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What is reflux

Gastro-oesophageal reflux (GORD) is one of the most common diagnosis made by doctors and can affect at least 10% of the adult population. Heartburn is the most common symptom of GORD and 12% of Western populations experience heartburn at least once a week, with 5% having daily heartburn. However, some GORD patients never experience heartburn but may have other less common symptoms such as pain when swallowing, nausea, longstanding cough (sometimes thought to be due to asthma) and regurgitation. It has a major impact on the quality of life and may lead to complications like ulceration, strictures, damage to teeth, and Barrett’s oesophagus.

What causes reflux

Causes are varied and not always fully known, but they include hiatus hernia, pregnancy, smoking, alcohol, coffee or tea, some foods such as citrus fruits or spicy foods. Other risk factors including being overweight or taking certain medications such as ibuprofen or aspirin
What are the symptoms of reflux
Common symptoms include a burning sensation in your chest (heartburn), usually after eating, which might be worse at night, chest pain (which can be mistaken for heart problems), difficulty swallowing or regurgitation of food. It can also cause a significant impact at nighttime, with inability to lie flat, a chronic cough, “asthma”. laryngitis.

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Diagnosis

Diagnosis is based on the symptoms the patient is experiencing and then a series of tests depending on the severity of the symptoms. An endoscopy would be the first line investigation, followed potentially by a barium swallow, oesophageal manometry and pH studies.

Treatment

The mainstay of treatment is with tablets such as proton pump inhibitors (omeprazole, lansoprazole) and H-2 receptor antagonists (Ranitidine). Surgery often involves a hiatus hernia repair and then a fundoplication where a part of the stomach is wrapped around the oesophagus to recreate the lower oesophageal sphincter or a LINX device which is a strip of magnetic beads placed around the junction of the oesophagus and stomach. 

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