Acid reflux is the result of the acidic contents of the stomach traveling up into the esophagus, where they cause damage to the esophageal lining. In some cases, progressive damage of the esophagus can make swallowing difficult or painful, which is also known as dysphagia. This can eventually make eating difficult and frequently requires treatment.
Acid Reflux Pathophysiology
Acid reflux is the result of impairment of the action of the lower esophageal sphincter, the Cleveland Clinic notes. Normally the contents of the stomach are kept from traveling up into the esophagus by a muscle called the lower esophageal sphincter. This muscle can spasm, allowing acid from the stomach to travel into the esophagus. Sometimes this muscle can be deformed, causing frequent acid reflux.
Triggers
A number of substances can trigger acid reflux, according to Medline Plus, a publication of the National Institutes of Health. Peppermint, chocolate and acidic substances can cause acid reflux. Alcohol, tobacco and caffeine are also substances that can cause the lower esophageal sphincter to spasm. Large meals with high fat contents can also trigger acid reflux. Patients may also experience acid reflux if they recline soon after eating.
Strictures and Dysphagia
One complication of chronic acid reflux is the development of esophageal strictures, the Mayo Clinic notes. When acid burns the esophagus multiple times, it can cause scar tissue to develop in the esophagus. The accumulation of scar tissue will eventually cause the formation of esophageal strictures, which can cause the esophagus to become narrow. Esophageal strictures make swallowing difficult and painful.
Diagnosis
Esophageal strictures can be identified using a barium swallow exam, according to the Mayo Clinic. With this type of test, the patient is given a liquid solution of barium to drink, which will coat the lining of the esophagus. The barium can then be seen on an X-ray, allowing physicians to visualize the interior of the esophagus. Endoscopy, in which the doctor examines the interior of the esophagus using a small flexible camera, can also be used to identify esophageal strictures. Acid reflux can also be diagnosed using a small device that detects acid in the esophagus.
Treatment
Dysphagia caused by acid reflux can be treated in a number of ways, according to the Mayo Clinic. The esophagus may be widened using a balloon attached to an endoscope. Surgery can also be performed to dilate the esophagus. Finally, once the strictures have been dilated, prescription medications can be used to treat the acid reflux and keep the strictures from coming back.
