CAUSE:

When you eat, food passes from the throat to the stomach through the esophagus. A ring of muscle fibers in the lower esophagus prevents swallowed food from moving back up. These muscle fibers are called the lower esophageal sphincter (LES).

 When this ring of muscle does not close all the way, stomach contents can leak back into the esophagus. This is called reflux or gastroesophageal reflux. Reflux may cause symptoms. Harsh stomach acids can also damage the lining of the esophagus

 THE RISK FACTORS INCLUDES:

•  use of alcohol (possibly)
• Hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities)
•  Obesity
•  Pregnancy
•  Scleroderma
•  Smoking
•  Reclining within 3 hours after eating

 Heartburn and gastroesophageal reflux can be brought on or made worse by pregnancy. Symptoms can also be caused by certain medicines, such as:

• Anticholinergics (for example, sea sickness medicine)
• Bronchodilators for asthma
•  Calcium channel blockers for high blood pressure 
•  Dopamine-active drugs for Parkinson disease
•  Progestin for abnormal menstrual bleeding or birth control
•  Sedatives for insomnia or anxiety
•  Tricyclic antidepressants

 Talk to your health care provider if you think one of your medicines may be causing heartburn. Never change or stop taking a medicine without first talking to your provider.

 Here are some key points about this disease. More detail and supporting information can be found in the main article.

•   This disease may result from a weak or damaged valve between the stomach and the esophagus.
•   Stomach acid that washes up into the esophagus can cause dangerous tissue damage.
•   Maintaining a moderate weight, quitting smoking, and reducing stress can help reduce the risk of this disease
•  Treating this disease may involve the use of proton pump inhibitors, antacids, and other medications, as well as lifestyle changes.

 TREATMENT:

  This is a chronic disease that requires long-term management. Doctors often treat this disease with medications and by suggesting lifestyle changes. If symptoms do not improve, doctors may suggest surgery.    

 Lifestyle changes:

 Lifestyle modifications are the cornerstone of this disease treatment because they can help improve symptoms. These modifications may include:

•  losing weight for people who are overweight or had a recent weight gain
•  sleeping in an inclined position
•  modifying diet and avoiding food triggers
•  avoiding eating meals at least 3 hours before going to bed

 Medications:

 Medications used to treat this disease suppress acid production. Of the available options, proton pump inhibitors are considered the most effective trusted Source in treating both types of this disease. They can help heal the lining of the esophagus.

 Other options include:

•  Blockers: These also reduce the amount of acid in the stomach and are not as good at healing the lining of the esophagus.
•  Antacids: These counteract the acid in the stomach because they are alkaline (bases). People can buy them over the counter to help relieve mild symptoms. Side effects can include diarrhea and constipation.
•   These help the stomach empty faster. Side effects include diarrhea, nausea, and anxiety. A 2021 study found that using this method with proton pump inhibitors is more effective than using proton pump inhibitor alone.
•  Erythromycin: This is a type of antibiotic that helps empty the stomach faster.

 Surgical options:

 If lifestyle changes and medications do not significantly improve the symptoms of this disease, a gastroenterologist may recommend surgery.

 Surgical treatments include:

•  The surgeon sews the top of the stomach around the esophagus. This adds pressure to the lower end of the esophagus and is generally successful at reducing acid reflux.
•  Endoscopic procedures: There are a range of endoscopic procedures available to treat this disease. These include endoscopic sewing, which uses stitches to tighten the sphincter muscle, and radiofrequency, which uses heat to produce small burns that help tighten the sphincter muscle.

  this disease can worsen and result in other conditions if left untreated. These may include:

•  Esophagitis: This is inflammation of the esophagus. It can also lead to gastrointestinal (GI) bleeding.
•  Esophageal stricture: Repeated irritation can cause scarring in the esophagus, making it narrow. This can cause difficulty swallowing.
•  Barrett’s esophagus: The cells lining the esophagus can change into cells similar to the lining of the intestine. This can develop into esophageal cancer.
•  Respiratory problems: It is possible to breathe stomach acid into the lungs, which can cause a range of problems, such as chest congestion, hoarseness, asthma, laryngitis, and pneumonia.

 Diagnosis:

 Anyone who experience frequent acid reflux symptoms should talk with their doctor, who may refer them to a specialist in gut medicine known as a gastroenterologist for further investigation.

 There are several possible tests to diagnose this disease, including:

•  Esophageal pH and impedance monitoring: This measures the amount of acid in the esophagus while the body is in different states, such as while eating or sleeping.
•  Upper GI endoscope: This is a tube with a camera attached that is used to inspect the esophagus. A small sample of tissue may also be taken at the same time for a biopsy.
•  Upper GI series: This is a type of X-ray that shows certain physical abnormalities that might cause this disease
•  Esophageal manometry: This measures muscle contractions in the esophagus during swallowing. It can measure the strength of the sphincter.
•  Bravo wireless esophageal pH monitoring: In this test, a small temporary capsule is attached to the esophagus. This measures the acidity continuously for approximately 48 hours.

 Prevention:

 Aside from the lifestyle changes mentioned above, adopting the following changes may help prevent the onset of this disease:

•  Eat small meals frequently.
•  Avoid eating very large meals.
•  Stay upright after eating.
•  Finish eating 2–3 hours before going to bed.
•  Quit or avoid smoking.
•  Avoid strenuous activities after eating.
•  Lose weight if overweight.
•  Minimize wearing tight clothing around the abdomen.
•  Sleep at a slight angle with the head slightly elevated.

 Diet:

 Certain foods may trigger this disease symptoms in some people. These include:

•  greasy foods
•  spicy foods
•  chocolate
•  peppermint
•  coffee
•  foods containing tomato products
•  alcoholic drinks