Hello,

Excessive acid secretion in the stomach occurs due to gastritis - inflammation of the inner lining of the stomach. The acid irritates the already inflamed gastric lining to cause more inflammation. The excess acid leaks from the stomach into the esophagus (food pipe), causing acid reflux and heartburn.

The stomach already contains some amount of gas - air swallowed during eating and drinking and gas produced by fermentation of food. The normal emptying time of the stomach - that is, the time taken for food to move out of the stomach to the intestines - is about 3 - 4 hours. In gastritis, this gastric emptying time is delayed, resulting in food remaining in the stomach for a loner time. This causes more fermentation and more gas formation.

The bloating and sense of fullness in the stomach comes from a collection of fermenting food, excess gas and excess acid. Since the stomach is bloated, belching and releasing some of the gas causes some amount of comfort. This is the reason why many persons with GERD often feel better after vomiting.

Acid in the mouth can cause swelling , not just of the lips but also of other parts of the mouth like the tongue, palate etc. But this is usually a mild swelling due to irritation. Since you have a noticable swelling, it is likely that you bite on your lips at night while asleep due to discomfort from the acid.

To decrease the heartburn and GERD, please take the following steps besides the prescribed medicines:

-- Take sips of ice cold water throughout the day from time to time. This will cool the stomach tissues, decrease acid secretion and dilute whatever acid is secreted. Ice-creams and cold custard also work, plus since they are semisolid, they have less chances of trickling upwards and causing heartburn.

- Take 4-5 small meals instead of 3 major meals. Ice-cold rice pudding is ideal for you.

- Avoid greasy, fried food .

- Sleep in a propped up position instead of flat on the bed to prevent acid reflux.

- As soon as you wake up in the morning and before getting up from bed, nibble at 2-3 dry crackers. These will absorb whatever acid and gas has collected in your stomach overnight. Lie quietly in bed for another 30 minutes.

- Liquid and soild food is not to taken together. Liquids are to be taken at least 1 hour after solids.

- Do not do anything that can cause gastric acid to flow upwards. No toe-touching exercises, no leaning forwards to pick up things etc.

- Besides the prescribed medicines, you can also take an antacid called Mucaine gel (OTC)- this antacid contains an anesthetic called lignocaine which can really decrease the sensations of heart burn and also help the muscles to relax. But it should not be taken for longer than 1 week.

Digene gel (OTC) is another antacid which should help you. Digene contains a gas absorbing substance called simethicone which will absorb the gas in the stomahc and prevent the acid from trickling up into the esophagus. Simethicone is also available as tablets (GasX).

I believe that these steps will decrease the inflammation of the esophagus and stomach walls which is causing the acid relux and heartburn.

I hope this helps.

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