Answering your questions about acid reflux

Acid reflux, commonly referred to as heartburn or gastro-oesophageal reflux disease (GORD), is a condition that affects millions of people. Although often manageable, untreated acid reflux can impact daily life and lead to complications. We speak to an esteemed consultant general and upper GI surgeon explores the causes, symptoms, and treatment options for acid reflux, helping you understand the condition and its management better.

What is acid reflux?

Acid reflux, also known as gastro-oesophageal reflux disease (GORD), occurs when stomach acid flows back into the oesophagus—the tube connecting your mouth to your stomach. This can irritate the lining of the oesophagus, leading to uncomfortable symptoms. Acid reflux is common and can affect people of all ages, though its severity varies widely from person to person.

What are the symptoms of acid reflux?

The most common symptom of acid reflux is heartburn—a burning sensation in the chest that often occurs after eating or at night. Some individuals may experience regurgitation, where acidic or bitter-tasting stomach contents come up into the throat or mouth. Other symptoms can include difficulty swallowing, chronic cough, a sore throat, or the sensation of a lump in the throat.

Less commonly, acid reflux may mimic symptoms of other conditions, such as chest pain that can feel similar to heart problems. If you experience severe or persistent symptoms, consult your doctor to rule out other underlying conditions.

Why does acid reflux happen?

Acid reflux occurs when the lower oesophageal sphincter (LOS), a ring of muscle at the bottom of the oesophagus, becomes weakened or relaxes at inappropriate times. Normally, the LOS acts as a barrier, preventing stomach acid from rising. However, when it does not function properly, acid can escape into the oesophagus, causing discomfort.

Certain factors can increase the likelihood of acid reflux, such as being overweight, eating large meals, or lying down soon after eating. Foods and drinks such as fatty or spicy meals, caffeine, alcohol, and citrus can also trigger symptoms. Smoking and certain medications may further contribute to the problem.

How is acid reflux diagnosed?

Doctors often diagnose acid reflux based on your symptoms and a physical examination. However, further tests may be recommended if your symptoms are severe, persistent, or atypical. These might include an endoscopy, where a thin tube with a camera is inserted into your oesophagus to check for inflammation, or pH monitoring, which measures acid levels in the oesophagus over a 24-hour period.

What treatments are available for acid reflux?

Treatment for acid reflux aims to reduce symptoms and prevent long-term complications. Lifestyle changes are often the first step. These include eating smaller meals, avoiding trigger foods, and elevating the head of your bed to prevent acid from rising while you sleep. Quitting smoking and losing weight, if needed, can also make a significant difference.

Medications may also be prescribed to control symptoms. Antacids provide quick relief by neutralising stomach acid, while H2 blockers and proton pump inhibitors (PPIs) reduce acid production. If symptoms persist despite these measures, or if complications like severe oesophagitis develop, surgical options may be considered.