What is reflux?
Reflux, also known as acid reflux or gastro-oesophageal reflux, occurs when stomach contents rise into the oesophagus, causing a burning sensation or discomfort in the chest. When reflux leads to troublesome symptoms or complications, it is called gastro-oesophageal reflux disease (GORD or GERD).
Typical symptoms include heartburn and acid regurgitation. Heartburn is discomfort or pain rising from the lower chest to the neck, often after eating or lying down. Regurgitation is the rise of food or fluid into the throat or mouth. Not everyone with GORD has symptoms.
Regular reflux can be distressing and may require treatment. Other possible symptoms include tooth decay, persistent cough, sore throat, chest pain, and disturbed sleep. Long-term reflux can cause complications such as a narrowed oesophagus, swallowing difficulties, or, rarely, oesophageal cancer.
If you have any of these concerning features, or if medication doesn’t work well, you should speak with your doctor about having a test called a ‘gastroscopy’ or ‘endoscopy’.
What causes reflux symptoms?
Reflux is typically caused by a weakness in the lower esophageal sphincter, which normally keeps food and acid in the stomach. Contributing factors include higher abdominal pressure from being overweight or obese, pregnancy, or having a hiatus hernia. Weight loss surgeries can also lead to reflux.
Certain foods and habits can exacerbate symptoms, such as fatty foods, chocolate, coffee, alcohol, cola drinks, peppermint, large meals, and smoking. Symptoms can be managed by avoiding trigger foods, not eating before bed, having smaller meals, raising the head of the bed, sleeping on the left side, losing weight, and wearing loose clothing.
Do I Need Any Tests for Reflux?
Reflux disease is usually diagnosed based on symptoms, and treatment is often prescribed without special tests. However, if you experience weight loss, difficulty or pain in swallowing, or vomiting blood, special tests are needed.
In such cases, or if medication is ineffective, a gastroscopy (endoscopy) may be recommended. This procedure uses a flexible tube to examine the oesophagus and stomach for inflammation, ulcers, or narrowing, and may involve taking small biopsy samples. Further tests to assess esophageal muscles or acid reflux duration are rare but may be necessary based on initial findings.
How is reflux treated?
Reflux treatment depends on symptom severity and frequency. For mild or occasional symptoms, lifestyle changes (diet, weight loss) and antacids can be effective. More severe symptoms may require medications like proton pump inhibitors or histamine receptor antagonists, which reduce stomach acid. Over-the-counter medications are available for occasional symptoms, but persistent symptoms should be evaluated by a doctor. Prescription medications are available on the PBS, often starting with proton pump inhibitors. Treatment is best when combined with lifestyle changes, especially weight loss.
– Source GESA: https://www.gesa.org.au/resources/patient-resources/