Acid reflux is a common condition that affects an estimated 60 million Americans at least once a month, according to the American College of Gastroenterology. Of those, 15 million experience acid reflux as often as once daily.
Also known as heartburn, due to the burning sensation it causes in the lower chest area, acid reflux occurs when acidic stomach contents or bile go back up into the esophagus. If this occurs persistently, more than twice a week, or if the condition becomes gradually worse, it is known as chronic acid reflux or GERD (gastroesophageal reflux disease).
Symptoms of Chronic Acid Reflux and Achalasia
The most common symptom of acid reflux is heartburn, whether due to a single episode of overeating, eating irritating foods, or persistent GERD. The uncomfortable burning sensation felt behind the breastbone area tends to get worse when lying down or bending over, and it can last for several hours or worsen after eating food.
The pain of heartburn can also extend up towards the neck and throat, and stomach fluid can reach the back of the throat, producing a sour or bitter taste and potentially a sore throat over time.
Because acid reflux is more common while lying down, stomach acid can back up into your throat, causing you to experience a coughing or choking sensation. This can lead to longer-term throat problems, such as inflammation of the vocal cords, a sore throat, or a hoarse voice, as well as lung problems, such as pneumonia, asthma symptoms, or permanent lung damage if the acid is inhaled into the lungs.
Other symptoms can include:
- Difficulty or pain when swallowing
- Chest or upper abdominal pain’
- Dry, persistent cough
- Dental erosion
- Bad breath
The causes of chronic acid reflux are varied, but many have to do with one’s lifestyle, specifically, obesity, smoking, low levels of physical exercise, and certain medications, including drugs for asthma, antihistamines, painkillers, sedatives, and antidepressants.
Certain foods and dietary habits are also tied to acid reflux, including caffeine, alcohol, a high salt intake, a diet low in fiber, eating large meals, lying down within several hours of eating, and consuming chocolate, carbonated drinks, and acidic juices.
Luckily, many of these factors are controllable, and addressing them can be as effective as medications.
The Four Stages of GERD
Chronic acid reflux can progress through four stages, a function of the frequency, volume, and during of the reflux.
Stage 1 (Mild)
Characterized by minor damage to the esophagus and occasional heartburn, which is easily suppressed with over-the-counter medications.
Stage 2 (Moderate)
Symptoms are of higher intensity and/or frequency but can be managed long-term with prescription-strength acid-suppressive medications.
Stage 3 (Severe)
Characterized by severe symptoms, including frequent regurgitation, and can lead to one or more complications, including esophagitis, scar damage, and even increased risk of cancer.
Stage 4 (Pre-cancerous or reflex-induced esophageal cancer)
Typically the result of many years of severe reflux. Stage 4 involves the development of a pre-cancerous condition, Barrett’s esophagus, or a more severe condition known as dysplasia, both of which raise the risk of reflux-induced esophageal cancer. Typical symptoms of GERD are often accompanied by burning in the throat, a chronic cough, or hoarseness, as well as a narrowing of the esophagus, which can lead to the sensation that food is sticking in the esophagus.
Chronic Acid Reflux vs. Achalasia
Achalasia is a rare condition of the esophagus, in which the nerve cells degenerate for reasons that are unknown. This can lead to difficulty swallowing, as well as other symptoms that are similar to chronic acid reflux, such as heartburn, regurgitation of swallowed food or liquids, or chest pain. As a result, it is common for achalasia to be misdiagnosed and treated as acid reflux, which can lead to prolonged discomfort and even long-term, irreversible damage.
When to See a Doctor
As with many conditions affecting your digestive tract, including your esophagus, early diagnosis and treatment is key to preventing long-term, and potentially irreversible, damage and suffering. If you are experiencing any symptoms related to persistent acid reflux or achalasia, Digestive Health Centers can help. Please schedule an appointment today to meet with a physician to get more information and discuss your options.