Acid Reflux

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

Why does acid flow back to the oesophagus?

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, allowing 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.

In most cases, a gastroenterologist will be able to make a diagnosis of acid reflux or GORD by evaluating your symptoms and medical history.

If your consultant suspects you have GORD, they may want to perform some tests to confirm a diagnosis and check for any complications.

These tests may include:

• endoscopy

• oesophageal manometry

• X-ray

• a Bravo oesophageal pH test

While it may not always be completely preventable, making certain lifestyle adjustments can significantly lower the risk and severity of acid reflux. These include:

• maintaining a healthy weight – excess weight can increase pressure on your abdomen and contribute to reflux

• adopting good posture – sitting up straighter and avoiding stooping, bending, or lying down after meals reduces reflux

• avoiding tight-fitting clothes – especially around the waist to reduce pressure on your stomach

• stopping smoking – both active and passive smoking are known to weaken the lower oesophageal sphincter and worsen reflux

• avoid common trigger foods and drinks – including chocolate, peppermint, coffee, fruit juices, fatty or spicy foods, citrus, tomatoes, garlic, and onions, which can irritate the digestive tract

• limiting alcohol intake – alcohol can relax the sphincter and increase reflux episodes

• raising the head of your bed by 6 to 8 inches – this tilt helps reduce nighttime reflux by preventing stomach contents from rising during sleep

• eating earlier in the evening – avoid eating in the last 3 hours before bedtime and drinking in the last 2 hours to reduce overnight reflux risk

If acid reflux becomes chronic (GORD) and is left untreated, it can lead to several serious complications affecting the oesophagus, throat, and respiratory system:

• oesophagitis – chronic irritation and inflammation of the oesophagus lining

• strictures – narrowing of the oesophagus due to scarring that can make swallowing difficult

• Barrett’s oesophagus – a pre-cancerous change in oesophageal lining that increases risk of oesophageal cancer

• oesophageal ulceration – painful sores or erosions in the oesophagus caused by repeated acid exposure

• chronic cough, hoarseness, or asthma-like symptoms – reflux can irritate the airways and lungs, causing respiratory complications

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 Welbeck specialist can discuss these treatments and recommend which would be right for you based on your circumstances.

Non-surgical treatments for acid reflux

Lifestyle changes

Making certain lifestyle changes can help 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

Heartburn medicines

If you keep getting heartburn, speak to a pharmacist for advice. They can recommend over-the-counter treatments that can help ease your symptoms. These include:

• antacids – medicines that help neutralise the acid content of your stomach. They include aluminium hydroxide, magnesium carbonate and magnesium trisilicate

• alginates – this group of medicines help 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

Prescription medicines for acid reflux

If over-the-counter medicines and lifestyle changes don’t reduce your acid reflux symptoms, we recommend you make an appointment with one of our gastroenterology specialists. They may provide you with a prescription medication, which may be a:

• proton pump inhibitor (PPIs)

• histamine receptor blocker (H2 blockers)

Your consultant may advise you to take medicine for 1 or 2 months to settle your symptoms. However, some people need long-term, daily medicine, depending on how quickly their symptoms return after stopping antacid treatments.

Surgical treatment of acid reflux

The vast majority of people with acid reflux respond well to appropriate acid-suppressing pharmacy medicines, so they don’t need surgery.

However, you may wish to have surgery for the following reasons:

• if your quality of life is significantly affected by acid reflux

• you don’t respond well to acid-suppressing medicines

• you have ongoing symptoms (asthma, dry cough, hoarseness)

• you experience side effects from acid-suppressing medicines

• there is s need for you 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’s usually carried out via keyhole surgery.

Other surgical procedures to reduce or stop acid reflux are currently being investigated. Your Welbeck gastroenterologist can provide you with more information about the latest surgical methods.

At Welbeck, our team of leading gastroenterologists offer world-class expertise in the diagnosis and treatment of acid reflux and GORD.

With diagnostics and treatments taking place within our 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.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.

Are heartburn and acid reflux the same thing?

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.

Heartburn is a symptom rather than a condition. It’s a burning feeling in your chest caused by acid in your oesophagus.

How can I reduce acid reflux at night?

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 3 hours before you go to bed and don’t drink in the last 2 hours before going to bed

• try raising the head of your bed by 6 to 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

What foods should I avoid for acid reflux?

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

Which foods help 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