REFLUX DISEASE

WHAT IS REFLUX DISEASE?

The stomach makes acid and by design is capable of withstanding this acid environment. The esophagus (swallowing tube) on the other hand, has no such capacity. As such, if acid were to enter the esophagus, it would irritate the esophagus. With persistence of this irritation, inflammation and ulcers can result. Reflux disease is caused by recurrent irritation of the esophagus by the acid entering the esophagus from the stomach.

 

WHY DOES REFLUX HAPPEN?

A number of factors protect the esophagus from acid injury. Chief among these factors is a sphincter (a napkin ring like structure) that helps prevent the movement of the acid from the stomach into the esophagus. For many medical reasons (one of which is the presence of a hiatal hernia) this sphincter can relax, remain open and, as such, will lose its ability to overcome the reflux movement of acid.

 

WHAT CAN I DO ABOUT IT?

In very simple terms, help the sphincter overcome acid reflux:

 

1) DO NOT EAT OR DRINK FOR 4 HOURS BEFORE GOING TO BED: Acid production by the stomach is high following a meal and remains so for at least 3 hours. When standing up straight, gravity is helping confine the acid to the stomach. When we lie down however, we cancel the effect of gravity. Therefore, it is very important not to lie down for 4 hours after meals. Before going to bed at night do not eat or drink (not even water) for 4 hours.

 

2) IF YOU SMOKE, STOP. IF YOU DON'T SMOKE, DON'T START: Smoking has been shown to relax the sphincter, thus worsening the problem.

 

3) RAISE THE HEAD OF THE BED BY 6-8 INCHES: This will help keep acid in the stomach when lying down. If you have a water bed, sleep on a wedge-shaped pillow that is 10 inches high and 30 inches long.

 

4) PROPER POSTURE DURING DAYTIME WILL ALSO HELP: Avoid bending over from the waist, use your knees instead. When sitting down, sit upright and don't try lifting heavy objects.

 

5) IF YOU ARE OVERWEIGHT, LOSING THE EXCESS WEIGHT WILL HELP: When you lie down, the weight of the wall of your abdomen will be transmitted to your stomach into the esophagus. The larger that weight is, the more reflux.

 

6) AVOID WEARING TIGHT FITTING GARMENTS OR BELTS: For the same reason as above, the pressure from the tight garments will be transmitted to your stomach thus helping push acid into the esophagus.

 

7) AVOID ALCOHOL, FATTY MEALS, COFFEE AND TEA: Alcohol will irritate your esophagus, increase acid formation by the stomach, and worsen the problem. Coffee and tea (even decaffeinated) increase acid production and relax the sphincter further. Citrus and tomato juices can be irritating and, as such, best avoided.

 

HOW RIGID SHOULD I BE IN FOLLOWING THESE INSTRUCTIONS AND FOR HOW LONG?

If you follow these instructions for at least 6 weeks, there is a very good chance that your discomfort will go away. After that, if you are feeling better, we can advise you about which of the measures you can eliminate.

 

Revised 9/08


 


 

 

ŠTed A. Tobey, M.D., Inc. ~ All Rights Reserved