What Triggers Acid Reflux

As the Thanksgiving season approaches, our hearts and stomachs swell with anticipation. The thought of delicious feasts, time with loved ones, and cozy evenings by the fireplace fills us with warmth. However, for those who suffer from acid reflux, this otherwise joyous season can come with a side of discomfort and distress. It’s no coincidence that Thanksgiving Week coincides with GERD Awareness Week. This presents a perfect opportunity to delve into what triggers acid reflux and how to navigate the holidays without sacrificing the joy of the season.

Gastro-Esophageal Reflux Disease(GERD), is a common medical condition where stomach contents flows backward into the esophagus, the tube that connects the throat to the stomach.

This can cause various symptoms, including:

1. Heartburn: A burning sensation or discomfort in the chest, often behind the breastbone. Heartburn is one of the most common symptoms of acid reflux.
2. Regurgitation: The sensation of acid or food coming back up into the throat or mouth.
3. Belching: Frequent burping or excessive gas may occur.
4. Dysphagia: Difficulty swallowing or a feeling of food getting stuck in the throat.
5. Coughing and Sore Throat: Acid that reaches the throat can lead to a persistent cough, hoarseness, or a sore throat.
6. Laryngitis: Inflammation of the voice box (larynx) due to irritation from stomach acid.
7. Chest Pain: While acid reflux can cause chest discomfort like heart-related pain, it’s important to distinguish between the two as they require different treatments.
8. Asthma: Some individuals with GERD may experience worsening asthma symptoms or more frequent asthma attacks.
9. Chronic Bad Breath: Acid reflux can lead to bad breath (halitosis) due to stomach acid reaching the mouth.

It’s important to note that occasional acid reflux symptoms, such as heartburn after a large meal, are normal and can often be managed with lifestyle changes or over-the-counter antacids. However, chronic, or severe acid reflux, known as gastroesophageal reflux disease (GERD), may require medical intervention. If you experience frequent or persistent symptoms of acid reflux, it’s advisable to consult a healthcare provider for evaluation and appropriate treatment to prevent potential complications and improve your quality of life.

Understanding what triggers acid reflux is the first step in managing the condition. Various factors can contribute to the discomfort associated with acid reflux. Some of the common triggers include:

1. Lower Esophageal Sphincter (LES) Dysfunction:  The LES is a muscular ring located at the junction of the esophagus and the stomach.  It acts as a valve, opening to allow food and liquids into the stomach and closing to prevent stomach contents (including stomach acid) from flowing back into the esophagus. When the LES relaxes too frequently or doesn’t close properly, stomach acid can reflux into the esophagus, leading to symptoms of acid reflux.
2. Hiatal Hernia: A hiatal hernia occurs when a portion of the stomach pushes through the diaphragm into the chest cavity. This displacement of the stomach can weaken the LES’s ability to keep stomach contents in the stomach, making reflux more likely.
3. Dietary Factors: Certain foods and beverages can relax the LES or stimulate excess stomach acid production, contributing to acid reflux. Common dietary triggers include:
   • Fatty or fried foods
   • Spicy foods
   • Citrus fruits and juices
   • Tomatoes and tomato-based products
   • Chocolate
   • Caffeine
   • Alcohol
4. Obesity: Excess body weight, especially around the abdominal area, increases pressure on the stomach. This pressure can force stomach contents into the esophagus, leading to acid reflux.
5. Pregnancy: Hormonal changes during pregnancy can relax the LES, allowing acid to flow back into the esophagus. As the baby grows, the uterus can also exert pressure on the stomach, contributing to reflux symptoms.
6. Smoking: Smoking weakens the LES, making it easier for stomach acid to reflux into the esophagus. Smoking also reduces saliva production, which normally helps neutralize acid in the esophagus.
7. Certain Medications: Some medications can contribute to acid reflux by relaxing the LES or irritating the esophagus. Examples include calcium channel blockers, antihypertensive drugs, muscle relaxants, and asthma medications.
8. Lifestyle Factors: Eating large meals or lying down immediately after eating can increase the risk of acid reflux. Eating close to bedtime can also trigger symptoms as lying down allows gravity to work against the LES.
9. Medical Conditions: Conditions such as scleroderma, diabetes, and gastroparesis can affect the normal functioning of the LES and increase the likelihood of acid reflux.
10. Delayed Stomach Emptying (Gastroparesis): Gastroparesis is a condition where the stomach takes longer than usual to empty its contents into the small intestine. This delayed emptying can lead to an accumulation of stomach contents and increased pressure on the LES.
11. Stress: While stress itself may not directly cause acid reflux, it can worsen symptoms and lead to poor eating habits, which may trigger or exacerbate reflux.

Despite these triggers, you can still enjoy the holiday season without sacrificing your favorite dishes or festivities. Here are some tips to help you manage your acid reflux during Thanksgiving and the holidays:

1. Mindful Eating: Pay attention to portion sizes and avoid overindulging. Enjoy small servings of your favorite dishes and savor each bite.
2. Dietary Choices: Opt for low-acid and non-spicy options. Avoid greasy or fried foods and balance your plate with vegetables and lean proteins.
3. Stay Hydrated: Drink water to stay hydrated, especially if you are enjoying alcoholic or caffeinated beverages.
4. Elevate Your Head: If you plan to take a post-meal rest, use extra pillows to elevate your head and upper body.
5. Wear Comfortable Clothing: Choose loose-fitting attire to prevent abdominal pressure.
6. Manage Stress: Find ways to reduce stress, such as deep breathing, diaphragmatic breathing, meditation, or a leisurely walk in the fresh air.
7. Consult a Gastroenterologist: If you experience chronic acid reflux or suspect you have GERD, don’t hesitate to make an appointment with a gastroenterologist. They can provide you with expert guidance and tailor a treatment plan to suit your specific needs.

Thanksgiving Week, which includes GERD Awareness Week, serves as a reminder for us to take our digestive health seriously. If you are experiencing persistent symptoms of acid reflux, such as frequent heartburn, regurgitation, or difficulty swallowing, this is the ideal time to seek professional help. At Gastroenterology Associates, a team of experienced gastroenterologists, we can help you understand your condition and develop a personalized treatment plan.

Written by Dr. Madhusudan Sunkavalli, Gastroenterologist