acid reflux specialist tests overview

Overview

Acid reflux, also called gastro-oesophageal reflux disease (GORD), is a condition where stomach acid flows back up into the tube that connects your mouth to your stomach (the oesophagus). This can cause a burning feeling in your chest and other symptoms.

Yes, acid reflux is very common. About 1 in 5 people in the UK have it at some point.

It can affect anyone, but it is more common in people who are overweight, pregnant, or who smoke. It can also run in families.

Symptoms

Common symptoms

• A burning feeling in the chest (heartburn), often after eating or at night
• Regurgitation (bringing food or sour liquid back up into the mouth)
• A feeling of a lump in the throat
• Chest pain
• Chronic cough or hoarseness

Symptoms in children

• Frequent spitting up or vomiting
• Irritability or crying during or after feeding
• Poor weight gain
• Refusing food

Symptoms in older adults

• Chest pain that may be mistaken for heart disease
• Worsening asthma or chronic cough
• Difficulty swallowing (dysphagia)
• Hoarseness or voice changes

Causes

Main causes

• A weak or relaxed valve between the stomach and oesophagus (the lower oesophageal sphincter)
• A hiatal hernia – where part of the stomach moves up into the chest

Risk factors

• Being overweight or obese
• Pregnancy
• Smoking
• Drinking alcohol
• Eating large meals or lying down right after eating
• Certain foods and drinks (like spicy foods, fatty foods, chocolate, coffee, and citrus)

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above
• If you have trouble swallowing or pain when swallowing

Book a routine appointment if:

• If you have heartburn or regurgitation most days for a few weeks
• If over-the-counter remedies are not helping
• If you have other symptoms like chronic cough, hoarseness, or a feeling of a lump in your throat

Diagnosis

Your doctor will first ask about your symptoms and medical history. They may recommend one or more tests to confirm acid reflux and check for any damage to your oesophagus.

Tests that may be done

• Upper endoscopy (gastroscopy) – a thin, flexible tube with a camera is passed down your throat to see the lining of your oesophagus and stomach
• Ambulatory pH monitoring – a small device is placed in your oesophagus to measure how often acid comes up over 24 hours
• Oesophageal manometry – a tube measures the pressure and function of your oesophagus and the valve between your oesophagus and stomach
• Barium swallow – you drink a chalky liquid that shows up on X-rays, helping doctors see the shape and movement of your oesophagus and stomach

What to expect at your appointment

Most tests are done as an outpatient procedure, meaning you can go home the same day. For an endoscopy, you may be given a sedative to help you relax. Manometry and pH monitoring may involve a period of wearing a monitor. Your doctor will explain what to do to prepare, such as not eating for a few hours beforehand.

Treatment

Treatment for acid reflux usually starts with lifestyle changes and over-the-counter medicines. If these are not enough, your doctor may prescribe stronger medication. In rare cases, surgery may be an option.

Self-care at home

• Eat smaller meals more often
• Avoid trigger foods and drinks (spicy, fatty, acidic, caffeine, alcohol)
• Don't lie down for at least 2 to 3 hours after eating
• Elevate the head of your bed by about 6 to 8 inches
• Lose weight if you are overweight
• Stop smoking

Medical treatments

Medicines for acid reflux include antacids (neutralise stomach acid), H2 blockers (reduce acid production), and proton pump inhibitors (stop acid production more effectively). Your doctor or pharmacist can advise which type may be best for you. Always follow the recommended dose and course length.

When is surgery considered?

Surgery, such as fundoplication, may be considered if medication does not work well or you cannot take long-term medication. It involves tightening the valve between the stomach and oesophagus. Talk to your specialist about whether this is an option for you.

Living with this condition

Living with acid reflux often means paying attention to what you eat and how you eat. Many people find that small changes make a big difference. If you have symptoms at night, raising the head of your bed can help.

Lifestyle tips

• Keep a food diary to identify your personal triggers
• Wear loose-fitting clothes around your waist
• Try to manage stress, as it can make symptoms worse
• Stay upright after meals

Diet and exercise

A balanced diet low in fatty and spicy foods can help. Regular, moderate exercise can support weight management and reduce symptoms, but avoid vigorous exercise right after eating.

Mental health and emotional wellbeing

Living with a chronic condition like acid reflux can be frustrating and may cause anxiety, especially if symptoms interfere with sleep or social activities. It's important to talk to your doctor if you feel stressed or down.

Prevention

Not all cases can be prevented, but you can lower your risk by maintaining a healthy weight, eating a balanced diet, not smoking, and limiting alcohol and trigger foods.

Complications

If left untreated

• Oesophagitis – inflammation and damage to the lining of the oesophagus
• Strictures – narrowing of the oesophagus from scar tissue, causing difficulty swallowing
• Barrett's oesophagus – changes to the cells lining the oesophagus that can increase the risk of oesophageal cancer

Long-term outlook

For most people, acid reflux can be managed effectively with lifestyle changes and medication. With proper treatment, complications are rare. Regular check-ups with your doctor can help catch any changes early. The outlook is generally very good.

Find support

International organisations

• International Foundation for Gastrointestinal Disorders (IFFGD)

Local organisations

• Your local health service or NHS UK · UK

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