When Should You See a Gastroenterologist for Acid Reflux?
An unhealthy diet and lifestyle can occasionally cause acid reflux, but most cases can be treated with over-the-counter medication. Usually, the acid reflux begins to stabilize a few minutes after the intake of medicine. In certain cases, however, intake of medicine and lifestyle and diet change will not be able to stop acid reflux.
It is best to see a gastroenterologist when medication and lifestyle and diet changes do not alleviate acid reflux. Acid reflux that occurs more than once a week with no response to medication is usually a sign of a developing gastrointestinal (GI) disorder.
This article will explain the various symptoms of gastrointestinal diseases related to acid reflux and the factors and causes that lead to acid reflux. It will also explain various medications that doctors prescribe to treat acid reflux. Lastly, it will detail the reasons to visit a gastroenterologist for an in-depth examination of the GI tract.
Acid Reflux, GERD, and Esophageal Cancer
Some of the most common gastrointestinal disease symptoms include abdominal pains, bloating, belching, lethargy, loose bowel movement, and loss of weight and appetite. Heartburn or acid reflux and acid indigestion is also common but can be negligible if it occurs only once a week.
Serious cases of the gastrointestinal tract are often related to heartburn. Heartburn occurs because of a weak lower esophageal sphincter that opens and closes when food or water is on its way into the stomach. The weak sphincter allows the acid from the stomach to reflux into the esophagus, causing a burning sensation on the chest around the heart area.
Heartburn usually occurs after eating, especially when lying down. This can happen occasionally and should not be a cause for worry. However, frequent occurrence of heartburn can not only be a sign of a gastrointestinal tract disease but can also cause other complications.
Acid reflux can cause gastroesophageal reflux disease or GERD. This disease occurs when the esophageal lining becomes irritated or inflamed due to frequent acid reflux. If untreated, the esophageal lining can alter composition and change color and structure, resembling the inner walls of the intestine. This state is called Barrett’s Esophagus.
Barrett’s Esophagus is an adaptation mechanism to prevent further irritation but is also a pre-cancerous stage. Without proper treatment, this condition can develop into esophageal cancer.
Today, around 20% of the Americans experience chronic acid reflux and may have GERD but remain undiagnosed. Frequent signs of GERD include discomfort when eating and difficulty in swallowing. Coughing, hoarseness, sore throat, and stomach regurgitation are also some symptoms that may require GERD diagnosis.
Habits, diet, and lifestyle are some of the frequent causes of GERD as it affects the amount of acid that refluxes from the stomach. Frequent smoking and alcohol consumption can worsen and make acid reflux more frequent. Excess weight and eating citrus and spicy foods can also increase the incidence of acid reflux.
Symptoms of gastrointestinal problems are fairly common, which can make it difficult to self-assess if a visit to a doctor is necessary. Certain symptoms can be alleviated through medication, but other symptoms are signs of a serious GI tract disease.
Dr. Nanda, a Brisbane-based Gastroenterologist details that a visit to a gastroenterologist is necessary when medication and lifestyle changes do not lead to a decline in the occurrence of symptoms and do not improve the overall condition of the GI tract. This also applies to the worsening of the condition of the GI tract and increasing frequency and intensity of the symptoms despite medication and lifestyle changes.
Interference with daily plans and activities such as discomfort when swallowing food and frequent acid reflux when going to bed may also require a visit to the gastroenterologist. Delaying the visit to the doctor can lead to weight loss due to loss of appetite.
Complications related to acid reflux are ulcers and stricture or narrowing of the esophagus. These complications can cause dysphagia or difficulty in swallowing and can intensify when undiagnosed for an extended period. It can also result in food sticking in parts of the esophagus and causing path blockage and irritation.
Hoarseness when speaking and audible wheezing when breathing are also signs of damage in the esophagus, which can potentially become Barrett’s Esophagus and esophageal cancer. Coupled with other symptoms of serious GI tract disease, an appointment with a Gastroenterologist for an upper endoscopy can reveal the physical condition of the esophageal lining.
