Debunking Acid Reflux

Debunking Acid Reflux Myths: It's Not Always About Too Much Acid

Acid reflux, often synonymous with heartburn, affects millions worldwide is a symptom. The burning sensation in your chest after a spicy meal or late-night snack is commonly blamed on excessive stomach acid splashing into the esophagus. While that's true in many cases, it's a myth that acid reflux always stems from overproduction of acid. In fact, for some people, the issue lies in an oversensitivity to normal levels of stomach acid, leading to symptoms without abnormal acid exposure. Lets talk about the cause.

Gastroesophageal reflux disease

Let's break it down. Gastroesophageal reflux disease (GERD) occurs when the lower esophageal sphincter (LES) weakens or relaxes inappropriately, allowing stomach contents to flow back up. Traditional thinking focuses on hyperacidity from factors like diet, stress, or obesity. However, research shows that not all heartburn is tied to acid overload. Conditions like esophageal hypersensitivity or functional heartburn can mimic GERD symptoms even when acid levels are typical.

Esophageal hypersensitivity, also called acid-hypersensitive esophagus, means the esophagus reacts intensely to even small amounts of acid. Symptoms arise from a positive correlation between reflux events and discomfort, but without erosive damage or excessive reflux. This hypersensitivity can be linked to psychological factors like anxiety, which amplifies pain perception, or visceral hypervigilance, where the body overreacts to normal sensations. Functional heartburn, another culprit, involves retrosternal burning without objective GERD evidence, often resistant to acid-suppressing meds like PPIs.

Misdiagnoses

Why does this matter? Misdiagnosing hypersensitivity as simple acid excess can lead to ineffective treatments. If antacids or PPIs don't help, it might signal oversensitivity rather than overproduction. Doctors may then recommend neuromodulators, like low-dose antidepressants, to reduce esophageal sensitivity, or lifestyle tweaks such as stress management and dietary adjustments.

In summary

In summary, acid reflux isn't one-size-fits-all. While cutting acidic foods helps many, understanding hypersensitivity encourages a broader approach to relief. If symptoms persist, consult a practitioner for tests to pinpoint the cause. Listen to your body—it's not always about the acid quantity, but how your system responds to it.