Report on Treatment of Acid Reflux/Stomach Acid for Practitioners

Gastric esophageal reflux disease or acid reflux is one of the most common issues and conditions that the majority of people experience today. In the chest, there is a burning sensation which characterises this condition and most practitioners refer it to as heartburn.

When a person eats something, it passes to the stomach from the throat. Esophagus is connecting stomach and throat, so food passes from it. It has some muscle fibre which are shaped like a ring for preventing food form moving backward to esophagus from the stomach. Lower esophageal sphincter is made by these muscle fibres.

In general, if LES does not close well, it allows hydrochloric acid, liquid, and good to enter esophagus. In fact, the inner esophageal tissue is not capable of handling the strong acidity which serves to inflame the region and this is what causes heartburn sensation. If esophageal tissue is damaged chronically, it can result in serious conditions such as esophageal cancer (Herbella & Patti, 2010).

Risk Factors for Acid Reflux of Treatment of Acid Reflux/Stomach Acid for Practitioners

Some of the most common risk factors for acid reflux include almost anything which obstructs the stomach region or esophagus such as scleroderma, pregnancy, and even hiatal hernia. Other proven factors involve alcohol consumption, smoking, and obesity. As a practitioner, it is important for you to know that these factors are critical to consider because they result in acid reflux as a side-effect.

It is quite a popular belief that acid reflux is because of hydrochloric acid’s excessive amount in the stomach. However, it has been revealed by science that it is not the case. Acid reflux is caused when the stomach secrets little hydrochloric acid.

Necessity of Stomach Acid of Treatment of Acid Reflux/Stomach Acid for Practitioners

Acid is secreted by the stomach during digestion for lowering its pH and make it reach the range of 1.5-2.5. In the meal, more protein results in a greater for this acid. Actually, people with non-obstructive acid reflux are usually not able to lower their pH.

Another important thing to know that is LES is recognised to be quite a sensitive valve and it initiates closure when the value of pH drops below the point of 3.0. And when there is not enough acid in the stomach, this valve remains open and acid can get into esophagus. In result, it can damage the tissue extensively. In addition, when diaphragm is herniated through sphincter, it is generally referred to as hernia and can lead to acid reflux (Chey, et al., 2009).

Hiatal Hernia of Treatment of Acid Reflux/Stomach Acid for Practitioners

Although hiatal hernia sounds like quite a damaging and painful condition because stomach pushes into the chest through a tear in the diaphragm, most people are unable to feel any symptoms. Frequently, it is observed when a person undergoes abdominal x-rays or chest x-ray. The identification can be made in CT scans and upper GI series as well. Furthermore, it can be identified when gastrointestinal endoscopy of duodenum, stomach, and esophagus is performed.

As a practitioner, for initial symptoms, you can just instruct the patient to place a hand under the left chest bone and feel whether there is a little bulge or not. It can immediately determine if the patient has a hiatal hernia or not.

Using Antacids for Acid Reflux of Treatment of Acid Reflux/Stomach Acid for Practitioners

As a practitioner, you might consider using antacids for relieving and treating acid reflux. There are a number of antacids which serve to provide quick relief. However, it is important to keep it in mind that antacids alone are not capable of healing an inflamed esophagus. Moreover, some antacids have side effects as well such as kidney problems or diarrhoea.

Antacids serve to reduce acidity but they make the problem worse by decreasing acidic levels a lot. In fact, this limits the body from digesting the food effectively. On pancreas’s enzymatic system, it causes further stress. It causes stress on other digestive organs as well. Antacids, several medications, and processed foods deplete critical trace minerals and B-vitamins which are essential in creating a necessary stomach acid supply.

Acid Reflux and H Pylori of Treatment of Acid Reflux/Stomach Acid for Practitioners

In general, H Pylori is quite a sophisticated microorganism with exceptional adaptive benefits which give it the capability of surviving the harsh and academic environment of stomach. Urease is an enzyme which is produced by it. This enzyme is responsible for breaking down the urea present in stomach along with ammonia and carbon dioxide. Additionally, it causes halitosis and belching for the person. It also neutralises the acidic effects of HCL acid.

The digestive process is disrupted by H Pylori. Therefore, inflammation can be caused by it throughout the gastrointestinal permeability and the gut. Constipation, irritable bowel symptoms, and iron-deficient anaemia can be caused by a leaky gut. There is also an increased risk of auto-immunity, osteoporosis, thyroid problems, and anaemia if the gut lining is damaged (Richter, 2007).

