acid reflux ultrasound explained

Overview

Acid reflux happens when stomach acid flows back up into your food pipe (the oesophagus). This can cause heartburn and other symptoms. An ultrasound is a scan that uses sound waves to create pictures of the inside of your body. For acid reflux, an ultrasound is sometimes used to look for a hiatal hernia (where part of the stomach pushes up into the chest) or to check the valve between your stomach and food pipe. However, ultrasound is not the main test for acid reflux – doctors usually diagnose it based on your symptoms and other tests first.

Yes, acid reflux is extremely common. Many people have occasional heartburn, and about 1 in 5 adults experience it at least once a week.

Acid reflux can affect people of all ages, but it is more common in adults over 40, people who are overweight, pregnant women, and those who smoke or drink alcohol regularly. It can also affect children, especially infants.

Symptoms

Common symptoms

• A burning feeling in the chest (heartburn), often after eating or at night
• Regurgitation – a sour or bitter-tasting fluid coming up into the throat or mouth
• Difficulty swallowing or a feeling of a lump in the throat
• Chronic cough, hoarseness, or sore throat
• Chest pain that is not related to the heart

Symptoms in children

• Frequent spitting up or vomiting
• Irritability, especially after feeding
• Poor feeding or refusal to eat
• Coughing or wheezing
• Not gaining weight as expected

Symptoms in older adults

• Less obvious heartburn – sometimes just a vague chest discomfort
• Difficulty swallowing or feeling like food gets stuck
• Chronic cough or hoarseness
• Aspiration (food or liquid going into the lungs), which can cause pneumonia

Causes

Main causes

• A weak or relaxed lower oesophageal sphincter (the ring of muscle between your stomach and food pipe) that allows acid to flow back up
• A hiatal hernia, which can make it easier for acid to reflux
• Increased pressure on the stomach from obesity, pregnancy, or bending forward after eating

Risk factors

• Being overweight or obese
• Pregnancy
• Smoking or exposure to secondhand smoke
• Drinking alcohol
• Eating large meals, especially late at night
• Eating trigger foods like spicy, fatty, or acidic foods, chocolate, caffeine, and peppermint
• Lying down soon after eating
• Certain medications (talk to your doctor about any you take)

When to see a doctor

See a doctor urgently if:

• If you have chest pain that concerns you – call emergency services immediately
• If you have trouble swallowing or pain when swallowing
• If you vomit blood or have black stools

Book a routine appointment if:

• If you have heartburn two or more times a week
• If over-the-counter antacids do not help
• If your symptoms are severe or interfering with daily life
• If you have had reflux for a long time and it is getting worse

Diagnosis

Doctors usually diagnose acid reflux by asking about your symptoms and doing a physical exam. They may also recommend tests to confirm the diagnosis or rule out other conditions. An ultrasound is not a routine test for acid reflux, but it may be used if a hiatal hernia is suspected or if your doctor wants to look at the structure of your upper abdomen.

Tests that may be done

• Symptom review and physical exam – the first step
• Endoscopy – a thin, flexible tube with a camera is passed down your throat to look at your food pipe and stomach
• pH monitoring – a small device measures how much acid is in your food pipe over 24 hours
• Barium swallow – you drink a chalky liquid and X-rays show if it flows back up
• Ultrasound – used in some cases to check for a hiatal hernia or to look at the valve between your stomach and food pipe

What to expect at your appointment

If your doctor recommends an ultrasound, it is a simple, painless test. You will lie on a table, and a gel will be spread on your belly. A small handheld device (a transducer) will be moved over your skin to create images. The test usually takes 15–30 minutes. You may be asked not to eat or drink for a few hours beforehand. Afterward, you can go back to your normal activities.

Treatment

Treatment for acid reflux focuses on reducing symptoms and preventing damage to your food pipe. It often starts with lifestyle changes and over-the-counter remedies. If those are not enough, your doctor may recommend prescription medicines or, in rare cases, surgery. Remember, always talk to a healthcare professional before starting any treatment.

