long lasting acid reflux

Overview

Long-lasting acid reflux, also called chronic gastroesophageal reflux disease (GERD), is a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (the esophagus). This can irritate the lining of the esophagus and cause discomfort.

Yes, it's very common. Millions of people around the world experience chronic acid reflux at some point in their lives.

It can affect people of all ages, but it is more common in adults over 40, people who are overweight, and those who smoke or drink alcohol. Pregnant women also often experience it.

Symptoms

Common symptoms

• Heartburn – a burning feeling in your chest, often after eating or at night
• Regurgitation – a sour or bitter taste in your mouth or throat
• Difficulty or pain when swallowing
• A feeling of a lump in your throat
• Chronic cough or sore throat
• Hoarseness or loss of voice

Symptoms in children

• Frequent vomiting or spitting up
• Irritability or crying during or after feeding
• Poor weight gain or refusing to eat
• Coughing or wheezing that doesn't go away

Symptoms in older adults

• Less obvious heartburn but more frequent throat clearing or coughing
• Difficulty swallowing or feeling food gets stuck
• Chest pain that may be mistaken for heart problems
• Hoarseness or voice changes

Causes

Main causes

• Weakened lower esophageal sphincter (the muscle that keeps stomach contents from flowing back)
• Hiatal hernia – when part of the stomach pushes up into the chest
• Excessive production of stomach acid or slow stomach emptying

Risk factors

• Being overweight or obese
• Pregnancy
• Smoking or inhaling secondhand smoke
• Eating large meals or lying down right after eating
• Consuming fatty, spicy, or acidic foods, or drinking alcohol or caffeine
• Certain medications (like some pain relievers or blood pressure drugs)

When to see a doctor

See a doctor urgently if:

• If you have chest pain that feels like a heart attack, call your local emergency number immediately.
• If you have trouble swallowing or pain with swallowing that doesn't go away in a few days, see a doctor urgently.
• If you vomit blood or have black stools, seek same-day medical care.

Book a routine appointment if:

• If you have heartburn or regurgitation two or more times a week, make an appointment.
• If over-the-counter antacids don't help after two weeks, talk to your doctor.
• If you have a chronic cough or hoarseness that doesn't go away.
• If you have difficulty swallowing that comes and goes.

Diagnosis

A doctor will listen to your symptoms and ask about your medical history. They may also try a treatment first to see if it helps. If needed, they'll recommend tests to confirm the diagnosis.

Tests that may be done

• Upper endoscopy – a thin tube with a camera is put down your throat to see your esophagus and stomach
• Ambulatory pH monitoring – a small device measures acid levels in your esophagus over 24 hours
• Esophageal manometry – measures the muscle contractions in your esophagus
• Barium swallow – you drink a chalky liquid and X-rays show the shape of your upper digestive tract

What to expect at your appointment

Most tests are quick and done as an outpatient. You may have mild discomfort but usually no major pain. Your doctor will explain each step and what you need to do to prepare, like fasting before the test.

Treatment

Treatment for long-lasting acid reflux usually starts with lifestyle changes and over-the-counter medicines. If those don't work, your doctor may recommend prescription medicines or, in rare cases, surgery. The goal is to control symptoms, heal the esophagus, and prevent complications.

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) with blocks or a wedge pillow.
• Avoid foods that trigger your symptoms, like fatty or spicy foods, citrus, tomato sauce, chocolate, and caffeine.
• Quit smoking and limit alcohol.
• Lose weight if you are overweight.

Medical treatments

Your doctor may recommend medicines that reduce stomach acid, such as proton pump inhibitors (PPIs) or H2 blockers. These are available in stronger prescription forms. They may also suggest antacids or alginates for quick relief. Always use medicines as directed and talk to your doctor about the best option for you.

When is surgery considered?

Surgery is rarely needed. It may be considered if medicines don't help or if you have severe complications like a hiatal hernia that causes symptoms. The most common procedure is called fundoplication, where the top of the stomach is wrapped around the lower esophagus to strengthen the valve.

Living with this condition

Living with long-lasting acid reflux means paying attention to what you eat, when you eat, and how you sleep. It can be frustrating at first, but most people learn to manage it well with small changes and regular check-ins with their doctor.

Lifestyle tips

• Keep a food diary to identify your triggers.
• Wear loose-fitting clothing around your waist.
• Don't exercise right after eating.
• Chew gum after meals to increase saliva, which can neutralize acid.
• Elevate the head of your bed.

Diet and exercise

A balanced diet with plenty of fruits, vegetables, lean proteins, and whole grains can help. Avoid high-fat meals and large portions. Gentle exercise like walking can improve digestion, but avoid heavy lifting or bending right after meals.

Mental health and emotional wellbeing

Chronic heartburn can be stressful and affect your sleep, mood, and daily life. It's normal to feel frustrated or anxious. Talk to your doctor if it's affecting your mental health – they can offer support or refer you to a counselor.

Prevention

You can't always prevent long-lasting acid reflux, but you can lower your risk by maintaining a healthy weight, not smoking, eating small meals, and avoiding trigger foods. Managing stress and staying active also help.

Complications

If left untreated

• Esophagitis – inflammation, irritation, or sores in the esophagus
• Stricture – narrowing of the esophagus that makes swallowing difficult
• Barrett's esophagus – changes in the cells of the esophagus that can lead to cancer
• Chronic cough, asthma, or laryngitis from acid reaching the throat or lungs

Long-term outlook

With proper management, most people with long-lasting acid reflux lead normal lives and avoid serious complications. Treatment works well for the majority, and surgery can help when needed. It's important to follow your doctor's advice and have regular check-ups to keep your esophagus healthy.

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