Acid reflux is a common condition in the West and there is a suggestion that it is increasing. Obesity is increasing in the West and since obesity can cause or worsen acid reflux, the increase in acid reflux is likely to be related to a combination of our diet, lifestyle and obesity. There is, however, a group that develops acid reflux as a part of life's natural process. Pregnant women develop GERD symptoms as a result of pregnancy.
It is estimated that as much as 80% of pregnant women have GERD symptoms and the symptoms vary from mild to very severe. It is rarely serious in this group and, of course, it is limited to the length of the pregnancy.
Nausea and vomiting is common in the first trimester and is mainly due to the rising level of the female hormone, estrogen and progesterone circulating in the blood stream. Acid reflux symptoms are more common in the third trimester.
In the third trimester, the uterus is large and has pushed up into the upper abdomen distorting the configuration of the organs in the abdomen. The stomach is pushed up against the diaphragm. This can affect the competence of the Lower Esophageal Sphincter (LES) and cause acid reflux. It can also force part of the stomach up through the diaphragmatic hiatus. This is a hiatus hernia. A hiatus hernia can result in acid reflux.
In addition weight gain during pregnancy (especially in the apple shape) will settle around the waist. This weight will press on the abdomen and increase the intra-abdominal pressure. This pressure on the LES may force food up into the esophagus.
During pregnancy estrogen and progesterone levels need to be high to maintain the pregnancy. These two female hormones are produced by the ovaries until the placenta takes over. These hormones relax smooth muscles of the uterus and are necessary to allow the uterus to stretch to accommodate the developing pregnancy.
Unfortunately this muscle relaxation is not confined to the uterus. The muscles of the GI tract are affected. In the large bowel reduced strength of peristaltic contraction leads to slow transit time and likely constipation. In the esophagus it reduces the tone of the LES allowing reflux and slows down peristalsis along the esophagus. The food swallowed is cleared slower and the LES is lax. A double whammy.
Patients who have had GERD symptoms before falling pregnant tend to have severe GERD in pregnancy. Sometimes in pregnancy GERD can be so severe that hospitalisation is necessary. Also vomiting can be so severe that weight loss follows. In pregnancy regular weight gain is expected. Weight loss suggests a referral to a gastro-enterologist especially if the weight is below the pre-pregnancy benchmark.
Severe GERD can lead to mal-nutrition. This can be harmful to the mother and may put the foetus at risk at a time of vital development and growth.
Ginger is a good safe treatment of GERD in pregnancy and you only need a small amount. It can stimulate saliva production. Saliva is a natural antacid. Ginger helps relieve nausea and vomiting and it is a carminative (relieve gas). Lifestyle change is important. If still smoking and drinking alcohol, then it is time to stop. Elevating the head of the bed is beneficial and lying on the left side is best because in this position the stomach is lower than the esophagus.
Avoid or reduce your intake of fats, coffee, tea, chocolate, certain citrus fruits, certain spices, tomatoes and garlic. When exercising, avoid bouncing up and down and exercises that involve bending forwards. Stick to exercises that keep you upright. Stretching exercises and power or brisk walking are unlikely to aggravate GERD symptoms.
Antacids are safe in pregnancy because they do not cross the placenta into the baby's circulation. However, antacids containing sodium (sodium bicarbonate) can cause fluid retention. Aluminium containing antacids can make constipation of pregnancy worse. Magnesium can slow down labour. These drugs are in Category A. The categories were laid down by the FDA in 1979 and are related to safety profile and potential harm to the foetus. Category A is safe in pregnancy.
The H2-receptor antagonists and proton pump inhibitors are in Category B except omeprazole which is in Category C. These drugs cross the placenta but trials results are not adequate to consider them safe during pregnancy. So far no trial has shown any harm to the foetus.
You are in an important meeting and are just about to close the biggest deal of your career. You should be somewhere up on cloud nine, but you only just manage to present a happy smiling face to your colleagues. It's not that you're not over the moon, and wouldn't like to celebrate with the rest of them, but you've got that burning feeling again that tells you that you shouldn't have had that burrito for lunch. You are suffering from heartburn. Or so you think. In actuality you could be suffering from Acid Reflux Syndrome.
It's not as bad as it sounds, or even looks like in print for that matter, but it is bad enough to keep you from enjoying your life. So, what exactly is acid reflux syndrome? Well, I can tell you what it's not. It's not indigestion, and it's not heartburn, the two main things that acid reflux syndrome get confused with everyday.
Since the simplest answer is always the best, most people will say they've got indigestion. Others will stick to, "it's simple heartburn, that's all I've got" as if their life depended upon it. But very few people realize that what they have might not be either of these two cases, but something else that closely mirrors them, like acid reflux syndrome.
Generally speaking, the guidelines for prevention are the same for all three disorders, as are the simpler treatment methods. Even the initial symptoms are the same, but with a few minor differences that can narrow down the field of diagnosis.
Some of the most common symptoms for acid reflux syndrome include, but are not limited to, intense heartburn, stomach problems, a consistent cough, a roughened voice, a sour or bitter taste in your mouth, and also a problem swallowing.
And that's just a few of the symptoms that sufferers will experience. As you can see however, heartburn is also a symptom, and not necessarily the cause of this syndrome.
If you think you might have acid reflux syndrome, you will need to consult your physician as soon as possible. If left untreated for any length of time, there is good chance that you will suffer from it for the rest of your life.
To give you a slight idea of what exactly this syndrome entails, it occurs when the liquids in your stomach (acids, foods etc.) come back up the esophageal pipe, in a reflux action. This damages the lining of the esophagus, and causes the burning sensation that you feel. That's why it needs to be treated promptly. Any delay on your part could result in the esophagus being damaged badly, thereby impairing it for your lifetime.
If you think you have acid reflux syndrome, then seek medical attention as soon as possible. Remember to never put off till tomorrow what you can do today. In this case it could prove to have serious and long term effects on your health.
Both Dr Phil Hariram & Bob Bastian are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
Dr Phil Hariram has sinced written about articles on various topics from . Dr. Phil Hariram is a retired General Practitioner who has spent 27 years treating acid reflux.