What is acid reflux relief?

In medically oriented terms, antonyms of the word relief include pain, distress or damage. That links its meaning to both subjective and objective aspects. Subjective, denoting sensations experienced by the sufferer such as pain and objective, meaning physical findings detected by specialists which are either functional distress or organic damage. Actually relief is related to control measures and it quantitatively signifies removal of an unpleasant existence or reduction of its magnitude. The definition of relief, therefore encompasses alleviation of pain, relaxation of distress and healing of damage. Acid reflux on the other hand has two sides; the subjective side (symptoms) which reflects the symptom of heartburn and the objective side (signs) that reflects the functional and/or organic signs of esophageal changes. Acid reflux relief is therefore a broad term that covers all the measures used to control symptoms and signs of acid reflux disease. Normally, the lower esophageal sphincter remains closed except during swallowing. This prevents the passage of food and acid from the stomach into the esophagus. If the lower esophageal sphincter becomes weakened or relaxed, stomach acid may back up into the esophagus. Frequent acid reflux can irritate and inflame the lining of the esophagus, causing symptoms and signs of acid reflux. A better understanding of relief would thus entail knowledge of some aspects of normal structure and function, so that changes in the disease and its control could be easily considered. Actually acid reflux relief involves both preventive and curative measures, and in addition to treatment; orientation with the causes, symptoms and complications of acid reflux are essential for proper management. Acid reflux relief includes: dietary changes,lifestyle modifications, specific medications and surgical operations.Basic knowledge of the underlying causes and progression of acid reflux and answering frequently asked questions about its relief; add to the depth of understanding.

Monday, February 25, 2008

Acid Reflux Relief logoThe lower Esophageal Sphincter: LES

The LES provides a pressure barrier between the esophagus and stomach. Although an anatomically distinct LES has been difficult to identify, microdissection studies show that, in humans, the sphincterlike function is related to the architecture of the muscle fibers at the junction of the esophageal tube with the gastric pouch. The sphincter actively remains closed to prevent reflux of gastric contents into the esophagus and opens by a relaxation that coincides with a pharyngeal swallow . The LES pressure returns to its resting level after the peristaltic wave has passed through the esophagus. Consequently, reflux of gastric juice that may occur through the open valve during a swallow is cleared back into the stomach.
If the pharyngeal swallow does not initiate a peristaltic contraction, then the coincident relaxation of the LES is unguarded and reflux of gastric juice can occur. This may be an explanation for the observation of spontaneous LES relaxation, thought by some to be a causative factor in gastroesophageal reflux disease (GERD). The power of the esophageal body is insufficient to force open a valve that does not relax. The relaxation of the LES that occurs with pharyngeal swallowing or distention of the esophagus is mediated by parasympathetic activity. Consequently, vagal function appears to be important in coordinating the relaxation of the LES with esophageal contraction.
The LES has intrinsic myogenic tone, which is modulated by neural and hormonal mechanisms. Alpha-adrenergic neurotransmitters or beta-blockers stimulate the LES, and alpha blockers and beta stimulants decrease its pressure. It is not clear to what extent cholinergic nerve activity controls LES pressure. The vagus nerve carries both excitatory and inhibitory fibers to the esophagus and sphincter. The hormones gastrin and motilin have been shown to increase LES pressure; and cholecystokinin, estrogen, glucagon, progesterone, somatostatin, and secretin decrease LES pressure. The peptides bombesin, B-enkephalin, and substance P increase LES pressure; and calcitonin gene-related peptide, gastric inhibitory peptide, neuropeptide Y, and vasoactive intestinal polypeptide decrease LES pressure. Some pharmacologic agents such as antacids, cholinergics, domperidone, metoclopramide, and prostaglandin F2 are known to increase LES pressure; and anticholinergics, barbiturates, calcium channel blockers, caffeine, diazepam, dopamine, meperidine, prostaglandin E1 and E2, and theophylline decrease LES pressure. Peppermint, chocolate, coffee, ethanol, and fat are all associated with decreased LES pressure and may be responsible for esophageal symptoms after a sumptuous meal.
During 24-hour esophageal pH monitoring, healthy individuals have occasional episodes of GE reflux. This physiologic reflux is more common when a person is awake and in the upright position than during sleep in the supine position. When reflux of gastric juice occurs, normal subjects rapidly clear the acid gastric juice from the esophagus regardless of their position.