Good Digestion of Treatment of Acid Reflux/Stomach Acid for Practitioners

HCL or hydrochloric acid is quite important for the development of an acidic environment in the stomach for ionising minerals and digesting protein. In addition to it, this also aids in stimulating bile releases from the gallbladder for metabolising fat effectively in the small intestine. Usually, when the body is not able to secrete sufficient HCL, we generally have poor food digestion and protein, and might even develop deficiencies of important nutrients.

It would not be wrong to say that low stomach acid is quite a common issue, especially among seniors, or those who have already suffered various infections, or have been on medications and antibiotics such as non-steroidal anti-inflammatories. The stage for damage is set by low acids of the stomach to the digestive tract's delicate lining. It even adversely influences the development of the leaky gut syndrome.

Healthy Stomach Acid of Treatment of Acid Reflux/Stomach Acid for Practitioners

As a practitioner, it is important for you to know that when patients have low acid, they are not capable of effectively breaking the proteins in the stomach down. It enables the entry of large proteins into small intensive. Consequently, major stress is created by it on the pancreas for producing sufficient enzymes for metabolising proteins.

Ultimately, this serves to wear out all pancreatic enzyme stores, which creates irritation and stress throughout the gut. In addition, it also leads to inefficient utilisation and absorption of important amino acids which serve to make up large protein molecules.

Incomplete digestion and large proteins serve to initiate auto-immune activity in different body regions and also causes the leaky gut syndrome. In fact, when protein digestion is not effective, it leads to the overgrowth of small intestinal bacterial. It also fuels other parasites and Candida. An acidic blood stream is created by it and minerals are depleted by it throughout the body. In general, the depletion of minerals leads to the inability of forming stomach acid. This only fuels the never-ending cycle (Herbella, et al., 2007).

Baking Soda Test of Treatment of Acid Reflux/Stomach Acid for Practitioners

As a practitioner, if there is a patient who wants to perform a test at home. You should tell your patient about the baking soda test. This is quite a unique test and it mainly revolves around drinking baking soda and developing a chemical reaction in your stomach between hydrochloric acid and baking soda. Normally, this results in the production of carbon dioxide and the person burps due to it. The ingestion of baking soda has actually been a remedy for centuries for upset stomachs.

However, there are some issues with this test. It is important to note that there are various variables which need to be controlled. Minimising all variables can be quite difficult and you can just recommend the patient to perform the test consecutively 3 times in the mornings for finding an average. If you recommend this, you will be guiding the patient to look for consistency instead of a one-time test. You should recommend that for increasing the accuracy of the test, it is important to perform the test as soon as the person wakes up. S

Theoretically, if a patient's stomach has sufficient stomach acid, he will belch within three minutes. Repeated and early belching might be because of excessive stomach acid while belching after three minutes determines quite a low level of acid.

Anti-Inflammatory Lifestyle of Treatment of Acid Reflux/Stomach Acid for Practitioners

As a practitioner, it is important for you to know both the natural and medical treatments for acid reflux. In this way, you can both treat and guide your patients. In this section, I will guide you about anti-inflammatory lifestyle while later on, I will tell you about the medications which treat acid reflux.

Generally, an anti-inflammatory lifestyle seems to include a diet which is rich in clean protein sources, healthy fat, and phytonutrient dense vegetables. Healthy sources of fat include purified fish oil supplements of omega-3, olive oil, avocados, and coconut products.

Meanwhile, healthy protein includes eggs, free range poultry, grass-fed red meat, and wild-caught fish. Moreover, anti-inflammatory herbs like garlic, oregano, ginger, cinnamon, and turmeric are quite powerful. Cereal grasses, sea algae, sea vegetables, and non-processed pink salts should be utilised on a regular basis for providing sufficient critical trace minerals.

Fermented Tonics of Treatment of Acid Reflux/Stomach Acid for Practitioners

It is quite important for people to avoid the consumption of large meals. Normally, food should be consumed at least two hours before a person goes to bed. After all, it allows gravity to push food through the digestive system. Probiotics and digestive enzymes are more than just a little important in improving the digestive process.

Actually, raw apple cider vinegar has sufficient acetic acid, good bacteria, and digestive enzymes. Two tablespoons of this vinegar in water can be quite helpful in improving the levels of stomach acid if a patient takes it before a rich protein meal. Additionally, it is also helpful and beneficial to utilise apple cider vinegar for marinating meat.

