If you've ever felt a burning sensation in your chest or had a sour taste in your mouth after eating, you might be familiar with reflux, or gastro-oesophageal reflux disease (GORD). This common condition affects millions of people around the world, and while the symptoms can range from mild discomfort to severe pain, the good news is that it’s treatable. In this blog post, we’ll explain what reflux is, its symptoms, the causes behind it, and the various treatment options, including diet, medications, and surgery.

What is Reflux?

Reflux occurs when stomach acid or content flows back into the oesophagus, the tube that carries food from your mouth to your stomach. Normally, a valve-like structure called the lower oesophageal sphincter (LES) keeps food and acid in the stomach. However, if the LES relaxes or weakens, acid can escape and travel upwards, causing irritation and inflammation in the oesophagus.

When this happens frequently or over an extended period of time, it leads to gastro-oesophageal reflux disease (GORD), a chronic condition that can cause complications if left untreated.

What Are the Symptoms of Reflux?

The symptoms of reflux can vary widely, but the most common signs include:

• Heartburn: A burning sensation in your chest, usually after eating, that may worsen when lying down or bending over.

• Regurgitation: The feeling of acid or food coming back up into your mouth, which may leave a sour or bitter taste.

• Chest pain: A sensation of discomfort or pain in the chest, which may sometimes be mistaken for heart-related issues.

• Difficulty swallowing: A sensation of food getting stuck or a feeling of tightness in the throat.

• Chronic cough or hoarseness: Especially in the mornings or after eating, due to acid irritating the throat.

• Sore throat: A frequent sore throat or the sensation of something stuck in the throat.

If you experience these symptoms frequently or they disrupt your daily activities, it may indicate GORD, and you should consult a healthcare professional for advice.

What Are the Causes of Reflux?

There are several reasons why reflux might occur. Some of the most common causes include:

1. Weak Lower Oesophageal Sphincter (LES): The LES is a muscle that normally opens to allow food into the stomach and closes to keep food and acid inside. If the LES is weak or relaxes inappropriately, stomach acid can flow back into the oesophagus.

2. Hiatus Hernia: This condition occurs when part of the stomach pushes up through the diaphragm into the chest cavity. A hiatus hernia can disrupt the normal functioning of the LES and increase the risk of reflux. It’s a common cause of GORD in many patients.

3. Obesity: Being overweight puts pressure on the stomach, which can cause acid to back up into the oesophagus.

4. Pregnancy: Hormonal changes and increased abdominal pressure during pregnancy can relax the LES and lead to reflux.

5. Diet and Lifestyle: Certain foods and habits can trigger reflux. These include:

• Spicy foods

• Citrus fruits

• Chocolate

• Caffeinated beverages

• Alcohol

• Fatty or fried foods

• Overeating or lying down immediately after eating

6. Smoking: Smoking weakens the LES and increases acid production, making reflux more likely.

How Is Reflux Treated?

Fortunately, there are several effective treatments available for managing reflux, depending on the severity and underlying causes of the condition.

Dietary Changes to help Reflux

One of the first steps in managing reflux is adjusting your diet. Certain foods can trigger or worsen symptoms, so identifying and avoiding these is key. Here are some general dietary recommendations:

• Eat smaller, more frequent meals: Large meals put more pressure on the LES and can lead to reflux.

• Avoid trigger foods: Foods like citrus, chocolate, coffee, fatty or fried foods, and spicy dishes can worsen reflux symptoms.

• Stay upright after meals: Lying down too soon after eating can encourage acid to flow into the oesophagus.

• Lose weight if needed: Extra weight puts pressure on the abdomen, which can increase the risk of reflux.

• Don’t eat late at night: Try to avoid eating at least two to three hours before bedtime to prevent nighttime reflux.

Medications for Reflux

If dietary changes alone aren’t enough, medications can be used to control reflux symptoms. Some of the most common types include:

• Antacids: These neutralise stomach acid and can provide quick relief for mild symptoms.

• H2-receptor antagonists (H2 blockers): These reduce acid production and provide longer-lasting relief.

• Proton pump inhibitors (PPIs): PPIs are stronger acid reducers that help heal the oesophagus and reduce symptoms, particularly in more severe cases of GORD.

While these medications can be very effective at controlling symptoms, they do not address the underlying cause of reflux. 

Surgery for Reflux

For patients who do not respond to medication or lifestyle changes, or for those who have complications like oesophageal strictures or Barrett's oesophagus, surgery may be an option. The most common surgical treatment for GORD is fundoplication. This procedure involves wrapping the top of the stomach around the LES to strengthen the barrier and prevent acid from flowing back into the oesophagus. It is often performed laparoscopically, which means fewer incisions, less pain, and a quicker recovery time.

For patients with a hiatus hernia, surgery can also repair the hernia and restore normal function to the LES, helping to prevent reflux.

Surgery for reflux can have many positive effects, for example, most people no longer have to take their reflux medication in the long term. Despite this, all surgery carries risks and it is important to discuss these with your surgeon to make an informed decision before embarking on surgery. 

Conclusion

Reflux is a common yet manageable condition that can range from an occasional annoyance to a serious health concern. If you experience chronic reflux symptoms, it’s important to talk to your doctor to determine the underlying cause and explore treatment options.

With lifestyle changes, medications, and, in some cases, surgery, most people with reflux can achieve significant relief and improve their quality of life. If you’re considering surgery for reflux or have more questions about how to manage your symptoms, we’re here to help. Schedule a consultation with Dr Roy Hopkins to discuss your options.

The information provided on this website is of a general nature and should not be considered a substitute for individualised medical advice. It is essential to consult a qualified medical practitioner for personalised advice regarding your health, diagnosis, and management. The content on this site is for general informational purposes only and does not establish a doctor-patient relationship.