What Are the Causes of Acid Reflux?

Acid reflux is a common condition that happens to everyone occasionally, usually after large meals. But for some people, it can become an unpleasant, ongoing concern that begins to impact their daily quality of life.

But what causes acid reflux? How do you find relief from acid reflux? This page is going to help you better understand the answers to these valuable questions, as well as help you learn to identify the signs of acid reflux.

Are you already experiencing the symptoms of acid reflux or Gastroesophageal Reflux Disease (GERD)? All you have to do is complete a short online assessment to get started with Felix and talk to a practitioner today.

What Is Acid Reflux ?

Whenever you eat food, it’s carried from your mouth to your stomach through your esophagus, which is a tube-like structure about 10 inches long and 1 inch wide (in adults).

At the end of the esophagus, there’s a circular ring of muscle called the Lower Esophageal Sphincter (LES), which relaxes when you swallow to allow food into the stomach, and then contracts shut again to prevent food or stomach acid from moving back up into the esophagus. This muscular action is supported by your diaphragm, which surrounds the LES.

When this process isn’t working properly, and either stomach acid or food are able to travel back up into the esophagus, this is called ‘acid reflux’.

Acid reflux (also called gastroesophageal reflux) is a very common condition that happens to everyone occasionally, where stomach contents back up into the esophagus or mouth. These episodes are especially common after large meals, and most of the time they’re short and don’t cause any symptoms.

However, for some people, acid reflux can become a painful, ongoing issue; even causing damage to the esophagus over time. This is more likely when this happens frequently, stomach acid is very acidic, or the esophagus can’t clear away acid/food particles quickly.

When this occurs, it may be diagnosed as Gastroesophageal Reflux Disease (GERD).

Common Causes of Acid Reflux Disease:

There are a number of different reasons that acid reflux can occur. However, certain things can increase the risks of acid reflux or GERD occurring, such as:

Hiatal/Hiatus Hernias

This is a condition in which the upper part of your stomach pushes through your diaphragm, which positions your LES inside your chest.

There’s an opening in your diaphragm for your esophagus to pass through, on its way to join your stomach. This is called the diaphragmatic hiatus.

When you get a hiatal hernia, the hiatus becomes dilated, and part of your stomach squeezes through this opening. This results in the diaphragm no longer being able to augment the function of the LES, and in turn, acid reflux becomes a more frequent occurrence.

Obesity

People that are overweight or experiencing obesity have an increased risk of GERD occurring, as well as an increased risk of experiencing a hiatal hernia.

The reasons for this aren’t fully understood yet, but some practitioners believe that it’s at least partially related to the increased abdominal pressure brought on by visceral fats.

Pregnancy

Many people experience acid reflux during pregnancy.

Thankfully, this usually resolves after delivery, with only rarely occurring complications.

Lifestyle Factors

Certain types of foods (i.e., fatty foods, chocolate, peppermint, etc.), as well as caffeine, alcohol, and smoking tobacco products can all worsen acid reflux and GERD symptoms.

Psychological Factors

People that are living with psychological distress often report an increase in their acid reflux symptoms when they’re experiencing periods of intense stress or sleep deprivation. Similarly, the severity of your symptoms can be impacted by psychosocial cormorbidities (i.e., anxiety, depression, etc.). 

Patients with hypervigilance (a heightened awareness and intensification of sensations), may begin to generate a conditioned fear response, which can lead to active avoidance of potential symptom triggers; despite the potential impacts on their health or quality of life.

Helicobacter Pylori

There is a complicated relationship between the helicobacter pylori bacteria and acid reflux/GERD symptoms.

Some people believe that H. Pylori bacteria may actually be protective against GERD symptoms, but studies are still being performed to understand its value and use as a treatment method.

Medications

Certain medications may also increase your risk of experiencing acid reflux or GERD. This is why you should talk to your practitioner if you begin to experience signs of acid reflux after beginning a new medication.

If you’d like to talk to a practitioner about acid reflux, and whether there are treatments that can provide you with acid reflux relief, get started with Felix today!

How Common Is Acid Reflux?

In a review of 15 epidemiological studies, GERD was found to be present in about 10-20% of the North American population, while less than 5% in Asia.

Another subsequent population-based survey done in the United States showed results that 22% of people had heartburn and/or regurgitation within the last month. 16% reported having just regurgitation.