Following are the ten steps that you can recommend to your patients for beating acid reflux without medication:

Sticking to an anti-inflammatory plan: In general, most people feel a decrease in acid reflux symptoms when they do not consume the most commonly available inflammatory foods from their daily diet. Usually, this would involve the elimination of refined vegetable oils, corn, peanuts, soy, pasteurised dairy, and gluten. Instead of it, you can just guide patients to consume a diet which does not have any carbohydrates and it is rich in healthy fats.

Don’t eat late: You can recommend a patient to not eat late in night. In fact, you should tell the patient to have the last meal at least two to three hours before going to bed.

Eating only one solid food meal on a daily basis: Another important recommendation that you can make is to have one to two tablespoons of ACV in only 4oz of water. The patient should have this water only ten minutes before having a large meal.

Using digestive enzymes: For digesting the food in an effective manner, a digestive supplement can also be taken. A digestive supplement can serve to decrease stress on the whole digestive system.

Consuming fermented foods: You can recommend your patients to consume fermented foods on a daily basis. Having only a few tablespoons of fermented grass-fed dairy, coconut milk yogurt, pickles, sauerkraut, and kimchee is suffice. Actually, the unique enzymes and probiotics within these specific foods help in improving your micro-biome and improve the production of HCL.

Consuming fermented tonics and drinks: These involve coconut wafer kefir and apple cider vinegar. You can guide the patient to have 2-4oz on a daily basis before meals or a single meal to improve your digestion and enhance the production of HCL.

Using ginger and lemon: You should guide the patient to make green drinks with a whole lime or lemon, or even ginger. Both of them have the necessary nutrients for enhancing the production of HCL.

Decreasing stress on the whole digestive system: As a practitioner, you should guide patients to not eat solid foods when they are experiencing stress. Generally, stress serves to decrease the secretion of enzyme production and digestive juices. Patients should consume liquid and raw foods in only small quantities when they are under stress. They should have large meals with healthy vegetables, good fats, and profits when they are more relaxed.

Using an HCL supplement: In general, improving the production of stomach acid is quite an important factor in improving the health of a person. Nutrient absorption is supported by hydrochloric acid and it helps in maintaining a healthy pH level which supports and promotes healthy gastric ecology (Festi, et al., 2009).

Diagnosis of Treatment of Acid Reflux/Stomach Acid for Practitioners

As a practitioner, if you want to diagnose acid reflux, you can identify it on the basis of symptoms and signs, and physical examination. For confirming the diagnosis of acid reflux, following can be utilised:

Under Endoscopy: It is a technique in which you insert a flexible and thin tube which is equipped with a camera and light down the patient's throat for examining the inside of the stomach and esophagus. When the reflux is present, these results can be normal but this technique can identify a number of complications including esophagus inflammation. It can also be utilised for collecting a tissue as a sample to be tested and experimented for different complications like Barrett’s esophagus.

Esophageal Manometry: In general, this test evaluates and identifies rhythmic muscle contractions in the stomach, specifically esophagus when a person swallows. The force and coordination of muscles are also measured by esophageal Manometry.

Ambulatory Acid Probe Test: In this technique, a monitor is placed in the patient’s esophagus for identifying for how long and when acid regurgitates. A small computer is connected to the monitor, worn around the waist. The monitor might be a flexible and thin tube which is threaded through the patient’s nose. Alternatively, there is also a clip which is placed in the patient’s esophagus during the process of endoscopy and it is passed down to stool after 2 days.

X-ray: Another method of identifying GERD is to take x-rays. They are generally taken after a patient drinks a chalky liquid which fills and coats his digestive tract internal lining. You will be allowed to see the silhouette of patient’s upper intestine, stomach, and esophagus. You can also ask the patient to swallow a pill of barium which can help in diagnosing the narrowing of esophagus which interferes with swallowing.

If a person does not experience any improvements with lifestyle changes, you can then use medications and even surgery in the worst cases.

Medications of Treatment of Acid Reflux/Stomach Acid for Practitioners

Antacids: As a practitioner, you might already be aware of antacids. They are capable of providing immediate and instant relief to patients. There are a number of antacids such as Tums, Rolaids, and Mylanta which are often prescribed for relieving GERD. However, as I have said before, antacids alone are not enough to heal and cure an inflamed esophagus which is damaged by higher levels of stomach acid. It is, however, important to note that if some antacids are overused, they can cause side effects like kidney problems and even diarrhoea.

