17019 Acid Reflux Gerd

Overview

Acid reflux is when stomach acid flows back up into the tube that connects your mouth and stomach, called the esophagus. This can cause a burning feeling in the chest, often called heartburn. When acid reflux happens often or causes damage, it is called GERD, which stands for gastroesophageal reflux disease.

Yes. Acid reflux is very common. Many people have heartburn from time to time, and acid reflux is one of the most common reasons people visit their general practitioner.

It can affect people of all ages, including children and older adults. It is more likely during pregnancy, after age 40, or if you carry extra weight around your belly.

Symptoms

Common symptoms

• A burning feeling in the chest, often after eating or at night
• A sour, bitter, or acidic taste in the mouth
• Regurgitation, when food or liquid comes back up into the throat
• Coughing or a hoarse voice, especially in the morning
• A feeling that something is stuck in the throat
• Sore throat or frequent clearing of the throat
• Difficulty swallowing or pain when swallowing

Symptoms in children

• Frequent spitting up or vomiting after eating
• Irritability, crying, or fussiness during or after feeds
• Poor appetite or refusing food
• Coughing, wheezing, or noisy breathing
• Belly pain or discomfort

Symptoms in older adults

• Less typical heartburn, but more trouble swallowing
• Hoarse voice or repeated coughing
• Chest pain that can be confused with heart problems
• Unintentional weight loss or poor appetite

Causes

Main causes

• A weak or relaxed ring of muscle at the bottom of the esophagus, called the lower esophageal sphincter, allows stomach acid to escape upward.
• A hiatus hernia, where part of the stomach pushes through the diaphragm, can make reflux easier.
• Certain foods and drinks, such as spicy or fatty foods, alcohol, caffeine, chocolate, and carbonated drinks, can trigger symptoms.
• Eating large meals or lying down soon after eating can worsen reflux.
• Pregnancy increases pressure on the stomach and can cause reflux.

Risk factors

• Being overweight or living with obesity
• Pregnancy
• Smoking
• Eating large meals late at night
• Some medicines — ask your doctor or pharmacist if any medicine you take can cause reflux
• Stress and poor sleep

When to see a doctor

See a doctor urgently if:

• Chest pain with shortness of breath, sweating, or pain spreading to the arm or jaw
• Vomiting blood or black, tarry stools
• Severe or sudden difficulty swallowing

Book a routine appointment if:

• Heartburn two or more times a week
• Symptoms that last for several weeks
• Symptoms not improving with lifestyle changes or pharmacy medicines
• Nighttime symptoms that wake you up
• Hoarse voice, cough, or sore throat that does not go away
• Trouble swallowing or painful swallowing

Diagnosis

Your doctor will ask about your symptoms, how often they happen, and what makes them better or worse. They may examine your chest and belly. For many people, the diagnosis can be made based on symptoms alone.

Tests that may be done

• Endoscopy — a thin, flexible tube with a camera is passed down your throat to look at your esophagus and stomach.
• pH monitoring — a small probe measures how much acid is in your esophagus over 24 hours.
• Esophageal manometry — a test that measures how well the muscles in your esophagus work.
• Barium swallow X-ray — you drink a chalky liquid that helps show the shape of your esophagus on X-ray.

What to expect at your appointment

You may be asked to keep a symptom diary and try lifestyle changes first. If needed, your doctor may refer you to a specialist for tests to look at your esophagus and confirm what is happening.

Treatment

Treatment aims to reduce symptoms, heal any damage, and prevent complications. It usually starts with lifestyle changes, then medicines that reduce stomach acid, and surgery is considered only for severe cases.

Self-care at home

• Eat smaller meals and avoid lying down for 2 to 3 hours after eating.
• Raise the head of your bed by 10 to 20 centimeters using blocks under the bedposts.
• Avoid foods and drinks that trigger your symptoms.
• Lose weight if a healthcare professional advises it.
• Stop smoking and avoid secondhand smoke.
• Wear loose clothing around your waist.
• Eat slowly and relax during meals.

Medical treatments

If lifestyle changes are not enough, doctors may recommend medicines that reduce or block stomach acid. These include antacids, H2 blockers, and proton pump inhibitors. Your doctor may suggest trying a short course and then review how you feel. Always ask your doctor or pharmacist before using any medicine, especially if you are pregnant, breastfeeding, or taking other medicines.

When is surgery considered?

Surgery is usually only considered when medicines do not control symptoms, when you cannot take long-term medicines, or if complications develop. A common operation wraps part of the stomach around the lower esophagus to tighten the valve. Your specialist will explain the options, benefits, and risks.

Living with this condition

For most people, GERD is a long-term condition to manage rather than fully cure. With daily habits and the right treatment, most people feel much better and can protect the esophagus from damage.

Lifestyle tips

• Plan regular meal times and eat in a relaxed setting.
• Keep a food diary to identify your personal triggers.
• Elevate the head of your bed and use a wedge pillow if needed.
• Manage stress with deep breathing, walks, or talking to someone you trust.
• Get enough sleep and try to keep a regular bedtime.

Diet and exercise

A balanced diet, smaller portions, and avoiding known triggers can reduce symptoms. Gentle exercise after meals helps with digestion and weight control, but avoid very vigorous exercise right after eating.

Mental health and emotional wellbeing

Living with persistent reflux can be uncomfortable and frustrating. It can affect sleep, eating, and social life. If you feel anxious, low, or tired, talk to your doctor or a counselor.

Prevention

You cannot always prevent acid reflux, but you can reduce how often and how badly it happens by keeping a healthy weight, avoiding triggers, eating smaller meals, and not lying down right after eating.

Vaccines

There is no vaccine for acid reflux or GERD.

Screening programmes

There is no routine screening for GERD. See your doctor if you have frequent symptoms so they can be checked and managed early.

Complications

If left untreated

• Long-term acid exposure can inflame or damage the esophagus, a condition called esophagitis.
• A narrowing of the esophagus, called a stricture, can make swallowing difficult.
• Barrett's esophagus — a change in the lining of the esophagus that needs monitoring because it slightly raises the risk of esophageal cancer.

Long-term outlook

With proper treatment and lifestyle changes, most people with GERD get good symptom relief and prevent serious complications. Some need long-term management, but life can be very normal.

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