Acid Reflux May Be an Immune Problem

According to a new study, gastroesophageal reflux disease (GERD) may not be the direct result of acidic digestive juices burning the esophagus (the tube that leads from the back of the mouth to the stomach), as has been long thought. It may actually be the result of  immune system cells causing inflammation in the esophagus. Researchers from the University of Texas Southwestern Medical Center at Dallas created GERD in rats by connecting the duodenum (the first part of the small intestine) to the esophagus, allowing stomach acid and bile to enter the esophagus. Instead of causing immediate esophagitis (inflammation of the esophagus), the problem didn't develop until weeks later. When the researchers examined the damaged esophageal tissue, they found it filled with immune cells. The study showed that GERD causes tissue in the esophagus to release immune chemicals called cytokines, which attract inflammatory cells. It's those inflammatory cells that cause the heartburn and chest pain associated with GERD.

"Currently, we treat GERD by giving medications to prevent the stomach from making acid, but if GERD is really an immune-mediated injury, maybe we should create medications that would prevent these cytokines from attracting inflammatory cells to the esophagus and starting the injury in the first place," Rhonda Souza, M.D., associate professor of Internal Medicine at UT Southwestern Medical Center and lead author of the study, said in a statement.

Treatment for heartburn and other GERD symptoms typically starts with over-the-counter medications that control acid and may include antacids, such as Maalox, Mylanta, Rolaids and Tums; medications that reduce acid production (H-2-receptor blockers), such as Tagamet HB and Pepcid AC; and proton pump inhibitors that block acid production, including Prevacid 24 HR and Prilosec OTC.

Lifestyle Changes May Help Curb GERD

If you suffer from GERD, talk to your doctor about what the best treatment may be for you. In addition to medications, making some simple lifestyle changes may also help reduce the frequency and severity of GERD symptoms. Try these tips:

  • Avoid tight-fitting clothing, which can put pressure on your stomach and the lower esophageal sphincter
  • Avoid foods that trigger heartburn, including fatty or fried foods, alcohol, chocolate, mint, garlic, onion and caffeinated beverages
  • Don't smoke. Smoking decreases the lower esophageal sphincter's ability to function properly
  • Wait at least two to three hours after eating before lying down or going to bed