Acid reflux: a comprehensive guide

Acid reflux is a digestive disorder affecting millions worldwide, is often a source of discomfort and concern for many. Consultant gastroenterologist Dr Andy Li answers your commonly asked questions about the condition and provides advice on how to manage symptoms.

What is acid reflux, and how is it different from heartburn?

Acid reflux, also known as gastroesophageal reflux disease (GERD), occurs when stomach acid flows backwards into the oesophagus. This backward flow can irritate the lining of the oesophagus and cause a range of symptoms.

Heartburn, on the other hand, is one of the primary symptoms of acid reflux. It manifests as a burning sensation in the chest or throat, often after eating or lying down. In essence, acid reflux is the broader condition, while heartburn is a specific symptom of it.

What causes acid reflux?

Several factors can contribute to the development of acid reflux, including the following:

Weak lower oesophageal sphincter (LES): The LES is a muscular ring that separates the oesophagus from the stomach. When it becomes weak or relaxes inappropriately, stomach acid can flow into the oesophagus, causing acid reflux.

Hiatus hernia: a hiatus hernia occurs when a portion of the stomach pushes up through the diaphragm. This displacement can disrupt the normal functioning of the LES, leading to acid reflux.

Dietary factors: certain foods and beverages can trigger acid reflux, including spicy foods, citrus fruits, tomato-based products, chocolate, coffee, and alcohol.

Overeating: consuming large meals or lying down immediately after eating can increase the risk of acid reflux.

Obesity: excess body weight can put pressure on the abdomen, promoting the backward flow of stomach acid into the oesophagus.

What are the symptoms of acid reflux?

The symptoms of acid reflux can vary in severity and may include:

Heartburn: a burning sensation in the chest, often after eating or lying down.

Regurgitation: the backflow of sour-tasting stomach contents into the mouth.

Difficulty swallowing: feeling a lump in the throat or experiencing difficulty swallowing (dysphagia).

Chronic cough: persistent coughing and wheezing, especially at night.

Sore throat: irritation of the throat lining can lead to a persistent sore throat.

Are there medications available for treating acid reflux?

Yes, several medications can provide relief from acid reflux symptoms. Over-the-counter antacids, which neutralise stomach acid, can offer short-term relief. Alginate therapies such as Gaviscon can also be effective in the short term. H2 blockers and proton pump inhibitors (PPIs) may provide more prolonged relief, but these often require a prescription for long term use.

It is essential to consult a healthcare professional to determine the most appropriate medication for your specific case.

What lifestyle changes can help manage acid reflux?

Lifestyle modifications are crucial in managing acid reflux. Some effective strategies include:

Maintaining a healthy weight: losing excess weight can reduce pressure on the abdomen and alleviate symptoms.

Dietary adjustments: avoid trigger foods and beverages, eat smaller, more frequent meals, and refrain from lying down immediately after eating.

Elevating the head of the bed: elevating the upper body during sleep can help prevent stomach acid from flowing back into the oesophagus.

Quitting smoking and limiting alcohol: both smoking and excessive alcohol consumption can worsen acid reflux symptoms.

Can acid reflux lead to complications?

If left untreated, acid reflux can lead to various complications, including:

Barrett's oesophagus: chronic acid exposure can lead to changes in the lining of the oesophagus, increasing the risk of oesophageal cancer.

Oesophageal strictures: repeated damage from stomach acid can lead to narrowing of the oesophagus, making swallowing difficult.

Respiratory issues: severe acid reflux can cause or exacerbate conditions like asthma and chronic bronchitis.

If you would like to book a consultation with Dr Li, do not hesitate to do so by visiting his Top Doctors profile today.