Understanding acid reflux: causes, symptoms, and solutions

Acid reflux, also known as gastro-oesophageal reflux disease (GORD), is a common digestive disorder that affects many people in the UK. It occurs when stomach acid flows back into the oesophagus, causing discomfort and other symptoms.

In this article, a leading gastroenterologist aims to provide an overview of acid reflux by answering common questions that patients may have, helping them better understand the condition and the available solutions.

What causes acid reflux?

Acid reflux occurs when the lower oesophageal sphincter (LES), a ring of muscle that acts as a valve between the stomach and the oesophagus, weakens or relaxes abnormally. This allows stomach acid to flow back into the oesophagus, causing irritation. Common factors that can contribute to acid reflux include:

• Diet: spicy foods, citrus, chocolate, caffeine, and fatty or fried foods are known to trigger acid reflux.
• Obesity: excess weight can put pressure on the stomach, pushing acid into the oesophagus.
• Smoking: smoking weakens the LES, making acid reflux more likely.
• Pregnancy: hormonal changes and the pressure from the growing foetus can cause acid reflux in pregnant women.
• Hiatal hernia: a condition where part of the stomach pushes through the diaphragm, making acid reflux more likely.

What are the symptoms of acid reflux?

The symptoms of acid reflux can vary, but the most common ones include:

• Heartburn: a burning sensation in the chest, often after eating, which may worsen when lying down.
• Regurgitation: a sour or bitter-tasting acid backing up into the throat or mouth.
• Dysphagia: difficulty swallowing or the sensation of a lump in the throat.
• Chronic cough: a persistent cough, particularly at night, may be linked to acid reflux.
• Hoarseness: irritation from acid reflux can cause hoarseness, especially in the morning.
• Nausea: some individuals may feel nauseous due to ongoing acid reflux.

Is acid reflux dangerous?

While occasional acid reflux is common and usually not a cause for concern, chronic or severe acid reflux (GORD) can lead to complications if left untreated. Some potential risks include:

• Oesophagitis: inflammation of the oesophagus, which can lead to discomfort and difficulty swallowing.
• Barrett's oesophagus: a condition in which the lining of the oesophagus changes, increasing the risk of oesophageal cancer.
• Oesophageal stricture: narrowing of the oesophagus due to scar tissue from repeated acid exposure.

If you experience frequent acid reflux or severe symptoms, it is essential to consult a healthcare professional for proper diagnosis and treatment.

What lifestyle changes can help manage acid reflux?

Many cases of acid reflux can be managed through simple lifestyle changes. Some recommendations include:

• Dietary adjustments: avoid trigger foods such as spicy, acidic, and fatty foods, and eat smaller, more frequent meals.
• Weight management: maintaining a healthy weight

can reduce pressure on the stomach and lower the risk of acid reflux.

• Elevate the head of your bed: raising the head of your bed by 6-8 inches can help prevent acid from flowing back into the oesophagus during sleep.
• Avoid lying down after eating: it is recommended to wait at least 2-3 hours after a meal before lying down or going to bed.
• Quit smoking: smoking weakens the LES, so quitting can help reduce acid reflux symptoms.
• Limit alcohol and caffeine: both can relax the LES and increase acid reflux, so reducing consumption may help.

What medical treatments are available for acid reflux?

When lifestyle changes are not enough, several medical treatments can help manage acid reflux:

• Antacids: over-the-counter antacids can neutralise stomach acid and provide quick relief from mild heartburn.
• H2 blockers: medications like ranitidine reduce acid production in the stomach and are available both over-the-counter and by prescription.
• Proton pump inhibitors (PPIs): PPIs, such as omeprazole, are stronger medications that block acid production and are often prescribed for more severe cases of acid reflux.
• Surgery: in cases where medication and lifestyle changes do not control the symptoms, surgery may be recommended. Procedures like fundoplication, where the top of the stomach is wrapped around the LES, can help strengthen the valve and prevent acid reflux.

When should I see a doctor about acid reflux?

If you experience acid reflux symptoms more than twice a week, or if your symptoms persist despite making lifestyle changes and using over-the-counter medications, you should see a doctor. Additionally, seek medical attention if you experience:

• Difficulty swallowing or frequent vomiting.
• Unexplained weight los.
• Chronic cough or hoarseness.
• Chest pain that radiates to the arm, neck, or jaw, as this could be a sign of a more serious condition, such as heart disease.

Conclusion

Acid reflux is a common condition that can cause significant discomfort, but it is manageable with the right lifestyle changes and medical treatments. Understanding the causes and symptoms of acid reflux can help patients take steps to alleviate their discomfort and avoid complications.

Are you thinking about getting a diagnosis for acid reflux? Arrange a consultation with Dr Sarah Clark via her Top Doctors profile.