications may be necessary. In some cases, doctors recommend surgery to avoid complications from long-term medication use.

Additional acid reflux facts

Needing OTC heartburn medicines more than twice a week is a potential warning of GERD. Severe heartburn that doesn’t respond to OTC medicines is another sign that it’s time to see a doctor.

GERD awareness week is always the same week as Thanksgiving. It’s a time of year when many people overeat, overindulge, and suffer with acid reflux. Increasing awareness during this season may help more people identify a chronic problem and seek effective treatment. To learn more, visit the American College of Gastroenterology or the National Institute of Diabetes and Digestive and Kidney Diseases.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 May 11
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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