During digestion, food is broken down into small particles and mixed with saliva in the mouth before proceeding to the esophagus (food pipe). This process of chewing lubricates the food before it is further mixed with various enzymes and hydrochloric acid within the stomach. From here it proceeds to the small intestines.
However, when the ring of muscle between the food pipe and the stomach becomes weak or relaxes inappropriately, food and acidic stomach juices flow back into the food pipe, a disorder known as gastroesophageal reflux disease (GERD) or acid reflux. The condition is characterised by heartburn, a sour acid taste in the mouth and damage to the mucosal lining.
In severe cases, a lot of pain is generated when swallowing due to an inflamed esophagus.
There is also a strong sensation of heartburn during this period, says Joseph Uwiragiye, a nutritionist from University Teaching Hospital in Kigali (CHUK).
“The feeling usually results from eating heavy meals or seeking bed rest immediately after eating,” he explains.
Factors such as obesity or overweight predispose individuals to acid reflux although foods that are rich in acids aggravate the problem.
Uwiragiye, for instance, points out that citrus fruits such as oranges, lemons, and tomatoes, among others, may not be the best for individuals with the condition.
“Alcoholic drinks and coffee are not recommended for people with the condition and could result into regurgitation,” explains Uwiragiye.
Acid reflux occurs in both infants and adults. In infants, it is as a result of unconditioned movements after consuming meals, while in adults it is mostly associated with eating certain types of foods.
Protais Munyarugamba, a general practitioner at Harmony Clinic in Kigali, explains that excessive intake of alcoholic drinks and caffeine are major contributors to acid reflux, but spicy foods trigger regurgitation.
“Too much coffee and alcohol destabilise the stomach environment while hot and spicy foods could provide appropriate conditions to force a reflux of stomach juices,” says Munyarugamba.
He adds that individuals with the problem need to ensure that food is taken at the right time and bed rest sought appropriately.
“Late night dinner is not the best, especially in individuals with hiatus hernia. During sleep, a high pillow cushion could help reduce the chances of the acid reflux,” he adds.
Dealing with the symptoms
The strong hydrochloric acid present in the stomach facilitates efficient digestion of food and also denatures pathogens that could be ingested along during meals.
Much as this acid is produced from its lining that is resistant to corrosion, the esophagus is not protected, a sensation that yields heartburns.
When heart burns occur, most people believe that taking certain foods such as milk or ginger could relieve the symptoms.
“Usually I use about half-a-litre of warm water mixed with ginger to soothe the feeling,” says Georgette Uhirwa, a resident of Remera.
However, according to Kibagabaga Hospital nutritionist Isaac Bikorimana, such measures do not offer a long-term solution since acid reflux results from a combination of physiological and dietary factors.
“Rushing to clear heart burns may not help enough unless dietary adjustments are made. These should be combined with regular exercise. Smaller quantities are necessary which requires planning for good balanced diet,” explains Bikorimana.
Fortunately, in infants, the condition is rarely serious and becomes less common as a baby gets older. It’s unusual for infant reflux to continue after the age of 18 months, according to Mayo Clinic.
A cancer scare
Although acid reflux is rarely taken as a serious condition, most studies found that it was a serious predisposing factor to throat and vocal cord cancer among nondrinkers and nonsmokers and the illness is less sensitive to medical prescriptions, according to a study published in Cancer Epidemiology, Biomarkers & Prevention.
Of the 631, 468 participants with throat and 163 vocal cord cancers, and 1,234 control subjects who had no previous history of cancer, results showed that the history of frequent heartburn was associated with a 78 per cent higher risk for cancers of the throat and vocal cord among volunteers who were neither heavy smokers nor drinkers.
Among the subjects with frequent heartburn, the experts discovered that taking antacids had a protective effect of 41 per cent lower likelihood of getting cancers of the throat and vocal cord.
However, recent research published a month ago showed that the acid reflux may not be the direct cause of damage to the esophagus. The research carried out at the UT Southwestern Medical Center and Dallas VA in US found that damage in patients with acid reflux diseases occurs through an inflammatory response prompted by secretion of certain proteins called cytokines.
Much as acid reflux is a common problem the emergency of new findings such as its correlation with throat cancers is a serious warning sign. Medical experts therefore suggest that before reaching out for symptomatic relief, individuals who experience frequent heart burns among other signs should seek professional consultation.
HOW TO AVOID ACID REFLUX
* Relax and eat your food slowly.
