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Stomach Acidity, Ulcers and Reflux Heartburn

The use of terms such as gastritis, peptic ulcers, acid reflux and gastroesophageal reflux disease (GERD) can sometimes be confusing for the average person. It often leads to a person wrongly attempting to self-medicate themselves with over-the-counter (OTC) products, sometimes without even the advice of a pharmacist. In order understand the differences and similarities between these conditions, it is important to first have a basic understanding of stomach anatomy and physiology.

The stomach is a hollow organ that connects with the esophagus (food pipe) at the top and small intestine towards its bottom end. It has specialized cells in its lining that secretes mucus, enzymes, hydrochloric acid and water. This creates the stomach juices, collectively referred to as the stomach acid, helps with the process of digestion. A mucus barrier protects the lining from the corrosive action of the gastric acid. Food that enters through the mouth passes down the esophagus, is churned in the stomach and partly digested by the acid and enzymes and then passed on to the small intestine for further digestion and nutrient absorption.

Gastritis and Stomach Ulcers

Gastritis is the medical term for inflammation of the stomach lining usually due to the action of the gastric acid. It is most commonly caused by the use of NSAIDs (non-steroidal anti-inflammatory drugs) and the bacteria H.pylori (Helicobacter pylori). Both these causative factors compromise the protective mucus barrier, irritate the stomach lining and may also increase the acidity of the stomach juices.

Over time this can erode the stomach lining and form open sores known as ulcers. The term peptic ulcer disease (PUD) refers to the formation of ulcers in the stomach and first part of the small intestine (duodenum). Ulcers in the stomach are known as gastric ulcers or stomach ulcers, while an ulcer in the duodenum is known as a duodenal ulcer. Peptic ulcers often arise as a complication of gastritis.

Acid Reflux and Gastroesophageal Reflux Disease (GERD)

Acid reflux and GERD are separate conditions from gastritis and peptic ulcers. However, it is often confused with each other and associated under the general term of stomach acidity. Reflux occurs when the gastric acid in the stomach flows backward into the esophagus. Usually the lower esophageal sphincter (LES) prevents this backflow but allows foods and drinks in the esophagus to flow into the stomach. Acid reflux arises when this sphincter’s function is compromised for some reason or the other.

Acute acid reflux is not uncommon and affects every person at some point or the other. It may be caused by overeating, alcohol, strenuous activity after eating and consuming very large meals. In these instances it is short-lived and does not recur unless the causative actions are repeated.  A more chronic form of this reflux is known as gastroesophageal reflux disease (GERD). While the same trigger factors that lead to acute acid reflux may exacerbate the condition, GERD is due to some other dysfunction of the LES that is more permanent in nature.

Both acute acid reflux and chronic GERD are commonly known as heartburn. This actually refers to to burning sensation felt in the chest when the stomach acid rises up into the esophagus. While the stomach, and to some extent the duodenum, are equipped to deal with the acid, the esophagus does not have the same protective mechanisms. The acid irritates the esophageal lining, leading to inflammation (esophagitis) and even open sores (esophageal ulcers).


Posted by in Digestive and Gut

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