June 12, 2016

The Acid Myth

Acid does not cause acid reflux.

Stomach acid is supposed to be harsh. And it’s supposed to stay in your stomach….

Acid reflux is caused by the muscle between your esophagus and stomach, the lower esophageal sphincter (LES). Normally, the LES opens to allow food into the stomach and closes to prevent food and stomach acid from flowing back into the esophagus. Reflux happens when the LES doesn’t stay closed when it’s supposed to and lets stomach acid back up into your esophagus. This happens for a variety of reasons: muscle weakness, hernia, smoking, obesity, pregnancy, and certain foods, among others. Repeated and frequent reflux could be an indication of Gastroesophageal Reflux Disease or GERD.

So two things are a part of acid reflux: the dysfunctional LES and the acid in the stomach that is allowed to regurgitate into the esophagus because of the dysfunctional valve. Because the esophagus is not accustomed to acid, the result is a painful sensation known as heartburn.

The main therapy for acid reflux is to avoid common triggers. If avoiding common triggers is not enough medications such as H2 receptor antagonists or proton pump inhibitors may be the next treatment step.

It is important to note, however, that even though the medications help reduce the heartburn by reducing the amount of acid in the stomach, the dysfunctional LES still has the ability to reflux and reflux may be occurring unnoticed. The effect of this could be harmful. That harmful potential and some of the unknown effects of long term use of antiacid medications lead some people to consider procedures that may help to restore the LES function.