acid reflux procedure preparation

Overview

Acid reflux happens when stomach acid flows back into the tube connecting your mouth and stomach (the oesophagus). This can cause heartburn and other symptoms. Sometimes, when lifestyle changes and medicines don't help enough, a doctor may suggest a procedure to strengthen the valve that keeps stomach acid from coming up. This article explains how to prepare for such a procedure.

Acid reflux is very common. Many people experience occasional heartburn. Frequent reflux that needs a procedure is less common but still affects many.

It can affect adults of all ages, and sometimes children. People who are overweight, pregnant, or have a hiatal hernia (a condition where part of the stomach moves up into the chest) are more likely to have severe reflux that may require a procedure.

Symptoms

Common symptoms

• Heartburn (a burning feeling in the chest)
• Regurgitation (food or sour liquid coming back up into the throat)
• Difficulty swallowing or a feeling that food is stuck
• Chronic cough, hoarseness, or sore throat
• Feeling of a lump in the throat

Symptoms in children

• Spitting up frequently
• Irritability, especially after eating
• Poor weight gain or refusing to eat
• Wheezing or recurrent pneumonia

Symptoms in older adults

• Heartburn may be less noticeable; instead, symptoms like chest pain, difficulty swallowing, or weight loss may occur
• More likely to have complications such as oesophagitis (inflammation of the oesophagus) or Barrett's oesophagus (changes to the cells lining the oesophagus)

Causes

Main causes

• Weak lower oesophageal sphincter (the muscle valve that keeps stomach acid from flowing back up)
• Hiatal hernia (part of the stomach moves up through the diaphragm into the chest)
• Increased pressure on the stomach from obesity, pregnancy, or certain activities
• Certain foods and drinks that relax the valve, like fatty foods, chocolate, caffeine, and alcohol

Risk factors

• Obesity
• Pregnancy
• Smoking
• Hiatal hernia
• Connective tissue disorders such as scleroderma
• Delayed stomach emptying (gastroparesis)

When to see a doctor

See a doctor urgently if:

• Severe chest pain or pressure (call emergency services)
• Vomiting blood
• Black or bloody stools
• Difficulty swallowing that gets worse

Book a routine appointment if:

• Frequent heartburn (more than twice a week)
• Symptoms that interfere with your daily life or sleep
• Heartburn that persists despite using over-the-counter medicines for more than two weeks
• Hoarseness, cough, or sore throat that won't go away

Diagnosis

Your doctor will typically start by asking about your symptoms and doing a physical exam. If they suspect acid reflux, they may recommend tests to confirm the diagnosis and check for any damage to your oesophagus.

Tests that may be done

• Upper endoscopy (a thin, flexible tube with a camera is passed down your throat to look at your oesophagus and stomach)
• Ambulatory pH monitoring (a small device measures how much acid is in your oesophagus over 24 hours)
• Oesophageal manometry (measures the muscle contractions in your oesophagus)
• Barium swallow X-ray (you drink a chalky liquid that shows on X-rays as it moves through your digestive tract)

What to expect at your appointment

If a procedure is recommended, your doctor will explain the specific type and what you need to do to prepare. This often includes stopping certain medicines, not eating or drinking for a period before the procedure, and arranging for someone to drive you home afterwards.

Treatment

Treatment for acid reflux often starts with lifestyle changes and medications. If these don't control your symptoms or if complications develop, a procedure may be considered. Preparing for a procedure involves steps to ensure it is safe and to improve outcomes.

Self-care at home

• Avoid foods that trigger your heartburn, such as fatty or spicy foods, chocolate, caffeine, and alcohol
• Eat smaller, more frequent meals and avoid eating within 2–3 hours of bedtime
• Lose weight if you are overweight
• Elevate the head of your bed by about 6–8 inches using blocks or a wedge pillow
• Stop smoking

Medical treatments

Your doctor may recommend medications that reduce stomach acid or help strengthen the lower oesophageal sphincter. These are often taken for some time. Before a procedure, you may be asked to stop or adjust some of these medicines. Always follow your doctor’s instructions about any medication changes.

When is surgery considered?

Surgery for acid reflux, such as a procedure to tighten the valve (fundoplication) or implant a magnetic ring (LINX device), is usually considered when other treatments have not worked or if you have complications like severe oesophagitis or Barrett's oesophagus. Preparing for surgery often includes a special diet, stopping certain medicines, and possibly a bowel preparation if needed. Your surgical team will give you detailed instructions.

Living with this condition

Living with acid reflux can be challenging, but most people manage well with lifestyle changes and treatment. After a successful procedure, many people find long-term relief from their symptoms.

Lifestyle tips

• Maintain a healthy weight
• Avoid your personal trigger foods
• Eat smaller meals throughout the day
• Don't lie down right after eating
• Wear loose-fitting clothing around your waist

Diet and exercise

A balanced diet low in fatty, spicy, and acidic foods can help reduce reflux symptoms. Gentle exercise like walking aids digestion and weight management. Avoid vigorous exercise right after meals, as it can increase stomach pressure.

Mental health and emotional wellbeing

Living with chronic reflux can cause stress, anxiety, or embarrassment. It's important to talk to your doctor or a counsellor if you feel overwhelmed. Taking care of your mental health is part of managing your overall well-being.

Prevention

Not all acid reflux can be prevented, but you can lower your risk by maintaining a healthy weight, avoiding known trigger foods, not smoking, and eating smaller meals. These steps can also help keep symptoms from getting worse.

Complications

If left untreated

• Oesophagitis (inflammation and damage to the lining of the oesophagus)
• Stricture (narrowing of the oesophagus that makes swallowing difficult)
• Barrett's oesophagus (changes to the cells in the lower oesophagus that can increase the risk of oesophageal cancer)
• Respiratory problems such as asthma, chronic cough, or pneumonia from stomach acid entering the lungs

Long-term outlook

With proper treatment, including lifestyle changes, medications, or a procedure when needed, most people with acid reflux manage their symptoms well. Procedures are generally safe and effective, often providing long-term improvement. Your doctor will work with you to find the best approach for your situation.

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