acid reflux screening test preparation

Overview

Acid reflux, also called gastro-oesophageal reflux disease (GORD) when it happens often, is when stomach acid flows back up into the tube that connects your mouth to your stomach (the oesophagus). Screening tests for acid reflux are medical checks to see if you have this condition and how severe it is. Preparing properly for these tests helps make sure the results are accurate.

Yes, acid reflux is very common. Many people experience it now and then. When it happens regularly, it may be diagnosed as GORD, which affects around 1 in 5 adults in the UK.

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

Symptoms

Common symptoms

• A burning feeling in the chest (heartburn), often after eating or at night
• A sour or bitter taste in the mouth
• Feeling like food is stuck in your throat
• Coughing or hoarseness, especially when lying down

Symptoms in children

• Irritability or crying after meals
• Poor feeding or refusing to eat
• Frequent vomiting
• Coughing or wheezing that won’t go away

Symptoms in older adults

• Heartburn that is less intense but more frequent
• Difficulty swallowing or feeling that food gets stuck
• Chest pain that is not related to the heart
• Worsening asthma symptoms or chronic cough

Causes

Main causes

• A weak or relaxed valve (sphincter) between the stomach and oesophagus allows stomach acid to flow back up
• A hiatal hernia, where part of the stomach pushes up into the chest
• Delayed stomach emptying

Risk factors

• Being overweight or obese
• Pregnancy
• Smoking
• Eating large meals or lying down right after eating
• Certain foods and drinks like spicy food, chocolate, caffeine, alcohol, and fatty meals
• Some medicines (talk to your doctor before stopping any prescribed medication)

When to see a doctor

See a doctor urgently if:

• You have difficulty swallowing or pain when swallowing
• You are losing weight without trying
• You have vomiting that does not stop
• You have had heartburn for more than 3 weeks despite self-care

Book a routine appointment if:

• You have heartburn or reflux symptoms that happen more than twice a week
• Over-the-counter remedies are not helping you feel better
• Your symptoms wake you up at night often

Diagnosis

Your doctor will first ask about your symptoms and medical history. If they suspect acid reflux, they may recommend a screening test to confirm the diagnosis or check for damage. The results help decide the best treatment plan for you.

Tests that may be done

• Endoscopy (also called gastroscopy): A thin, flexible tube with a camera is passed down your throat to look at the lining of your oesophagus and stomach.
• pH monitoring: A small tube or capsule is placed in your oesophagus to measure how much acid comes up over 24 to 48 hours.
• Barium swallow: You drink a chalky liquid that coats your digestive tract, and X-rays are taken to show any problems.
• Oesophageal manometry: A thin tube measures the strength and coordination of your oesophageal muscles.

What to expect at your appointment

Preparation depends on which test you are having. For an endoscopy, you will usually be asked to not eat or drink for 6 to 8 hours beforehand. For pH monitoring, you may need to stop taking certain acid-reducing medicines for a few days. Your doctor or nurse will give you clear instructions. The tests are generally safe, and you can go home the same day. You may have a sore throat or mild bloating afterwards, but this usually passes quickly.

Treatment

Treatment for acid reflux aims to reduce symptoms, heal any damage to the oesophagus, and prevent complications. It usually starts with lifestyle changes and may include medicines that reduce stomach acid or help the stomach empty faster. In some cases, surgery can be considered.

Self-care at home

• Eat smaller, more frequent meals instead of large ones
• Avoid lying down for at least 2 to 3 hours after eating
• Raise the head of your bed by 15 to 20 centimetres (use extra pillows or a wedge)
• Avoid foods and drinks that trigger your symptoms, such as fatty foods, chocolate, coffee, and alcohol
• If you are overweight, losing even a small amount of weight can help

Medical treatments

Doctors often start with medicines that reduce stomach acid, such as antacids for quick relief or stronger acid-suppressing medicines for longer control. These are available over the counter or on prescription. Your doctor will recommend the one that is right for you. Do not take more than the recommended dose. If medicines do not help, your doctor may refer you for further tests or to a specialist.

When is surgery considered?

Surgery may be an option if medicines do not work well or if you cannot take them long-term. The most common procedure is called fundoplication, which tightens the valve at the top of the stomach. This is usually only considered after other treatments have been tried. Your specialist will explain the risks and benefits.

Living with this condition

Living with acid reflux means managing your symptoms every day. Many people find that small changes in what and how they eat make a big difference. Keeping a diary of when symptoms happen can help you and your doctor find patterns and triggers. It is important to follow your treatment plan and to prepare properly for any screening tests your doctor recommends.

Lifestyle tips

• Eat slowly and chew your food well
• Avoid tight clothing around your waist
• Try to maintain a healthy weight
• Quit smoking if you smoke
• Limit alcohol, especially before bedtime

Diet and exercise

A balanced diet with plenty of fruits, vegetables, and whole grains is good for overall health. Avoid foods that cause your symptoms, such as spicy dishes, citrus fruits, onions, and high-fat meals. Gentle exercise like walking after meals can help digestion, but avoid vigorous activity right after eating. If you have reflux, talk to your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Living with a chronic condition like acid reflux can be stressful. Worrying about symptoms or discomfort may affect your sleep and mood. It is important to talk to your doctor or a counsellor if you feel anxious or down. Managing stress with relaxation techniques like deep breathing or mindfulness can also help reduce reflux triggers.

Prevention

You cannot always prevent acid reflux, but you can lower your chances by maintaining a healthy weight, not smoking, and avoiding large meals late at night. Making these changes can help reduce how often and how severe your reflux is.

Screening programmes

There is no standard screening for acid reflux in people without symptoms. If you have risk factors or a family history of conditions like Barrett’s oesophagus, your doctor may suggest regular checks. Early diagnosis through proper tests can help prevent complications. Preparing correctly for these tests is key to getting accurate results.

Complications

If left untreated

• Oesophagitis – inflammation and swelling of the oesophagus lining
• Stricture – narrowing of the oesophagus that can make swallowing difficult
• Barrett’s oesophagus – changes in the cells of the oesophagus that can increase the risk of cancer
• Chronic cough or asthma symptoms

Long-term outlook

For most people, acid reflux can be well controlled with lifestyle changes and medicine. Even if you have long-standing reflux, treatment can relieve symptoms and prevent damage. Regular check-ups and following your doctor’s advice help keep your oesophagus healthy. Serious complications are rare, and catching them early through screening tests gives the best chance for successful management.

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