Can acid reflux run in families?

Written by: Dr Natalia Zarate-Lopez
Published: | Updated: 26/09/2023
Edited by: Sophie Kennedy

Although many people experience mild heartburn from time to time, persistent symptoms of acid reflux can cause significant discomfort and affect your overall wellbeing and quality of life. In this informative article, consultant neurogastroenterologist Dr Natalia Zarate-Lopez shares her insight on the most common causes of acid reflux, diagnostic tests and also discusses the most effective lifestyle changes to help manage symptoms.



What causes acid reflux?


Acid reflux symptoms happens when acid from the stomach moves towards the oesophagus (food pipe) causing symptoms of heartburn, chest pain or regurgitation. This can be due to a weak lower oesophageal sphincter (LES), a ring of muscle that works as a valve and separates your oesophagus and stomach or a hiatus hernia. One third of patients might have symptoms, equally severe, due to an increased sensitivity of the oesophageal nerves to normal levels of acid. Management of acid reflux depends greatly on the mechanism/s contributing to symptoms generation.


What are the symptoms of acid reflux?


The main symptoms of acid reflux are heartburn, a burning sensation in the middle of your chest, an unpleasant sour taste in your mouth caused by stomach acid, chest pain, dysphagia and less frequently chronic cough or a hoarse voice.


Are acid reflux symptoms influenced by lifestyle factors?


Yes, acid reflux can be influenced by our diet, weight and meal routines. Coffee, alcohol, oily fatty foods, spicy foods or acidic foods (juices, tomatoes) can exacerbate symptoms. Avoiding meals before going to bed can also help symptom control.


Which lifestyle changes can help to relieve acid reflux?


Lifestyle changes that may help reduce the frequency of acid reflux include:

It can also help to raise the head end of your bed by ten to twenty centimetres so your chest and head are above the level of your waist, which can stop stomach acid travelling up towards your throat.


What investigations can be considered for patients with acid reflux symptoms?


Patients not responding to first line therapies, like life style modifications, antiacids or a short course of acid reducer drugs should be considered for a gastroscopy. This is a test to check inside your throat, food pipe and stomach. It allows to determine if there is inflammation in the food pipe or factors like a hiatus hernia contributing to the symptoms.


Oesophageal physiology tests involve measuring for a period of time how much acid there is in the oesophagus and the relation between this and symptoms. It is important that the timing, rational and interpretation of these tests are performed by doctors with appropriate expertise.


What types of treatment are available?


Treatments for acid reflux symptoms depend on the mechanism responsible for the symptoms. Proton pump inhibitors and H-2-receptor blockers can provide symptom relief when acid is the main culprit for symptoms. The dosage and duration of treatment depends on the severity of symptoms and presence or absence of reflux related complications. Surgery may also be an option in more severe cases.


Neuromodulatory medication can be considered when symptoms are severe but oesophageal nerve sensitivity rather than excessive acid is the mechanism behind the symptoms.




If you are concerned by symptoms of acid reflux and wish to schedule a consultation with Dr Zarate-Lopez, you can do so by visiting her Top Doctors profile.

By Dr Natalia Zarate-Lopez

Dr Natalia Zarate-Lopez is a prominent consultant neurogastroenterologist in London, where she practices at Cleveland Clinic London in addition to her UCLH NHS practice. She specialises in a wide range of functional and sensorimotor gut disorders such as functional dyspepsia, oesophageal motility disorders, gastroparesis, amongst chronic constipation, faecal incontinence, and nutrition. Dr Zarate-Lopezhas an expertise on advanced upper GI and lower GI physiology investigations, like oesophageal manometry, 24h pH/impedance, anorectal manometry, among others.

After receiving her medical qualification in Barcelona, Spain, Dr Zarate-Lopez continued there to finish her basic gastroenterology specialist training. She was then awarded the distinguished Canadian Association of Gastroenterology Clinical Fellowship, where she completed her project on integrating basic science and clinical research on the investigation of pacemakers in the gut, the interstitical cells of Cajal. This project evolved to become the core of her PhD in medicine from the University of Autònoma de Barcelona.

Dr Zarate-Lopez then continued her post CCT specialist training in neurogastroenterology in the UK at St Mark's Hospital and The Royal London Hospital. It was here she honed her expertise in lower GI physiology and pelvic floor disorders, as well as the impact of rheumatological, neurological, and endocrine disorders on gut sensorimotor function. Dr Zarate-Lopez currently received more than 400 referrals per year for her outpatient specialist clinic, including tertiary and quatertiary referrals, especially for patients with functional or neurogastroenterological disorders.

Her research in her field has been extensive, as Dr Zarate-Lopez has more than 40 peer-reviewed publications, including the UK representative for the European Guidelines for Functional Dyspepsia and for Gastroparesis. Presently, her particular active research interest is in the development and implementation of innovative techniques to manage patients with functional and motility gut disorders. She is also interested in developing an evidence-based approach to the nutritional requirements of patients with functional and neurogastro gastrointestinal disorders.

In conjunction with her research and publications, Dr Zarate-Lopez is invested in the promotion of better training in her subspeciality field of neurogastroenterology to trainees. She is an active member of the Young Adults Section of the BSG and continues to collaborate with the Neurogastro Section of the BSG. She has, thus far in her career, provided informative talks in relation to complex functional gastroenterology as well as gastroparesis in neurodegenerative disorders. She is an expert when it comes to the management of patients with neurological conditions whose gastric function has deteriorated. 

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