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What is Acid Reflux?
Acid reflux is a common digestive condition that happens when some acid or bile in the stomach flows back up into the food pipe (oesophagus) in your body. The oesophagus is a long, muscular tube that connects your mouth to your stomach.
Acid reflux is also known as heartburn, acid indigestion, or pyrosis. If it occurs more than twice a week, it is diagnosed as gastro-oesophageal reflux disease (GORD), which is a more serious condition than acid reflux. GORD can lead to long-term health complications.
Causes of 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. This condition can be due to lifestyle factors, diet and medicines, as well as conditions that can’t be prevented. Common causes of acid reflux include:
- Smoking (active or passive)
- Low levels of physical exercise
- Certain foods (chocolate, peppermint, coffee, fruit juices, fatty or spicy foods)
- Medicines (including asthma medicines, calcium-channel blockers, antihistamines, painkillers, sedatives, and antidepressants)
- A hiatus hernia (when part of the stomach moves up into the chest)
What makes acid flow back to the oesophagus?
Acids and bile inside your stomach naturally help to break down food for digesting. 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.
Symptoms of Acid Reflux
Symptoms of acid reflux can vary in type, severity and frequency. Acid reflux symptoms can be mild but severe symptoms can affect quality of life. The main symptoms are heartburn, which is a burning sensation in the chest, and/or a sour or bitter taste in your mouth, due to regurgitation of acid back into your throat.
Common symptoms include:
- An acid taste in the mouth
- Chest pain
- Nausea (feeling sick)
- Indigestion (dyspepsia)
- A burning pain when you swallow hot drinks
Your acid reflux symptoms may feel worse after eating a meal, lying down, bending over or bending and lifting.
Diagnosis of Acid Reflux
Diagnostic tests for acid reflux are not always needed if you have typical symptoms of this condition. Many people who experience these symptoms are diagnosed with ‘presumed acid reflux’.
However, your gastroenterologist or doctor may recommend diagnostic tests if your symptoms are severe, not typical or do not improve with treatment. Gastroenterology specialists may use certain investigations to diagnose acid reflux, GORD or rule out other conditions. These tests may include:
- Endoscopy (Gastroscopy): camera imaging of the oesophagus
- Biopsy: taking a tissue sample from the oesophagus for laboratory analysis
- Oesophageal manometry: pressure measurement of the oesophagus
- Impedance monitoring: measuring rate of fluid movement along the oesophagus
- pH monitoring: acidity testing
Diagnostic same-day procedures at OneWelbeck Digestive Health
Welbeck Health is part of the world’s largest day case outpatient group. Our leading gastroenterology specialists have diagnosed and managed patients with acid reflux and gastro-oesophageal reflux disease (GORD)
The new Digestive Health Centre facilities at Welbeck Health in London are equipped with cutting edge technology to provide you with fast, high-quality-diagnostic services. Most of these services can be conducted the same day , without the need for overnight stay. It may take a few days for the results of laboratory tests from a biopsy to become available.
Treatment of Acid Reflux
Treatment for acid reflux includes lifestyle changes, pharmacy medicines, prescription medicines or surgery. Your treatment will depend on how severe your symptoms are, as well as your overall health.
Your digestive health specialist at OneWelbeck can discuss these various treatments and recommend which ones would be right for your individual 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
- Giving up 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 (class) 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.
Prescription medicines for acid reflux
If pharmacy medicines and lifestyle changes don’t reduce (suppress) your acid reflux symptoms, then see a gastroenterology specialist or GP. They may recommend you take a prescription medication. Two types of prescription medicines are available to treat acid reflux:
- Proton pump inhibitors (PPIs): include omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole
- Histamine receptor blockers (H2 blockers): include cimetidine, famotidine, nizatidine and ranitidine
Your doctor may advise you to take a 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.
Acid Reflux Surgery
Most people with acid reflux will not need surgery. The vast majority of people with this condition respond well to appropriate acid suppressing pharmacy medicines.
However, a small number of patients, surgery 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 leaking up from the stomach. It is usually carried out by ‘keyhole’ surgery.
Other surgical procedure to reduce or stop acid reflux are currently being investigated. Your gastroenterologist at OneWelbeck can provide you with more information about new surgical methods.
Frequently Asked Questions
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 three hours before bedtime and don’t drink in the last two hours before bedtime.
- Try raising the head of the bed by 10-20 cm (6 inches). This will elevate your head and chest so heartburn and acid reflux will be less likely to occur. Try using a wedge pillow to do the same thing.
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, chili and pizza sauce
- Garlic and onions
Dr Banks is systematic, thoughtful, follows up via email and telephone. Knows when to be conservative and not over-react to symptoms and interpret results intelligently. I know that if I emailed him even at the weekend he would reply. He’s thorough, listens well and is clearly interested in full history and possible links. I have been really impressed – best gastroenterologist I’ve seen in a while.Patient treated at The Lister Hospital
Acid Reflux Specialists
Our digestive health specialists at OneWelbeck in London are leaders in their field. They are equipped with the latest diagnostic medical technology at custom-built, day-case facilities to investigate any symptoms and ensure you receive the best available care.
Specialists at OneWelbeck
To speak with a specialist about Acid Reflux, contact our team today.
We are available from Monday to Friday: 8am – 8pm.