Medications for reducing the production of acid: There are a number of medications which serve to reduce the production of acid in the stomach and they are referred to as H-2 receptor blockers. They include ranitidine, Axid AR, Pepcid AC, and Tagamet HB. In comparison with antacids, H-2 receptor blockers are quite slow. However, they offer longer relief and they might decrease the production of acid from stomach for up to half a day. As a practitioner, it is up to you to determine how much dosage and strength of this medicine is required by a patient.

Medications for healing the esophagus and blocking acid production: In general, these medications are referred to as proton pump inhibitors. Compared to H-2 receptor blockers, they are stronger and they give time to the damaged esophageal tissue to recover and heal. These proton pump inhibitors involve omeprazole and lansoprazole.

Prescription Medications of Treatment of Acid Reflux/Stomach Acid for Practitioners

There are a number of prescription strength treatments and they include:

Medication for strengthening the lower sphincter: GERD might be eased by baclofen by reducing the frequency of lower esophageal sphincter’s relaxations. Some side-effect might involve nausea and fatigue.

H-2 receptor blockers: In general, they involve prescription-strength ranitidine, nizatidine, and famotidine. Actually, these medications are well-tolerated. However, long-term usage might be related to a slight increase in the risk of deficiency of vitamin B-12.

Proton pump inhibitors: Normally, these include Dexilant, Aciphex, Protonix, Prilosec, Prevacid, and Nexium. Even though they are well-tolerated, these medications might because the cause of deficiency of vitamin B-12, nausea, headache, and diarrhoea.

Surgery of Treatment of Acid Reflux/Stomach Acid for Practitioners

As a practitioner, in worst-case scenarios, you should have knowledge of surgeries for treating GERD. After all, acid reflux can be controlled and managed with medication. However, if medications are not proving to help the patient, you might use:

LINX Device: In generally, in this technique, a ring of small magnetic beads is tightly wrapped around esophagus and stomach’s junction. Actually, the magnetic attraction between these beads is so power that the junction remains closed to the acid. However, it is weak enough to allow necessary food to pass through. With a minimal invasive surgery, it is possible to implant the LINX device.

Fundoplication: The top of patient’s stomach is wrapped around the lower sphincter for tightening the muscle and preventing the reflux from happening. Usually, Fundoplication is performed with only a minimal invasive procedure. In addition to it, the wrapping of the stomach’s top part can be either complete or partial.

Overall, this is almost everything that you need to know about GERD and its treatment, as a practitioner. I told you that gastric esophageal reflux disease or acid reflux is one of the most common issues and conditions that the majority of people experience today. In the chest, there is a burning sensation which characterises this condition and most practitioners refer it to as heartburn. Then, I told you about the risk factors and how you can treat or help the patient. Honestly, I would recommend that you guide the patient about a healthy lifestyle. It does not mean that you should not prescribe medicine in worse cases. Other than just prescribing medicine, you should tell patients about the causes of acid reflux. You should also guide them about how they can change their diet to live healthy and prevent GERD from occurring (Patrick, 2011).

References of Treatment of Acid Reflux/Stomach Acid for Practitioners

Chey, W. D. et al., 2009. Treatment patterns and symptom control in patients with GERD: US community-based survey. Current medical research and opinion, 25(8), pp. 1869-1878.

Festi, D. et al., 2009. Body weight, lifestyle, dietary habits and gastroesophageal reflux disease. World journal of gastroenterology: WJG, 15(14).

Herbella, F. A. & Patti, M. G., 2010. Gastroesophageal reflux disease: From pathophysiology to treatment. World journal of gastroenterology: WJG, 16(30).

Herbella, F. A. et al., 2007. Gastroesophageal reflux disease and obesity. Pathophysiology and implications for treatment. Journal of Gastrointestinal Surgery, 11(3), pp. 286-290.

Patrick, L., 2011. Gastroesophageal reflux disease (GERD): a review of conventional and alternative treatments. Alternative Medicine Review, 16(2).

Richter, J. E., 2007. Richter, Joel E. "The many manifestations of gastroesophageal reflux disease: presentation, evaluation, and treatment. Gastroenterology Clinics of North America, 36(3), pp. 577-599.