Acid Reflux and Heartburn

Discover the diagnosis, symptoms and causes of acid reflux and heartburn, along with how to manage the effects of these conditions.

What is Acid Reflux And Heartburn?

Acid reflux is a condition where stomach acid leaks back up into the oesophagus, the tube that carries food from your mouth to your stomach. This backflow, known as reflux, can irritate the oesophagus, causing the uncomfortable burning sensation in your chest called heartburn, along with other symptoms.

Acid reflux can sometimes cause esophagitis. Esophagitis is the inflammation of the oesophageal lining caused by prolonged exposure to stomach acid.

The oesophageal lining can handle a certain amount of acid. However, some people have a more sensitive lining and prone to symptoms with minimal reflux. Others may have higher acid levels but experience no discomfort or esophagitis.

Understanding GORD

Gastroesophageal reflux disease (GORD) is a broader term that covers the full range of this condition, including acid reflux with or without esophagitis or other symptoms.

Symptoms

Our highly experienced GPs understand and recognise the symptoms of acid reflux.

Heartburn is the the hallmark symptom of acid reflux. This is a burning chest pain that typically worsens after meals or when you lie down. Other common symptoms are:

• Severe chest pain (rare) – Can mimic a heart attack, requiring prompt medical attention.
• Upper abdominal and chest pain
• Nausea
• Acidic taste in the mouth
• Bloating
• Belching
• Difficulty swallowing (dysphagia)
• Persistent cough, especially at night
• Hoarseness
• Feeling of a lump in the throat (rare)

Causes

A muscular ring called the lower oesophageal sphincter (LES) acts as a valve at the base of the oesophagus, normally preventing acid from leaking back up. When the LES weakens or malfunctions, it allows acid to flow upwards, triggering the symptoms of GORD.

Several factors can contribute to LES dysfunction and the development of GORD:

Dietary and Lifestyle Factors: Consumption of certain foods (spicy, fatty, acidic), excessive caffeine or alcohol intake, and smoking can all weaken the LES or increase stomach acid production.

Structural Abnormalities: Hiatal hernia, where part of the stomach pushes through the diaphragm, can weaken the LES.

Increased Intra-abdominal Pressure: Obesity, pregnancy, or tight-fitting clothing can elevate pressure within the abdomen, pushing stomach contents upwards.

Diagnosis

Our private GP will give you a comprehensive and accurate diagnosis from your symptoms. An evaluation of GORD often includes:

• A Detailed Medical History: A thorough discussion of symptoms, dietary habits, and medication use can provide valuable clues.
• Physical Examination:  This may reveal signs suggestive of GORD complications.
• Diagnostic Tests: While not always necessary, upper endoscopy and oesophageal pH monitoring can offer definitive confirmation of GORD and assess the severity of oesophageal damage.

Management Strategies

GORD management aims to alleviate symptoms, prevent complications, and improve overall quality of life. Treatment approaches typically fall into these categories:

Lifestyle Modifications: Recommended initial steps include weight management, dietary adjustments (avoiding trigger foods), smoking cessation, and elevating the head of the bed during sleep.

Pharmacotherapy: Several medication classes are employed:

• Antacids: Provide rapid relief for occasional heartburn but have limited long-term efficacy.
• Histamine receptor blockers (H2 blockers): Reduce stomach acid production.
• Proton pump inhibitors (PPIs): Considered the most effective medication for GORD, significantly suppressing acid secretion.
• Surgery: In severe cases where medications fail to control symptoms, minimally invasive surgical procedures to strengthen the LES may be considered.

Complications of Untreated GORD

Left untreated or inadequately managed, GORD can lead to the following complications:

• Oesophageal ulcers: Open sores in the oesophageal lining caused by chronic acid exposure.
• Oesophageal stricture: Narrowing of the oesophagus due to scarring from inflammation.
• Barrett’s oesophagus: A precancerous condition characterized by abnormal cell growth in the oesophagus.
• Oesophageal adenocarcinoma: A type of oesophageal cancer that can develop from Barrett’s oesophagus.

Taking Charge of Your Reflux

By understanding acid reflux and the treatment options available, you can work with our GP to develop a management plan that effectively addresses your symptoms and helps you prevent complications. Early diagnosis and proper treatment are crucial for maintaining a healthy oesophagus and overall well-being.

Dietary Guidelines for a Heartburn-Free Life

While medications can play a significant role in managing acid reflux, what you put on your plate can significantly impact your symptoms. Here are some dietary tips to keep heartburn at bay:

• Identify and Avoid Trigger Foods: Common culprits include spicy, fatty, and acidic foods like tomatoes, citrus fruits, and processed foods. Chocolate, peppermint, and coffee can also worsen reflux for some individuals. Pay attention to how your body reacts to different foods and eliminate or limit those that trigger symptoms.
• Embrace Smaller, More Frequent Meals: Overeating stretches the stomach, putting pressure on the LES and increasing the likelihood of reflux. Opt for smaller portions spread throughout the day to minimize stomach distension.
• Mind Your Timing: Avoid eating large meals close to bedtime. Allow at least 2-3 hours for digestion before lying down. This gives your stomach time to empty its contents and reduces the risk of acid reflux while you sleep.
• Chew Thoroughly: Proper chewing breaks down food into smaller particles, making it easier to digest and reducing strain on the stomach.

Lifestyle Changes for a Reflux-Friendly Routine

In addition to dietary modifications, incorporating these lifestyle changes can provide significant relief from acid reflux symptoms:

• Maintain a Healthy Weight: Excess weight puts extra pressure on your abdomen, pushing stomach contents upwards. Losing weight, even a moderate amount, can significantly improve reflux symptoms.
• Elevate Your Head During Sleep: Prop up the head of your bed by 6-8 inches using pillows or bed wedges. This helps keep stomach acid where it belongs, reducing the chance of nighttime reflux.
• Manage Stress: Stress can exacerbate acid reflux symptoms. Relaxation techniques like deep breathing exercises, meditation, or yoga can help manage stress and potentially reduce heartburn.
• Quit Smoking: Smoking weakens the LES and irritates the oesophageal lining, worsening reflux. Kicking the habit can significantly improve your overall health and reduce acid reflux symptoms.

Our Aylesbury team is here to discuss your needs and support your future health.

Arranging To Visit A Private GP

To discuss any issues related to acid reflux and heartburn make an appointment with one of our private GPs. Appointments are available to everyone and can often be booked for the same day. There is no need to be registered with our Buckinghamshire hospital, or live locally.

Should you have insurance which covers a GP visit, we can in most cases invoice. Where you are paying directly, the cost for a 30 minute consultation is £125.

Any additional costs will always be discussed. They could apply if you are referred for an MRI scan, or to a consultant, or for other agreed decisions to support your health.

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