Grow Youthful: How to Slow Your Aging and Enjoy Extraordinary Health
Grow Youthful: How to Slow Your Aging and Enjoy Extraordinary Health

Acid reflux (heartburn, GERD, GORD)

What is acid reflux?

Symptoms of acid reflux

Causes of acid reflux

Remedies for acid reflux

References

What is acid reflux?

Heartburn (also known as acid reflux, gastric reflux, or gastro-oesophageal reflux disease (GERD or GORD) ) is a digestive disorder that occurs when the contents in your stomach burp and bubble up into the oesophagus. Heartburn occurs because the lower oesophageal sphincter (LES), a valve controlled by a ring of muscle between the oesophagus and stomach, does not close properly. The LES valve is pH sensitive, and needs to be kept acidic to keep it closed. (1, 2, 3, 4, 5, 6, 7, 8, 9)

Strong stomach acidity means good, powerful digestion. Young people have strong stomach acid, and digest their food quickly and effectively. In contrast, with weak stomach acid the food is likely to sit in the stomach for a long time, and tends to burp up into the oesophagus.

Symptoms of acid reflux

Causes of acid reflux

Remedies for acid reflux

References

1. When there is sufficient acid, the LES (lower oesophageal sphincter) opens easily with only 5 mm Hg of pressure from above (swallowing) yet 80 mm Hg pressure from below will not force it open. A burp or a lack of acid will cause it to open. It instantly closes again at the first sign of acid.
Dornhurst, A.C., Harrison, K., and Pierce, J.M. Observations on the normal oesophagus and cardia. Lancet 1: 695-98, 1954.

2. Lastaste and Conthier. Removal of the acid secreting portion of the stomach causes failure of sphincter inhibition and reflux. 1967

3. Cannon, Walter B. Acid closure of the cardia. Am. J. Physiol. 23: 105-14, 1908.

4. Collis, J. Liegh. The causes of the variable response to gastric reflux in hiatus hernia. Royal Col. of Surg. of Edinb. : 77-87, 1969.

5. Alwin, J.A. Thorax, 8:38, 1953. Cited by Collis op. Cit.

6. Dougherty, R.W., and Meredith, C.D., Cinefluorographic studies of the ruminant stomach and of eructation. Am. J. Vet. Res. 16:96-100, 1955.

7. Dougherty, R.W. and Habel, R.E. and Bond, H.E. Esophageal innervation and the eructation reflex in sheep. Am. J. Vet. Res. 19:115-28, 1958.

8. Dougherty, R.W. The physiology of eructation in ruminants. In Digestive physiology and nutrition in the ruminant, Ed. Lesi, D., Butterworth & Company, London, 1960. (Proceedings of the University of Nottingham seventh Easter school in agricultural science, 1960)

9. Dougherty, R.W. Bloat in ruminants, In: Forages, Eds. Hughes, H.D., Heath, M.W. and Metcalf, D.S., The Iowa State University Press, 2nd Edition, 1962.

10. Peter Bytzer et al, Copenhagen University and Koge University Hospital. Gastroenterology, July 2009.

11. Gastroenterology. Reimer C, et al. Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy. Gastroenterology 2009; 137: 80-87.

12. Gastroenterology. McColl KEL, Gillen D. Evidence that proton-pump inhibitor therapy induces the symptoms it is used to treat. Gastroenterology 2009; 137: 20-22.

13. Matthew A Jackson, Julia K Goodrich, Maria-Emanuela Maxan, Daniel E Freedberg, Julian A Abrams, Angela C Poole, Jessica L Sutter, Daphne Welter, Ruth E Ley, Jordana T Bell, Tim D Spector, Claire J Steves. Proton pump inhibitors alter the composition of the gut microbiota. Gut 2016;65:749-756 doi:10.1136/gutjnl-2015-310861.

14. Floris Imhann, Marc Jan Bonder, Arnau Vich Vila, Jingyuan Fu, Zlatan Mujagic, Lisa Vork, Ettje F Tigchelaar, Soesma A Jankipersadsing, Maria Carmen Cenit, Hermie J M Harmsen, Gerard Dijkstra, Lude Franke, Ramnik J Xavier, Daisy Jonkers, Cisca Wijmenga, Rinse K Weersma, Alexandra Zhernakova. Proton pump inhibitors affect the gut microbiome. Gut 2016;65:740-748 doi:10.1136/gutjnl-2015-310376.

15. Caoilfhionn O'Donoghue, Katie Solomon, Lynda Fenelon, Fidelma Fitzpatrick, Lorraine Kyne. Effect of proton pump inhibitors and antibiotics on the gut microbiome of hospitalised older persons. Journal of Infection, Volume 72, Issue 4, April 2016, Pages 498-500. doi:10.1016/j.jinf.2016.01.015.