Gastroesophageal reflux – causes, symptoms and treatments

Gastroesophageal reflux disease (GERD) is one of the most frequently diagnosed gastrointestinal conditions. According to scientific studies, reflux symptoms such as heartburn and reflux of stomach contents into the esophagus affect up to 20–30% of the population in developed countries. Although it is often associated solely with a burning sensation in the esophagus, it is actually a complex problem that should not be ignored.

What is reflux?

Acid reflux is a condition in which acidic stomach contents flow back into the esophagus. This occurs when the lower esophageal sphincter (LES) doesn't function properly. Normally, it should close after each swallow. However, if it remains too loose, hydrochloric acid and digestive enzymes irritate the delicate lining of the esophagus.

Symptoms of reflux

The most characteristic symptoms are:

• heartburn, i.e. a burning sensation in the chest that worsens after meals,
• reflux of acidic contents into the throat,
• feeling of a sour or bitter taste in the mouth,
• epigastric pain, belching, nausea.

However, it is worth knowing that reflux can also cause unusual symptoms such as:

• chronic hoarseness,
• cough at night,
• erosions on tooth enamel (caused by contact with acid),
• feeling of a "lump in the throat".

Causes of reflux

Many factors influence the development of reflux:

• lifestyle: fatty and hard to digest diet, alcohol, coffee, chocolate and carbonated drinks, smoking, obesity and a sedentary lifestyle, taking certain medications (e.g. antidepressants, antispasmodics) may relax the esophageal sphincter,
• anatomical factors: hiatal hernia, weakened diaphragm muscles,
• physiological and hormonal factors: reflux occurs more often in pregnant women (the influence of progesterone and pressure from the uterus).

Why does reflux occur in newborns?

Reflux is very common in young children. It results, among other things, from the immaturity of the lower esophageal sphincter (LES). In newborns, the muscle separating the esophagus from the stomach is still underdeveloped and opens easily. As a result, stomach contents back up into the esophagus and mouth. Furthermore, a child spends most of their time lying on their back, and gravity doesn't help keep liquid food in the stomach. It's also worth noting that a child's small stomach has a very limited capacity, so it easily overflows and "regurgitates" excess food as regurgitation. Therefore, in young children and newborns, reflux is called physiological reflux, resulting from the developing digestive system.

Reflux and gastric hyperacidity

Gastric hyperacidity, or increased production of hydrochloric acid in the stomach, most often manifests as a burning sensation in the upper abdomen, stomach pain, belching, and nausea. It can result from factors such as diet, stress, certain medications, or Helicobacter pylori infection. Gastroesophageal reflux, on the other hand, is the backflow of stomach contents into the esophagus due to a malfunction of the lower esophageal sphincter. This acid does indeed contain hydrochloric acid, but the problem isn't the amount itself, but its presence in a place where it shouldn't be (in the esophagus). Reflux can occur with both hyperacidity and with normal, or even reduced, acid production—because the mechanism of acid reflux is key. In summary, hyperacidity is too much acid in the stomach, while reflux is acid and other food contents flowing back into the esophagus. Therefore, it's possible to have reflux without hyperacidity, and conversely, hyperacidity without reflux.

Reflux treatment

Pharmacological treatment most often involves the prescription of proton pump inhibitors, which reduce hydrochloric acid secretion. These only alleviate the symptoms, but do not address the underlying cause. Furthermore, additional side effects may occur, such as:

• nutritional deficiencies (reduced absorption of vitamin _B12 , magnesium, iron and calcium, possible weakening of bones causing osteoporosis and increased risk of fractures);
• infections (lower stomach acidity facilitates the multiplication of bacteria, which increases the risk of intestinal infections and pneumonia);
• changes in the intestinal microbiome (chronic acid reduction promotes dysbiosis, which may affect digestion and immunity).

A more effective treatment is a lifestyle change and following a few simple rules: eating smaller portions, avoiding meals before bedtime, sleeping with the upper body slightly elevated, and losing weight if overweight. Chamomile and licorice infusions will also provide natural relief, while pickled vegetables will help rebuild the gut microbiome. Probiotic therapy with Lactobacillus acidophilus Er-2 strain 317/402 Narine will also provide invaluable support. Narum Tab, in tablet form, was created to act in the stomach, regulating its pH, eliminating pathogenic microorganisms, and maintaining balance in this environment. Combined with Narum Forte and the multi-strain Narum Plus, it creates a comprehensive package that restores the balance of the digestive microbiome.

Complications of reflux – why should it not be ignored?

Acid reflux, although very bothersome, can be quickly alleviated today with symptomatic relief. However, it's important to remember that if left untreated, it can lead to serious complications such as chronic esophagitis, strictures and erosions, and even Barrett's esophagus, which increases the risk of esophageal cancer. Therefore, if reflux symptoms persist, it's important to identify and address the underlying cause.

Gastroesophageal reflux disease (GERD) is a condition that affects millions of people worldwide. Its symptoms not only reduce quality of life but can also lead to serious complications. The good news is that in many cases, lifestyle changes, diet, probiotic therapy, and conscious habits can significantly reduce symptoms.

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