How long can acid reflux last
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Duration of Acid Reflux: Insights from Research
Understanding Acid Reflux Duration
Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common condition where stomach acid flows back into the esophagus, causing discomfort and potential damage to the esophageal lining. The duration of acid reflux episodes can vary significantly based on several factors, including age, underlying conditions, and treatment methods.
Acid Reflux in Infants
Research involving 509 healthy infants has shown that acid reflux is a common physiological phenomenon in this age group. The study measured esophageal pH over 24 hours and found that the reflux index, which indicates the percentage of time the esophagus is exposed to acid, decreases with age. At birth, the reflux index is around 13%, which drops to 8% by the age of 12 months. This indicates that while acid reflux episodes are frequent in infants, they tend to decrease as the child grows older1.
Long-term Control of Acid Reflux in Adults
For adults with chronic GERD, long-term control of acid reflux can be achieved through medical or surgical interventions. A study comparing laparoscopic antireflux surgery (LARS) and esomeprazole therapy over five years found significant reductions in esophageal acid exposure in both groups. Patients who underwent LARS had a median 24-hour esophageal acid exposure of 0.7% after five years, compared to 1.9% in those treated with esomeprazole. This suggests that both treatments are effective in reducing acid reflux over a long period, with LARS showing slightly better outcomes2.
Postoperative Reflux Following Bariatric Surgery
In the context of bariatric surgery, the type of procedure can influence the duration and severity of acid reflux. A study comparing sleeve gastrectomy (LSG) and one anastomosis gastric bypass (MGB/OAGB) found that patients who underwent LSG experienced higher acid exposure and increased rates of esophagitis one year post-surgery. This indicates that LSG may lead to more prolonged and severe acid reflux compared to MGB/OAGB, suggesting that the latter may be a better option for patients with pre-existing reflux conditions3.
Conclusion
The duration of acid reflux episodes can vary widely depending on age, treatment methods, and surgical interventions. In infants, acid reflux is common but tends to decrease with age. For adults, both medical and surgical treatments can effectively control acid reflux over the long term, with surgical options like LARS showing slightly better results. In bariatric surgery patients, the choice of procedure can significantly impact the severity and duration of postoperative reflux, with MGB/OAGB being preferable for those with pre-existing reflux issues. Understanding these factors can help in managing and mitigating the effects of acid reflux effectively.
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Most relevant research papers on this topic
Gastroesophageal reflux, as measured by 24-hour pH monitoring, in 509 healthy infants screened for risk of sudden infant death syndrome.
The normal range for gastroesophageal reflux in healthy infants is about 10% during the first 12 months of life, decreasing from 13% at birth to 8% at 12 months.
Observational Study
Highly CitedGastroesophageal Acid Reflux Control 5 Years After Antireflux Surgery, Compared With Long-term Esomeprazole Therapy.
Laparoscopic antireflux surgery (LARS) significantly reduces 24-hour esophageal acid exposure in chronic GERD patients over 5 years, while esomeprazole therapy effectively controls symptoms.
RCTEvaluation of reflux following sleeve gastrectomy and one anastomosis gastric bypass: 1-year results from a randomized open-label controlled trial
Laparoscopic sleeve gastrectomy (LSG) is recommended for patients with preoperative subclinical reflux or low grade (A) esophagitis due to higher acid exposure time and esophagitis rate compared to Mini-/One anastomosis gastric bypass (
RCT
Rigorous JournalSix to 12-year outcomes of magnetic sphincter augmentation for gastroesophageal reflux disease
Magnetic sphincter augmentation (MSA) is a safe and effective treatment for gastroesophageal reflux disease, improving symptoms, decreasing drug dependency, and reducing esophageal acid exposure over 6-12 years.
Observational StudyRigorous JournalLiquid-containing Refluxes and Acid Refluxes May Be Less Frequent in the Japanese Population Than in Other Populations: Normal Values of 24-hour Esophageal Impedance and pH Monitoring
Liquid-containing and acidic reflux events may be less frequent in the Japanese population, while non-acidic gas reflux events are common and cause frequent proximal reflux events.
Observational StudyRigorous JournalThree- to 4.5-year prospective study of prognostic indicators in gastro-oesophageal reflux disease.
Most gastro-oesophageal reflux disease patients still require acid suppression therapy 3 to 4.5 years after initial diagnosis, with age, BMI, and presence of oesophagitis at initial endoscopy being key predictors.
Observational StudyHighly CitedTwenty-four hour esophageal pH monitoring in gastroesophageal reflux
Twenty-four hour pH esophageal monitoring in children with gastroesophageal reflux is more objective, precise, and reliable than other methods, aiding in identifying at-risk children and guiding surgical intervention.
Observational StudyHighly CitedOne hundred consecutive patients treated with magnetic sphincter augmentation for gastroesophageal reflux disease: 6 years of clinical experience from a single center.
Magnetic sphincter augmentation for GERD provides safe and long-term reduction of esophageal acid exposure, substantial symptom improvement, and elimination of daily proton pump inhibitor use without long-term complications.
Observational StudyHighly CitedTwenty-Four-Hour Esophageal Impedance-pH Monitoring in Healthy Preterm Neonates: Rate and Characteristics of Acid, Weakly Acidic, and Weakly Alkaline Gastroesophageal Reflux
Esophageal impedance monitoring can detect weakly acidic and weakly alkaline gastroesophageal reflux in healthy preterm neonates, potentially aiding in understanding the role of weakly acidic reflux in the pathophysiology of gastroesophageal reflux disease.
Observational StudyHighly Cited