Many people experiencing acid leaking up (refluxing) into the gullet (oesophagus) are diagnosed with ‘presumed acid reflux’. In this situation they have typical symptoms and the symptoms are eased by treatment. Tests might be advised if symptoms are severe, or do not improve with treatment, or are not typical of GORD.
The circular band of muscle (sphincter) at the bottom of the gullet (oesophagus) normally prevents acid leaking up (reflux). Problems occur if the sphincter does not work very well. This is common but in most cases it is not known why it does not work so well. In some cases the pressure in the stomach rises higher than the sphincter can withstand – for example, during pregnancy, after a large meal, or when bending forward.
Acid reflux can also create an unpleasant, sour taste in the mouth, bloating and a feeling of sickness, and bad breath. Heartburn can be described as a burning sensation in the middle of the chest, caused by stomach acid. Nissen Fundoplication Surgery – this procedure involves wrapping and stitching the top part of the stomach around the lower oesophagus to create a more effective and stronger sphincter to help prevent acid leaving the stomach. Proton-pump inhibitors, medication which works to reduce the amount of acid produced in the stomach, have always been the traditional choice of Âtreatment before surgery.
This often settles symptoms down and allows any inflammation in the gullet (oesophagus) to clear. After this, all that you may need is to go back to antacids ‘as required’ or to take a short course of an acid-suppressing medicine ‘as required’. If you have symptoms frequently then see a doctor. An acid-suppressing medicine will be advised. Two groups of acid-suppressing medicines are available – proton pump inhibitors (PPIs) and histamine receptor blockers (H2 blockers).
They may also ask you to fill in a questionnaire to rate how often and how badly your symptoms affect you. However, if even small amounts of reflux come all the way up into the pharynx and larynx, other problems can occur. This is because the tissue lining the larynx and pharynx is more sensitive to injury and irritation from stomach juices than the lining of the oesophagus. Damage to the larynx from stomach refluxate will affect a person’s voice and can sometimes affect their lungs and breathing.
Also see a doctor if heartburn comes alongside other symptoms such as food getting stuck in your throat, being sick frequently, or losing weight for no good reason. Antacids are medicines that neutralise the acid in the stomach and can quickly relieve heartburn and acid reflux for a few hours. People experience symptoms of GORD in a variety of ways.
PPIs are taken for life often, and are safe to take over a long time. Have your last meal of the day two to three hours before bedtime and avoid late night snacks if possible. This is because eating encourages the stomach to produce more acid.
For example, if you find that a PPI at full dose does not help your symptoms then you might benefit from seeing a specialist who can go into more detail about what can be done. Some people find particular foods give them more reflux than others – you need to experiment a bit to find what you should avoid. Little research has been done on the use of probiotics for reflux in adults but there is some suggestion they might be helpful in children and infants. Please note this is a generic GOSH information sheet so should not be used for the diagnosis or treatment of any medical condition.