Acid reflux is a very common condition, also known more commonly as heartburn or indigestion. In medical terms, this condition can also be referred to as gastro-oesophageal reflux disease (GORD).
It occurs when stomach contents, typically acidic, reflux back up into the oesophagus, or mouth.
Many people may experience mild symptoms of heartburn, occasionally, for example after a big meal.
If you have symptoms of acid reflux on a regular basis, then a specialist assessment can usually detect the problem, and ensure your symptoms are not related to other conditions.
When we eat, food is chewed, swallowed then transported to the stomach down the oesophagus, also known as the food pipe, which is about 10 inches long and 1 inch across. The wall of the oesophagus is made up of muscles that contract and move the food down to the stomach in a co-ordinated way.
The lower end of the oesophagus has a ring of muscle called the LOS, or lower oesophageal sphincter, and this relaxes to allow food through but it also prevents stomach contents and acid passing up the other way.
If this muscle is not working properly, or is weaker than it should be, it can lead to the problems of acid reflux.
Heartburn, indigestion, acid reflux, GORD and GERD are all terms used to describe this condition.
To investigate the symptoms of acid reflux, you may need an endoscopy of the stomach, called a gastroscopy.
This can be done under sedation and will show if there is any damage to the lining of the oesophagus for example redness or inflammation, and even ulcers.
It can also diagnose a hiatus hernia and Barrett’s oesophagus, two other conditions.
Failing improvements from lifestyle changes, there are treatments available to help combat the symptoms of acid reflux.
Antacids may help, and the potency of these can range from simple over the counter products to others that need to be prescribed by a doctor or specialist.
Some of these tablets, taken once a day, switch off stomach acid production almost completely.
In a few cases, the acid reflux is so bad that surgery is an option.
This typically is done by means of a keyhole technique and is known as a laparoscopic Nissen fundoplication where part of the stomach is wrapped around the lower end of the oesophagus to tighten things up and prevent reflux.
A hiatus hernia is a very common finding when a gastroscopy is performed.
The diaphragm is a large, flat muscle that sits below the lungs and separates the chest from the abdomen. The oesophagus passes through an opening in this muscle layer before it enters the stomach and this is called the diaphragmatic hiatus.
If there is a slight weakness in this area, part of the stomach slips through and sits above the diaphragm where it shouldn’t be and this is called a hiatus hernia.
There is no way to prevent the hernia occurring. The vast majority are small and are of no real significance. They may be associated with reflux but the treatment of the reflux is not really any different as a result.
When the cells lining the very end of the oesophagus are exposed to stomach acid, over time they can change from one type to another type, usually not found in the oesophagus.
Such a change, which appears as a slight change in colour of the lining of the oesophagus, is called Barrett’s oesophagus.
A very small number of these patients go on to develop oesophageal cancer and in order to prevent this as much as possible, we keep an eye on Barrett’s oesophagus by repeating the endoscopy every few years to identify any suspicious changes early on.
Most patients with Barrett’s oesophagus never get oesophageal cancer, however it is always best to take greater care in detecting the early signs through regular check-ups.
Feel reassured that you are not alone and that specialist help is available.