Acid Reflux in Pregnancy

Acid Reflux in Pregnancy.

By: Dr Phil Hariram

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.

Article Source: http://www.ApprovedArticles.com

Dr. Phil Hariram is a retired General Practitioner who has spent 27 years treating acid reflux. www.acidrefluxguru.com

Acid Reflux Syndrome

What Is Acid Reflux Syndrome ?

Acid reflux is an irritating and at times hurting disease that crops up when acid and other materials in the tummy back up or reflux into your esophagus. The esophagus is the muscular tube that connects between your throat and your stomach.

When acid reflux occur, the refluxed materials from the stomach may stay in the lower part of the esophagus. This can give the sufferer a feeling of heartburn and nausea. Eventually, this will result in injury to the esophagus.

Sometimes, the refluxed materials will flow back all the way into the mouth. This will give the sufferer a burning feeling in the throat. At times, it is even possible to discover tiny, undigested fragments of food in the mouth.

What Causes Acid Reflux?

The most common cause of acid reflux is a malfunctioning lower esophageal sphincter. The esophageal sphincter is a muscular ring at the bottom of the esophagus that prevents stomach contents from backing up into the throat and mouth. When food is swallowed, the sphincter contracts muscularly to drive the food into the stomach. If that sphincter is not working right, the acids from the stomach can come back into the esophagus causing painful heartburn, burning in the throat, and an acidic taste in the mouth.

Common Treatment For Acid Reflux?

Doctors typically propose lifestyle changes as the initial treatment. These alterations might consist of eating less for each meal, getting rid of extra weight, refraining from alcohol and cigarettes, keeping your body upright for a couple of hours after meals, and sleeping with your head elevated.

Additionally, there are over-the-counter medications that you can purchase to relief the symptoms. These medications include Pepcid and Zantac. They are called Histamine Receptor Antagonists. They work by reducing the quantity of acid in the stomach. Other medicines such as Mylanta and Tagamet, work by neutralizing the acid in the stomach.

If over-the-counter medications do not work, doctors may prescribe proton pump inhibitors such as Nexium and Prevacid. These medicines put a stop to the discharge of acid into the stomach and intestines.

If you are suffering from acid reflux, consult your doctor to find out which treatment alternatives are most excellent for you.

Home remedies

It is Easy to Treat Acidity with

Home Remedies for Acidity

The stomach generally secrets acid, which is an essential substance in digestive process. This acid will help in breaking down the food during the digestion and when there is excess production of the acid in the stomach, it turns in the condition called as acidity or APD - acid peptic disorder. Generally, there are some protective mechanisms naturally present in the body, in the stomach and the proximal intestines. Nevertheless, between the protective mechanism and the level of acid secreting gets disturbed and the balance is altered, the entire situation is then known as acidity.

Acidity is caused due to many reasons such as diet, organ deformity, weakness of the valve between the stomach and esophagus, heavy and spicy meals etc. Here are some of the useful home remedies for the treatment of acidity -

• If you are not diabetic, acidity is quite easy to treat. You can have a small piece of jaggery after the meals and whenever you feel an attack, you can have the plain water with sugar.

• One can take a cup of water and boil it. After that, add one teaspoon of Aniseed and then leave it for the whole night. In the next morning, filter the water and then add one teaspoon of honey to it. Have it three times a day and you can treat acidity in a very effective manner.

• You can also have a cardamom and a clove and powder it. Take it as a mouth freshener after each meal. This will not only take care of your acidity, but it will be also helpful to cure your bad breath.

• Take about one and a half liter of water and add one teaspoon Caraway seeds to it. Boil the solution and simmer it for 15 minutes. Have it while it is lukewarm at least twice or thrice a day for minimum one week. This is very good remedy for treating acidity.

• Many experts suggest that almonds are really good for treating the acidity problem. For this, one can eat them or can paste and then simply lick it.

• One of the best home remedy for curing acidity is sucking one piece of clove after the meals. This will not only give instantaneous relief from acidity but will also help in reducing the onslaught of the disease arising out of acidity. Cloves also have direct effect on the digestive process. They help in building appetite, removing phlegm and increasing the white blood cell count in the body to fight against various infections.

• As a part of home remedy for acidity, you can squeeze the juice of whole orange and mix it with roasted cumin seeds. To enhance the formula, add pinch of rock salt. Have it as once and it will give good relief from the acidity.

• One of the proven and old home remedy for treating acidity is drinking coconut milk. Have it about 200 ml and then drink plain water.

Gastroesophageal Reflux Disease Diet

Purpose
The esophagus is the tube that carries food from the throat to the stomach. However, it is not just a simple tube. The lower esophagus has a specialized muscle around it that usually stays tightly closed, opening only to allow food and liquid into the stomach. It acts to prevent the reflux of stomach acid into the esophagus.

Symptoms occur when this specialized muscle weakens and allows stomach acid to splash up into the esophagus. These symptoms include heartburn, chest discomfort, and bitter fluid flowing up into the mouth. Chest discomfort can occur. If the stomach juice trickles into the breathing tubes, hoarseness, cough, and even shortness of breath can occur. This entire problem is called GERD (Gastroesophageal Reflux Disease). A number of factors, including certain foods, may cause the lower esophageal muscle to relax, causing GERD.

Nutrition Facts
A diet designed to prevent or reduce acid reflux is usually easy to follow. The basic food groups of cereals, vegetables, fruits, dairy products, and meats can be eaten with only a few limitations. So, this diet generally meets the Recommended Dietary Allowances (RDA) of the National Research Council. A vitamin C supplement may be needed if an individual does not tolerate citrus foods such as orange, tomato, etc.

What is Acid Reflux

Acid Reflux

What is Acid Reflux?
Acid reflux is a condition where gastric juices containing acid travel back from the stomach into the esophagus (gullet or swallowing tube).

Symptoms of acid reflux include:

• • Heartburn (a burning feeling rising from the stomach or lower chest up towards the neck).
• • Regurgitation (bringing food back up into the mouth).
• • Chest pain.
• • Difficulty in swallowing (dysphagia).
• • Hoarseness, dental erosion and asthma (because acidic juices can make their way into the throat, mouth and air passages of the lungs).

How do you get Acid Reflux?

Some people experience this problem regularly and have a condition called gastroesophageal reflux disease or GERD.

• • The food in the stomach is partially digested by stomach acid and enzymes, which are special chemicals that help to break down food so the body can use it.
• • Normally, the partially digested acidic content in the stomach is delivered by the stomach muscle into the small intestine (bowel) for further digestion.
• • In patients with acid reflux, stomach acid content travels backwards into the esophagus, causing inflammation and damage.
• • Factors contributing to acid reflux include fatty foods, cigarettes, chocolate, caffeine, alcohol, obesity, pregnancy and delayed stomach emptying.
• • Obesity and pregnancy increase pressures within the abdomen (body trunk), pushing the stomach contents back into the esophagus.
• Some patients have stomachs that empty their contents into the intestines very slowly.
• • A stomach full of food and acid is more prone to reflux, especially when the patient lies down (supine)..