Cause 8: Non-Acidic Reflux
While most people are familiar with the acidic sting of heartburn associated with classic acid reflux, there exists a lesser-known counterpart: non-acidic reflux. As its name suggests, this condition involves the backflow of non-acidic stomach contents into the esophagus. Sounds benign? Think again. Just because it lacks the characteristic acidity doesn’t make it any less problematic.
Non-acidic reflux is characterized by the regurgitation of bile, enzymes, and undigested food particles from the stomach and, in some cases, the duodenum (first part of the small intestine) into the esophagus. While these substances might lack the caustic pH of stomach acid, they can be equally, if not more, irritating. Bile and digestive enzymes, for instance, are designed to break down fats and food particles. When these end up in the esophagus, they can initiate a cascade of inflammation.
Symptoms of non-acidic reflux can be somewhat elusive. Patients might complain of a bitter taste in the mouth, chronic cough, or a persistent sensation of something being stuck in the throat. Because these symptoms can overlap with other conditions, diagnosis often requires specialized tests such as impedance monitoring, which tracks the flow of substances in the esophagus.
Addressing non-acidic reflux is a twofold endeavor. Lifestyle changes, including dietary modifications and propping oneself up while sleeping, can reduce the frequency and intensity of reflux episodes. Medications that reduce bile production or alter stomach emptying might also be employed. In refractory cases, where conventional treatments fail, surgical interventions might be explored. (7)
