Acid reflux and reflux related conditions

Acid reflux

Acid reflux is a very common disorder affecting millions of people. The problem is usually not an overproduction but of stomach acid being in the oesophagus. Normally the gut has mechanisms to protect the oesophagus from acid passing up into it but for a variety of reasons these can fail and cause distressing symptoms

Acid reflux can manifest in a number of different ways. Typical symptoms include heartburn (a burning feeling typically in the chest), chest pain (painful feeling anywhere in the chest) and regurgitation (food coming up into the mouth and then swallowed again). There are a number of other symptoms which can also be ascribed to reflux such as a sore throat, constant throat clearing, a hoarse voice or a feeling of a ball in the throat.

Because acid reflux can cause so many different symptoms patients often need to undergo a number of different investigations to find an underlying cause which can waste time and lead to prolonged symptoms.

So how do I get my acid reflux investigated?

Sometimes, but not always, you may need to undergo an endoscopy to determine whether acid reflux is causing your symptoms. This involves the passage of a camera into the oesophageal via the mouth. This is a comfortable test and can be done with or without sedation. This will reveal whether there is any damage to the oesophagus and also any anatomical reasons for the reflux such as a hiatus hernia.

What might the treatment be?

Lifestyle factors are important to confront when treating reflux. The types of food eaten will definitely contribute. These include fatty and spicy foods. Foods that cause bloating will also predispose to reflux as will fizzy drinks. How you eat is also important. Eating smaller portions and eating well before bedtime (at least three hours) helps to allow the stomach to empty so that food and acid doesn’t flow back up into the oesophagus.

Will I need any other tests?

Sometimes if there is any diagnostic doubt further testing is needed. This may involve a test called 24 hour pH impedance. This involves passing a very thin catheter through the nose into the oesophagus with some local anaesthetic. This is left for 24 hours so that the patient eats and drinks normally and does all the things they would normally do.

Sebastian Zeki
Sebastian Zeki
Gastroenterology consultant

My clinical practice and research interests included upper gastrointestinal pathologies