From a clinical perspective, heartburn and regurgitation (the two most common symptoms of acid reflux and GERD), appear at least twice weekly at a rate of 6% for heartburn and 3% for regurgitation.

There are some limitations in these epidemiologic estimates about GERD’s prevalence, because they’re based on the assumption that heartburn and/or regurgitation are the only indicators of the disease.

However, people with objective evidence of GERD (i.e., esophagitis, Barrett’s Esophagus), don’t always experience heartburn, or their level of heartburn isn’t sufficiently severe to be an indicator of GERD’s presence.

Does Acid Reflux Ever Go Away?

For those wondering “What does acid reflux feel like?”, in many cases, acid reflux feelings (i.e., heartburn) can be intermittent. It may appear for a few days or weeks, and then go away again. There can be months or even years between flare-ups.

Most people only have heartburn during the 2-3 hour period of finishing a meal.

Because there are so many lifestyle elements that can impact acid reflux and GERD, many are able to manage their symptoms by making adjustments to things like their diet, reducing alcohol intake, and smoking cessation.

Are There Any Long Term Complications With Acid Reflux?

Yes, over time GERD may lead to complications; especially when it's left untreated. There are a number of problems related to esophageal damage and other issues that can occur, including:

Erosive Esophagitis

This condition occurs when your esophageal lining is damaged, due to the exposure to stomach acid. It can lead to erosions or ulcers, which can bleed.

Bleeding from these erosions or ulcers may not always be visible to you, but they can be identified using stool tests.

Esophageal Stricture

Esophageal stricture occurs when damage caused by acid reflux results in the esophagus scarring or narrowing. This causes a partial blockage (stricture), which can cause food or pills to get stuck in the esophagus.

The narrowing found in this condition is caused by scar tissue, which develops due to ulcers forming in the esophagus.

Barrett’s Esophagus

This condition occurs when the normal cells that line your lower esophagus (squamous cells), are replaced by a different type of cell, called intestinal cells.

In most cases, this process is caused by long-term GERD, alongside erosive esophagitis.

Because intestinal cells carry a small risk of transforming into cancer cells over time, if you have Barrett’s Esophagus, you should have periodic upper endoscopy testing done, in order to monitor the early warning signs of cancer.

Lung & Throat Problems

If stomach acid backs up into your throat, it can cause inflammation of your vocal cords, sore throats, as well as a hoarse voice.

Sometimes, the acid can be inhaled into the lungs, causing pneumonia or asthma symptoms. Over time, acid in your lungs can lead to permanent lung damage.

Dental Problems

Long-term, repeated episodes of acid reflux (where regurgitation is regularly occurring), can erode the enamel of your teeth.

IMPORTANT NOTE: Potentially serious complications may occur in people with severe GERD. However, many people with GERD won’t develop any serious complications; especially if they get treatment for their condition.

If you’d like to talk to a practitioner about your acid reflux symptoms today, just complete a short online assessment to get started.

Does Acid Reflux Get Worse With Age?

In all the studies that have been done on acid reflux and GERD thus far, age hasn’t been listed as a risk factor.

Therefore, we can assume that age doesn’t play a significant role in your risk of experiencing either acid reflux or GERD.

What Are the Treatments Available for Acid Reflux?

The type of GERD treatment recommended to you by your healthcare practitioner is customized to match the frequency and severity of your symptoms and/or complications.

One of the most commonly recommended GERD treatments for relief of acid reflux symptoms is to make lifestyle changes. For people that are just starting to experience mild symptoms of acid reflux, these approaches are a great place to start, before seeking medical attention.

If these don’t work on their own, making lifestyle changes first will help guide them on how to best approach additional treatments, if needed.

