Acid Reflux

– The information has been reviewed by Dr. Yang Pei Cheung, George

Epidemiology

Acid reflux is a common urban disease in Hong Kong. According to statistics released in 2012, about 12.2% of Hong Kong’s population (around 970,000 people) experience acid reflux symptoms at least once a month. Although the number of acid reflux patients increases with age, overall the disease trends towards younger ages.

What is Acid Reflux?

Acid reflux is a common name for gastroesophageal reflux disease, which refers to the rising of food and acid from the stomach to the esophagus. When the lower esophageal sphincter (LES) between the stomach and esophagus fails to function normally, stomach acid may flow into the esophagus. As the mucous membrane of the esophagus is fragile, it will be damaged by gastric acid which causes heartburn. If acid reflux is not properly treated, it may be further complicated by esophageal inflammation, bleeding, and precancerous lesions that increase the chance of esophageal cancer.

Symptoms

Chest pain (Heartburn)
Nausea
Loss of appetite
Easily full or upset stomach
Coughing
Laryngitis
Hoarse voice
Asthma
Teeth erosion

Causes + Risk Factors

Poor eating habits or obesity may cause the LES to relax and open at inappropriate times, allowing gastric acid to flow into the esophagus.

Risk Factors

Obesity
Bad eating habits
Stress
Medications that cause stomach irritation
Pregnancy
Hiatal hernia
Smoking
Alcohol

How is Acid Reflux diagnosed + Treatment

Gastroscopy: A traditional method for diagnosing acid reflux, the main purpose of a gastroscopy s to check whether the patients has esophagitis caused by acid reflux, excluding other digestive system diseases.
24 Hour pH Monitoring:Patients suffering from acid reflux will have an esophagus pH of less than 7. The more serious the condition, the lower the value. Based on the pH value obtained via instrument monitoring, it can be determined whether the patient has acid reflux with 80% accuracy. This is most suitable for patients who have been troubled by acid reflux for long periods of time who have made poor progress in treatment.
Proton Pump Inhibitor Test:Can inhibit the secretion of gastric acid. If chest pain is found to be reduced or eliminated after two to four weeks of medication, it can be determined that the patient is suffering from acid reflux with 80% accuracy. If chest pain persists, the pain may be due to other causes and further examination will be required. This detection method can create simultaneous therapeutic effects for the patient.

Treatment

If the patient’s inflammation is not too severe, we recommend that the patient take medication and make changes to their lifestyle to control and relieve the condition.

Medication	Asides from using proton pump inhibitors, doctors may also arrange for the patient to take drugs that neutralizes gastric acid and reduces it’s “aggressiveness”. There are also drugs that can add a protective layer to the esophagus, increasing it’s “defenses” to avoid further damage.
Surgery	If the esophagus is seriously damaged from acid reflux, or part of the stomach bulges through the diaphragm causing a hiatal hernia, the doctor may recommend the patient undergo minimally invasive fundoplication to increase pressure in the esophagus and reduce acid reflux.

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