As we age, the muscle that separates the lower esophagus and the stomach — known as the sphincter — begins to relax, causing food and stomach acid to return to the esophagus. Over time, acid in the esophagus can cause problems. This condition is known as acid gastric reflux disease.

What are the symptoms?
Pain in the stomach is the most common symptom of gastric acid reflux disease and is referred to as “heart burn.” This pain is the result of acid stimulating nerves in the lower esophagus. It is important, of course, to make certain that the pain is not angina or heart pain. Cardiac pain often is the result of exercise or emotional upset; heart burn is most common after eating or when lying down, especially at night after a big meal. Less common symptoms of gastric acid reflux disease include: coughing, nausea, wheezing and regurgitated fluid. 

Why is this important?
Over time, acid that enters the esophagus can damage esophageal tissue. This first causes esophagitis, which is inflammation of the esophagus. Esophagitis can lead to two subsequent complications. The first complication is an ulcer, which forms from erosion of normal tissue by acid in the esophagus. Ulcers, in turn, can cause bleeding. Scars also can form, ultimately forming a stricture, which makes swallowing difficult.

Another major complication of chronic esophagitis is Barret’s esophagus, which causes tissue and cells in the esophagus to become pre-cancerous. Esophageal cancer is increasing in the United States and is prevalent in the Low Country. Therefore, it is important to prevent gastric reflux. 

What are the therapies?
If you suspect that you have gastric acid reflux disease, you should consult your doctor. Then, you and your doctor may decide to do any of the following:
• Take over-the-counter antacids to relieve symptoms by modifying acid. 
• Do not lie down after a big meal.
• Begin treatment with a “proton pump inhibitor” (PPI) prescription medicine, including Nexum. These medicines reduce the amount of acid formed in the stomach. They also help heal ulcers and reverse changes with esophagitis. 
• A gastroenterologist may perform an endoscopic procedure to visually inspect the esophagus or perhaps biopsy the esophagus. However, endoscopy typically is used when symptoms aren’t relieved with other interventions. Endoscopy can be performed easily in an office.
• Other techniques are available to monitor gastric acidity over a 24 hour period.  

Bottom Line
Healthy aging requires us to be alert for any problems. Gastric acid reflux disease is preventable and treatable, but your doctor must be made aware of the problem.

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