Self-care at home

• Eat smaller, more frequent meals instead of large ones
• Avoid lying down for at least 2–3 hours after eating
• Raise the head of your bed by 15–20 cm (6–8 inches) using blocks or a wedge pillow
• Avoid foods that trigger your symptoms, such as spicy, fatty, or acidic foods
• Lose weight if you are overweight
• Quit smoking and limit alcohol
• Wear loose clothing around your waist

Medical treatments

If lifestyle changes aren't enough, doctors may recommend medications that reduce stomach acid, such as antacids, H2 blockers, or proton pump inhibitors (PPIs). These come as tablets, liquids, or capsules. Your doctor will decide which type and strength is safest for you. Do not take these for longer than recommended without medical advice. In some cases, a doctor may prescribe a medicine that helps strengthen the lower oesophageal sphincter.

When is surgery considered?

Surgery is rarely needed. It may be considered if medicines do not control your symptoms, if you have severe damage to your food pipe, or if you have a large hiatal hernia. The most common procedure is called fundoplication, where the top of the stomach is wrapped around the lower part of the food pipe to prevent reflux. Talk to your doctor about whether surgery might be right for you.

Living with this condition

Living with acid reflux means managing your symptoms day by day. Most people find that simple changes in eating habits, sleep position, and stress management make a big difference. It may take some trial and error to find what works for you. Keep a diary of your symptoms and triggers – this can help you and your doctor adjust your plan.

Lifestyle tips

• Eat slowly and chew your food well
• Avoid eating within 3 hours of bedtime
• Stay upright after meals – walking gently can help
• Manage stress with activities like deep breathing, yoga, or talking to a friend
• If you smoke, ask your doctor for help quitting
• Limit caffeinated drinks, alcohol, and carbonated beverages

Diet and exercise

A balanced diet can help control reflux. Avoid trigger foods like spicy dishes, citrus fruits, tomatoes, onions, garlic, chocolate, and high-fat meals. Instead, focus on lean proteins (chicken, fish), whole grains, and non-citrus fruits and vegetables. Exercise is good for overall health and weight management, but avoid vigorous exercise right after eating. Gentle walking or stretching is fine.

Mental health and emotional wellbeing

Living with chronic acid reflux can be frustrating and stressful. It may affect your sleep, your enjoyment of meals, and your social life. Some people feel anxious about symptoms like chest pain. It is normal to feel this way. If you notice that worries about reflux are making you anxious or sad, talk to your doctor. They can recommend support groups or counselling. Taking care of your mental health is just as important as physical care.

Prevention

You cannot always prevent acid reflux, but you can reduce your risk by maintaining a healthy weight, not smoking, limiting alcohol, and eating a balanced diet. Avoiding large meals and not lying down right after eating also helps. For some people, preventing flare-ups is about knowing their triggers and avoiding them.

Screening programmes

There is no routine screening test for acid reflux. If you have ongoing symptoms, see your doctor for an assessment. If you have risk factors like obesity or a family history of hiatal hernia, your doctor may check for it during a routine visit.

Complications

If left untreated

• Oesophagitis – inflammation and irritation of your food pipe
• Stricture – narrowing of the food pipe due to scarring, making swallowing difficult
• Barrett's oesophagus – changes in the lining of the food pipe that can rarely lead to cancer
• Dental problems – acid can damage tooth enamel
• Chronic cough or asthma flare-ups from acid irritating the airways

Long-term outlook

For most people, acid reflux can be managed well with lifestyle changes and treatment. Serious complications are uncommon, especially if you see a doctor early and follow their advice. If you have Barrett's oesophagus, your doctor will monitor it regularly. Even then, the risk of cancer is very low. With proper care, most people with acid reflux live a normal, healthy life.

Find support

International organisations

• NHS – Acid Reflux and GORD ↗
• Mayo Clinic – GERD ↗

Local organisations

• Your local GP surgery or health centre · Global

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