For serious problems of the stomach and the intestines, some of the serious symptoms that may require a visit to a gastroenterologist are severe abdominal pains, rectal bleeding, frequent constipation or diarrhea, and frequent stomach cramps, These symptoms are often signs of serious GI tract diseases including inflammatory bowel diseases, irritable bowel syndrome, Celiac disease, and Crohn’s Disease.
For acid reflux, heartburn, and hyperacidity, antacids are the most common prescription medication.
Antacids prevent acid build-up the stomach through the infusion of magnesium and aluminum salt which triggers diarrhea and constipation, respectively. The combination of the two ingredients promotes movement in the stomach to release the build-up of digestive juices while preventing acid reflux.
Other prescription medications include foaming agents and prokinetics. Foaming agents create a foam within the stomach to counteract acid build-up and prevent reflux. Prokinetics, on the other hand, fortifies the lower esophageal sphincter and promotes movement in the stomach to allow it to facilitate the movement of acid in the stomach and prevent acid reflux.
Stronger medication like histamine H2-receptor antagonists or H2 blockers and proton pump inhibitors (PPI) can treat acid reflux better than antacids and can also promote recovery from GERD. H2 blockers reduce the acid production in the body, particularly in the stomach lining, and are more effective than antacids. It can also be used to treat GI conditions related to stomach acid overproduction like gastric ulcer.
PPI also reduces acid production in the body and can help reduce the incidence of acid reflux better than H2 blockers and antacids. They are more effective but take longer to take effect than antacids and H2 blockers but will provide longer-lasting relief.
Both PPI and H2 blockers are effective medicines to counter acid reflux, but they are typically recommended to treat occasional cases of acid reflux and must therefore not be taken regularly due to the risk of long-term side effects. These side effects can include renal failure, dementia, heart attack, risk of bone fracture, and vitamin deficiency.
Usually, gastroenterologists recommend slightly invasive procedures to check the condition of the GI tract such as endoscopy if PPIs and H2 blockers fail to alleviate the symptoms of the GI disorder.
When to See a Gastroenterologist?
Usually, acid reflux can be treated with diet and lifestyle changes and medication. Avoiding alcohol consumption and smoking, eating smaller portions per meal, and losing weight often helps in preventing acid reflux. Also, intake of antacids, PPIs, and H2 blockers often cure acid reflux and other acid-related GI tract disorder symptoms without them recurring for months.
However, if acid reflux persists despite dietary and lifestyle changes and medication, a gastroenterologist can help narrow down the cause of the recurring acid reflux. It is best to seek help from a gastroenterologist when acid reflux becomes frequent and disruptive of daily activities.
Heartburn that occurs once a week is considered normal and can be treated with medicine. However, heartburn that occurs more than once a week and repeatedly occurs within six months is a sign of a serious gastrointestinal disorder.
A gastroenterologist can perform diagnostic examinations such as barium swallow radiograph to see an X-ray of the GI tract. For more in-depth examination, the gastroenterologist can perform an upper endoscopy to check the surface of the GI tract or ambulatory pH monitoring to check the amount of acid that refluxes from the stomach.
Furthermore, difficulty in breathing, occurrence after meals, during exercise, and at specific periods of the day are usually signs of a developing esophageal disorder. This can occur due to peptic stricture and requires examination by a gastroenterologist.
People aged 50 and above should also regularly visit a gastroenterologist for check-ups since they are more prone to colon cancer. Early cancer screening can check for developing polyps or ulcer which can be easily treated. Blood in stool is a sufficient reason to go to a gastroenterologist for a check-up because this can be a sign of gastrointestinal bleeding.
Acid reflux is a common occurrence and is often attributed to lifestyle and diet. It is usually considered a mild discomfort that can be treated with over-the-counter medication.
However, acid reflux can be a symptom of a serious gastrointestinal disease if it does not go away upon intake of medication and altering lifestyle and diet. Consulting a gastroenterologist can reveal the cause of acid reflux and can potentially prevent complications that can develop into a more serious GI tract disease.