Instead of eating a lot at one sitting, which can make acid-reflux symptoms worse, eat only until you’re comfortably full (versus overly stuffed). Be sure to sit down and take your time during a meal; strive to truly taste and enjoy each mouthful. One tried-and-true trick to eating more slowly is to put down your fork on the table between every few bites
* Quit smoking.
Need another reason to give up cigarettes? Smoking increases your risk for GERD! Smoking slows digestion and increases stomach acid, while it also limits salvia production — your body’s natural defense against stomach acid! Besides harming your esophagus, cigarette smoke also damages the digestive system and weakens your stomach’s LES muscle, which directly causes acid reflux.
* Chew cinnamon gum after meals.
Chewing gum stimulates saliva production, which helps to neutralize stomach acid. Gum chewing also encourages frequent swallowing, which clears irritating acid from the esophagus more quickly. Just make sure to choose non-mint flavors, since peppermint and spearmint can relax the LES and exacerbate symptoms. Pick up cinnamon or fruit flavors instead.
* Wear loose fitting clothing.
Avoid anything tight around your middle, which can put pressure on your stomach and worsen the discomfort and pain of GERD. Until your symptoms are under control, think stretchy and comfortable
* Don’t lie down after eating.
If you’re prone to acid reflux, it’s important that you don’t lie flat for a minimum of two hours after you’ve eaten a meal or snack. In fact, stand up and walk around to help encourage the gastric juices to flow in the right direction. For the same reason, while sleeping, keep your upper body elevated by placing a few books or a foam wedge underneath the mattress or propping up the legs at the head of the bed with blocks or books.
* Watch out for potential trigger foods.
When it comes to your diet, eating smaller meals is by far the most important step you can take to prevent reflux, more so than changing the foods you eat. That said, there are specific foods that can aggravate symptoms in certain individuals. The most common culprits are fried or fatty foods, alcohol, caffeinated beverages like coffee and tea, chocolate, mints and mint-flavored items, citrus juices and fruits, tomatoes and tomato sauce, spicy foods, onions, garlic, and carbonated beverages. Everyone has different triggers, though, so if you find that these foods don’t cause you any discomfort, you can continue to enjoy them.
* Cut the fat.
Lay off the chicken wings, fried foods, deep-dish pizza, and marbled steak. High-fat meals like these relax the LES and delay stomach emptying, making it more likely that you’ll experience reflux. Instead, make lean proteins (like skinless poultry, seafood, beans, and lean cuts of red meat) and fiber-rich produce and whole grains your diet staples.
* Incorporate moderate exercise.
The key word here is moderate. Vigorous exercises like running can agitate your digestive tract and provoke reflux, but incorporating moderate, low-impact exercises such as walking is actually beneficial (and it keeps you upright, allowing gravity to aid digestion).
* Limit beverages during meals.
If you suffer from GERD, limit your fluid intake with meals. Liquids add to the volume of food in your stomach and increases stomach distension. A full belly puts more pressure on the lower esophageal sphincter (LES), the muscle that normally prevents food from moving back up into your esophagus, and thus adds to your risk of reflux. To minimize stomach volume, take small sips of water while you eat, and try to drink mostly between rather than during meals.
EXPERTS SHARE THEIR VIEWS
Charles Sindabimenya, a urologist
People with gastric problems should always consult dieticians before deciding on what to eat since most of them tend to have problems with acid reflux because of what they consume. Foods that cause heartburns should be avoided.
Claudine Uwajeneza, a medical student
In cases of continuous bloating, one should keep away from consuming too much cabbage, salt-rich products as well as fatty foods. Small meals before retiring to bed are better. Using a pillow while sleeping is also helpful.
Francis Kazungu, a general practitioner
Eating slowly and taking small quantities of food are some of the measures to prevent acid reflux. If the condition persists, medication could bring relief. Smoking should be avoided at any cost. Above all, eating healthy and exercising is vital in keeping acid reflux at bay.
Sonia Sebuseruka, an ophthalmologist
A continuous heart burn should be of concern, it can result into inflammation, thus further complication. However, sometimes chewing gum may be of help as it aids in the stimulation of saliva production which allows one to swallow the acid that tends to remain in the esophagus.
Bosco Hangenimana, a nurse
People with acid reflux diseases should avoid taking hot and spicy foods as well as heavy meals, especially at night. Too much alcohol is not good and seeking medication will help a lot.
Compiled by Lydia Atieno