Lifestyle Changes

• Losing Weight (If You’re Overweight or Recently Gained Weight) - This may help reduce acid reflux symptoms. It also offers the benefit of decreasing your risk of type 2 diabetes and heart disease.
• Raise the Head of Your Bed 6-8 Inches - This is beneficial for people with nighttime heartburn. Elevating the head of the bed raises your head and shoulders above your stomach, allowing gravity to help reduce acid reflux symptoms. Just remember to actually elevate the head of the bed. Don’t just use pillows. That will only elevate your head and neck, which has a minimal impact on reflux symptoms.
• Sleep on Your Left Side - Sleeping on your left side positions your stomach fluid away from the upper right side of your stomach, where the esophagus connects. This makes it harder for reflux to occur.
• Eat Meals at Least 2-3 Hours Before Bed  - Laying down right after eating, or while you still have a full stomach can contribute to an increase in acid reflux symptoms.
• Avoid Tight Clothing - Clothing that squeezes your stomach area can reduce the ability of your stomach’s natural protections to prevent acid/food stuffs from traveling back up into your esophagus and causing reflux symptoms.
• Avoid Trigger Foods - There are certain foods (caffeine, chocolate, alcohol, peppermint, or fatty foods) that can cause the LES to relax, which can lead to acid reflux. If you notice that you experience worse symptoms after eating certain foods, it’s a good idea to try to limit or avoid these foods, when possible.
• Quitting Smoking - Saliva from your mouth helps to neutralize acid reflux, but smoking reduces the amount of saliva in your mouth and throat. Smoking also lowers the pressure in your LES and provokes coughing, which can cause frequent episodes of acid reflux in your esophagus. This is only one of a number of major benefits to quitting smoking, but in some cases, this can reduce or eliminate symptoms.

While there is limited evidence to support why they may be effective, avoiding late meals and wearing loose, comfortable clothing seem to help provide acid reflux relief for some people.

Laying down with a full stomach may increase the risks of acid reflux, so planning meals 2-3 hours before bed can help reduce symptoms; especially if you’re prone to nighttime reflux.

As for clothing, at a minimum, tight, uncomfortable clothing increases general discomfort, but it can also increase pressure on your abdomen. This may promote hiatus hernias or forcing stomach contents into your esophagus.

If lifestyle changes aren’t helping to reduce your signs of acid reflux, it may be time to talk to a practitioner. Complete an assessment when it’s convenient for you, and get started with Felix today.

Which Treatments Are Most Effective for Acid Reflux?

When lifestyle changes aren’t making enough of a difference, and you’re forced to seek medical assistance, your practitioner will want to evaluate the severity and frequency of your symptoms, before making a recommendation.

Medical Treatments for Mild Symptoms of Acid Reflux

For those with mild symptoms, Antacids (i.e., TUMS, Maalox, etc.), may be suggested to help neutralize stomach acid. These medications are frequently used for short-term relief of heartburn. They work quickly, but only last for 30-60 minutes after each dose.

Alternatively, Alginates (i.e., Gaviscon, etc.), which have more prolonged effects, are sometimes recommended. They float to the top of your gastric content, so that it can keep newly secreted stomach acid away from your esophageal inlet.

When these types of medications aren’t enough to reduce symptoms, your practitioner may suggest histamine receptor antagonists (i.e., cimetidine, famotidine, etc.), to reduce the production of acid in your stomach. They’re more effective at relieving heartburn than antacids, and they last longer.

However, histamine receptor antagonists aren’t usually enough to treat people with severe or frequently occurring symptoms.

Medical Treatments for Moderate-to-Severe Acid Reflux Symptoms

In the event that histamine receptor antagonists aren’t effective enough for the severity of your acid reflux symptoms, your practitioner may suggest Proton Pump Inhibitors (PPIs).

These medications include: esomeprazole and lansoprazole, which are available in both generic and brand name versions.

Your practitioner will help determine your optimal treatment, which may be done through taking types of PPI in at least 8-week cycles.

Should your symptoms return within three months of stopping your medication, or if you begin to experience severe esophageal inflammation, long-term treatment is usually recommended. Your practitioner may also suggest external care to help rule out other problems.

If symptoms return three or more months after you stop your medication, your practitioner may recommend another course of PPI treatment. The goal will be to take the lowest effective dose of medication, while preventing complications and controlling symptoms.

IMPORTANT NOTE: PPIs are generally safe to use, but they may be expensive to take; especially for long periods of time. The long-term risks of using PPIs may include an increased risk of certain types of stomach infection, or a reduced ability to absorb certain minerals and nutrients, but the risks are small.

Even with small risks, this emphasizes the need for you to take the lowest effective dosage, for the shortest possible period of time.

When Should I Talk to a Practitioner About Acid Reflux?

If you’re experiencing the symptoms of acid reflux or GERD, and making lifestyle changes hasn’t been enough to reduce the impact of your symptoms, it’s time to talk to a healthcare practitioner.

Complete a short online assessment to get started today, and one of our practitioners will help evaluate what type of treatment plan may work best for you, based on your health, medical history, and the severity/frequency of your symptoms.

With Felix in your corner you can take back control of your health and quality of life, so that you can get back to living life on your terms - the way it should be.