Acid reflux: Everything patients need to know

Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common digestive disorder that occurs when stomach acid flows back into the esophagus. This can lead to a range of uncomfortable symptoms and, in some cases, may indicate more serious underlying conditions. In this article, renowned consultant general, laparoscopic, upper GI and bariatric surgeon Mr Ricardo Camprodon explains what acid reflux is, its potential implications, and various treatment options available.

What is acid reflux?

Acid reflux is a prevalent chronic health problem, significantly impacting the physical and emotional well-being of those affected, hindering productivity. In the UK, up to 20 percent, or the equivalent of 11 million adults, suffer from it. Acid reflux occurs when the lower oesophageal sphincter (LOS), a muscular ring at the junction of the oesophagus and stomach, fails to close properly after food consumption.

This allows stomach acid to travel back up into the oesophagus, causing irritation and inflammation of its lining. Many experience classic symptoms such as indigestion, heartburn, and regurgitation of sour liquid or food. Diagnosing GERD can be challenging due to overlapping symptoms with other conditions like gallstone disease, functional dyspepsia, irritable bowel syndrome, and small intestinal bacterial overgrowth.

Can it be a sign of something more serious?

While occasional acid reflux is common and usually harmless, frequent or severe episodes may indicate gastroesophageal reflux disease (GERD). Untreated GERD can lead to complications such as oesophagitis (inflammation of the oesophagus), oesophageal strictures (narrowing of the oesophagus), Barrett's oesophagus (a precancerous condition), and even oesophageal cancer in rare cases. Therefore, it is crucial to consult a healthcare professional if you experience persistent acid reflux symptoms.

How can I best control my symptoms?

Effectively managing symptoms starts with lifestyle modifications also crucial aspects of symptom control:

• avoiding dietary triggers that may weaken the lower oesophageal sphincter or increase stomach acidity including spicy foods, citrus fruits, caffeine, alcohol, chocolate and gassy vegetables.
• adjusting eating habits with smaller, more frequent meals and avoid lying down immediately after eating
• quitting smoking 
• achieving a healthy weight, excess weight puts pressure on the oesophageal hiatus leading to increased incidence of acid reflux
• preventing constipation

How can it be treated?

Various treatment options are available alone or in combination for maximal control of acid reflux. These include antacids, particularly proton pump inhibitors (PPIs), which are effective in managing symptoms, healing oesophageal damage, and preventing further complications.

However, despite their popularity and effectiveness, up to one-third of patients may experience side effects with PPIs, and the long-term implications of this medication are noteworthy. Foaming agents, also known as alginates, such as Gaviscon or Peptac, treat acid reflux by creating a barrier on top of the stomach contents to prevent acid from flowing back into the oesophagus.

These agents are often combined with antacids and are typically taken after meals and before bedtime for the best relieving effect. In rare cases, prokinetics that promote faster emptying of the stomach and increase bowel activity may be appropriate, reducing the likelihood of reflux.

Surgical interventions

Despite their important role, when lifestyle modifications and medications fail to adequately control symptoms, surgical options may be considered. These include laparoscopic fundoplication (a minimally invasive procedure that wraps the top of the stomach around the oesophagus to reinforce the weakened LOS) and LINX device placement (a magnetic ring placed around the LOS to prevent reflux). Surgery also provides an opportunity to restore anatomy in cases where there is a concomitant hiatal hernia.

Home remedies and additional tips

• Raising the head of your bed whilst sleeping can help prevent stomach acid from refluxing into the oesophagus during sleep.
• Herbal remedies like ginger, chamomile, and liquorice root may offer relief from acid reflux symptoms.

Mr Ricardo Camprodon is a renowned consultant general, laparoscopic, upper GI and Bariatric surgeon based in Birmingham and Halesowen. If you would like to book a consultation with Mr Camprodon, you can do so today via his Top Doctors profile.