Acid reflux is a common digestive condition that happens when some acid or bile in the stomach flows back up.
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Acid reflux is a common digestive condition that happens when some of the acid or bile in your stomach flows back up (is regurgitated) into your food pipe (oesophagus).
Occasional acid reflux is not a disease but can be uncomfortable. However, if you experience acid reflux more than twice a week (chronic), it is diagnosed as gastro-oesophageal reflux disease (GORD). This is a more serious condition than acid reflux which can affect your quality of life and can also lead to long-term health complications if left untreated.
Acid reflux affects people of all ages but it’s more common in people aged 35 to 64. There’s often no clear reason why it happens but it can be due to lifestyle factors, diet and medicines, as well as conditions that can’t be prevented.
Causes of acid reflux include:
Obesity
Smoking (active or passive)
Low levels of physical exercise
Pregnancy
Stress and anxiety
Alcohol
Certain foods and drinks like chocolate, peppermint, coffee, fruit juices, fatty or spicy foods
Certain medicines including anti-inflammatory painkillers, asthma medications, calcium-channel blockers, antihistamines, painkillers, sedatives and antidepressants
A hiatus hernia
A stomach ulcer
A bacterial stomach infection
Certain surgeries including gallbladder removal, cholecystectomy, gastric sleeve surgery, hernia repair and lung surgery
Acids and bile inside your stomach naturally help to break down food during digestion. When you swallow, a circular band of muscle at the bottom of the (lower oesophageal sphincter) normally relaxes, to allow food and drink to flow into the stomach. The sphincter then closes again.
However, if the sphincter weakens or does not work properly, then stomach acid and bile can flow back up into your oesophagus to cause acid reflux.
The terms acid reflux, heartburn (pyrosis), and GORD are often used interchangeably. This is misleading as they are actually different things.
Acid reflux is a condition which occurs when acid is regurgitated from the stomach into the oesophagus. This causes the symptom of heartburn - a burning sensation in the middle of your chest. GORD is chronic acid reflux.
Symptoms of acid reflux can vary in type, severity and frequency. Acid reflux symptoms can be mild and manageable or severe to the point where your quality of life is affected.
The main symptoms of acid reflux are heartburn and/or a sour or bitter taste in your mouth, caused by the regurgitation of acid back into your throat.
Other symptoms include:
Nausea (feeling sick)
Bloating
Belching
Indigestion (dyspepsia)
A burning pain when you swallow hot drinks
Your acid reflux symptoms may feel worse after eating a meal or when lying down, bending over or bending and lifting.
Heartburn is a symptom rather than a condition. It’s a burning feeling in your chest caused by acid in your oesophagus.
Acid reflux is considered to be chronic if you’ve had it at least twice a week for several weeks. Chronic acid reflux is called GORD and can cause complications in the throat, oesophagus and airways if left untreated.
If you have acid reflux and think you have GORD, make an appointment to see a OneWelbeck specialist gastroenterologist as soon as you can for fast diagnosis and effective treatment.
In most cases, a gastroenterologist will be able to make a diagnosis of acid reflux of GORD by evaluating your symptoms and medical history.
If your doctor suspects you have GORD, they may want to perform some tests to confirm a diagnosis and check for any complications.
These tests may include an endoscopy, oesophageal manometry, X-ray and a Bravo oesophageal pH test.
Treatments for acid reflux include lifestyle changes, over-the-counter medicines, prescription medicines and surgery. Your treatment will depend on how severe your symptoms are, as well as your overall health.
Your OneWelbeck specialist can discuss these treatments and recommend which would be right for you based on your circumstances.
Making certain lifestyle changes can help to reduce the symptoms of acid reflux. These changes include:
Losing weight if you’re overweight or obese
Improving your posture (sitting up straighter)
Avoiding tight-fitting clothes
Stopping smoking
Avoiding stooping, bending or lying down after eating
Raising the head of your bed by 6 to 8 inches
If you keep getting heartburn, then speak to a pharmacist for advice. They can recommend over-the-counter treatments that can help to ease your symptoms. These include:
Antacids: Antacids are a group of medicines which help to neutralise the acid content of your stomach. They include aluminium hydroxide, magnesium carbonate and magnesium trisilicate
Alginates: This group of medicines help to protect the lining of the gullet (oesophagus) from stomach acid. Alginates include sodium alginate and alginic acid. They are added to various antacid brand medicines
If over-the-counter medicines and lifestyle changes don’t reduce your acid reflux symptoms, then we recommend you make an appointment with one of our gastroenterology specialists. They may recommend you take a prescription medication. Two types of prescription medicines are available to treat acid reflux:
Proton pump inhibitors (PPIs)
Histamine receptor blockers (H2 blockers)
Your doctor may advise you to take medicine for one or two months to settle your symptoms. However, some people need long-term, daily medicines, depending on how quickly their symptoms return after stopping antacid treatments.
The vast majority of people with acid reflux respond well to appropriate acid-suppressing pharmacy medicines so do not need surgery.
However, a small number of patients may wish to have surgery for the following reasons:
If quality of life is significantly affected by acid reflux
Failure to respond well to acid-suppressing medicines
Ongoing symptoms (asthma, dry cough, hoarseness)
Undesirable side effects from acid-suppressing medicines
A need to avoid the use of long-term medicines
The standard surgical treatment for acid reflux is laparoscopic surgery (also known as fundoplication). This operation can ‘tighten’ the lower oesophagus to prevent acid from leaking up from the stomach. It is usually carried out by ‘keyhole’ surgery.
Other surgical procedures to reduce or stop acid reflux are currently being investigated. Your OneWelbeck gastroenterologist can provide you with more information about the latest surgical methods.
At OneWelbeck, our team of leading gastroenterologists offer world-class expertise in the diagnosis and treatment of acid reflux and GORD.
Based within the state-of-the-art Digestive Health Centre and Endoscopy Centre our expert clinicians work together to devise comprehensive pre-assessment and procedure management plans to deliver the very best patient care.
Most people with acid reflux will experience some heartburn at night. The following changes may help to reduce this:
Go to bed with an empty, dry stomach - don’t eat in the last three hours before you go to bed and don’t drink in the last two hours before going to bed
Try raising the head of your bed by 6-8 inches - this will elevate your head and chest so heartburn and acid reflux will be less likely to occur. Using a wedge pillow can have the same effect
Different foods can cause acid reflux in different individuals. Typical acid reflux foods to avoid include:
High-fat meals and fried foods, such as chips (French fries), butter, whole milk, cheese, ice cream, creamy salad dressings and sauces
High-fat cuts of red meat, such as marbled sirloin or prime rib
Citrus foods, such as oranges, grapefruit, lemons, and limes
Tomatoes and tomato-based foods, such as tomato sauce, salsa, chilli and pizza sauce
Garlic and onions
Read more on things to avoid if you have acid reflux.
While some foods can make acid reflux worse, others may help alleviate your symptoms, such as:
Oatmeal
Brown rice
Couscous
Sweet potato
Broccoli
Bananas
Nuts
Fennel
Celery
Watermelon
Broth-based soups
Herbal tea
How long acid reflux lasts varies from person to person, but you can have symptoms for anywhere from a few minutes to a few hours. It will usually stop once your stomach has emptied of its contents.
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We have brought together a group of leading colorectal and general surgeons and gastroenterologists to create our Digestive Health team. With over 300 years of combined experience, these expert clinicians are the best in their field and are all focused on delivering the very best patient care.