Gastric juice does not typically cause a burning sensation within the stomach. But reflux of gastric juice into the esophagus can cause a burning sensation. One reason for the burning sensation caused by the gastric reflux is that the esophagus ______.

There’s a ringlike muscle where the esophagus meets your stomach called the lower esophageal sphincter (LES). A properly working LES protects the esophagus from the acid in your stomach by keeping the pathway between them clenched shut.

When the LES is loose or too relaxed, acidic gastric juices (the stuff in your stomach) can bubble up into your esophagus, which is a major cause of acid reflux. (Other causes include hiatal hernias, when part of the stomach pushes through the diaphragm.)

A little bit of reflux is normal. But if there is excessive stomach acid in the esophagus, there patient may likely be in a lot of discomfort.. The most common causes of acid reflux are lifestyle choices such as overeating, eating before bed or exercising immediately after a large meal. Other causes include:

i. Obesity

ii. Too much alcohol or coffee

iii. Acidic foods

iv. Cigarettes

v. Certain drugs, especially blood pressure, anti-anxiety and pain medications

vi. Hiatal hernia

v. Pregnancy

Diagnostic tests can be performed such as Upper endoscopy, in which a long, flexible tube explores the esophagus (under sedation), or the esophageal pH test, an outpatient procedure in which the patient wears a small probe for 24 hours to detect the amount of acid being produced.

Once GERD is confirmed, treatments include lifestyle changes, medications and surgery can be commenced. For instances:

A. Lifestyle changes:

i. Quit smoking

ii. Lose weight

iii. Wear looser clothes

iv. Avoid food for a couple of hours before bedtime

v. Prop yourself up slightly to sleep instead of lying flat

vi. Eat smaller meals

vii. Stay upright for three hours after a meal

B. Medications:

i. Over-the-counter antacids to neutralize the acid in your stomach (such as Maalox, Mylanta and Rolaids)

ii. Prescription antacids eg. Alka Seltzer, Milk of Magnesia.

iii. H2 blockers that reduce the amount of acid your stomach makes (such as Zantac and Pepcid)

iv. Proton-pump inhibitors that further reduce the amount of acid your stomach produces and are available both over the counter and by prescription (such as Prilosec, Nexium and Prevacid).

v. Prokinetics that help clear stomach contents and strengthen the LES (such as Reglan).

C. Surgery being the last option can be conducted if the above therapies looses effect known as Fundoplication. Fundoplication is a surgical procedure in which the upper part of the stomach is wrapped around the lower part of the esophagus to strengthen the LES.