Causes and Treatment for Acid Reflux

Acid reflux is a common digestive condition in which stomach contents flow back into the oesophagus, a tube approximately 1 inch wide and 10 inches long that connects the mouth to the stomach.

Located at the bottom of the oesophagus, the lower oesophageal sphincter (LES), a circular ring of muscles connects the oesophagus to the stomach. When you swallow, the LES relaxes and opens to allow food to enter the stomach, where it mixes with stomach acid to aid in digestion. Afterwards, the LES closes to prevent stomach acid and food from flowing back into the oesophagus.

Occasional reflux is quite common after a large meal and most of the time the condition is brief. Despite not usually causing significant issues or complications, it could still damage the oesophagus and induce a number of bothersome symptoms.

Symptoms of acid reflux

Common acid reflux symptoms include:

• Heartburn (a burning sensation in the chest)
• Regurgitation (the feeling of stomach contents being forced back up your oesophagus)
• Difficulty swallowing or pain when swallowing
• Sour taste in the mouth
• Nausea or vomiting
• Bad breath
• Voice hoarseness
• Chest pain

There is a much more severe form of acid reflux known as GERD (Gastroesophageal Reflux Disease). It is defined as a chronic digestive condition and is characterised by persistent symptoms that can significantly impact one’s quality of life.

What causes acid reflux?

Acid reflux occurs when stomach acid flows back into the oesophagus due to a weakened or relaxed lower oesophageal sphincter (LES), the muscle that normally prevents acid from rising upward. 

Common triggers of acid reflux

Several factors can increase the risk of acid reflux:

• Dietary triggers: Spicy foods, fatty meals, caffeine, and alcohol
• Eating habits: Large meals or lying down soon after eating
• Lifestyle factors: Smoking and poor sleep habits
• Obesity: Increased abdominal pressure pushing acid upward
• Pregnancy: Hormonal changes and pressure on the stomach
• Medical conditions: Hiatal hernia affecting stomach positioning 

Why do these triggers matter

These factors can weaken or relax the LES, allowing stomach acid to flow back into the oesophagus and cause symptoms such as heartburn and regurgitation.

Diagnosis of acid reflux

Based on your reported symptoms, your doctor may perform an upper gastrointestinal (GI) endoscopy. This involves using an endoscope, a thin, flexible tube with a camera to inspect the oesophagus and lining of the stomach. During the procedure, biopsy samples may be taken to check for damage or signs of infection.

Prolonged oesophageal pH test can also be done to determine how severe the acid reflux is. This involves the insertion of a small tube with a sensor through the nose into the oesophagus or placing a wireless sensor during an upper endoscopy. The sensor remains in place for 24 hours.

How is acid reflux treated?

Treatment for acid reflux depends on the severity of symptoms and may include lifestyle changes, medications, or medical procedures.

Lifestyle changes for mild acid reflux

Several lifestyle changes to help alleviate mild acid reflux include:

• Avoid trigger foods such as spicy or fatty meals
• Do not lie down immediately after eating
• Maintain a healthy weight
• Reduce caffeine and alcohol intake

Medications for acid reflux

Medications for acid reflux include:

• Antacids for short-term relief due to its ability to neutralise stomach acid
• H2 blockers (e.g. famotidine) to reduce stomach acid production
• Proton pump inhibitors (PPIs) (e.g. omeprazole and pantoprazole) for more severe symptoms

When is further treatment needed?

More advanced treatment may be required if:

• Symptoms persist despite medication
• Acid reflux occurs frequently
• Complications such as oesophageal damage develop

Potential complications

Complications that come with acid reflux are usually not serious with most people, especially if they are receiving treatment. However, some individuals with severe acid reflux may sometimes experience potentially serious complications.

Prevention tips

Lifestyle and dietary modifications are recommended to lower the frequency and severity of acid reflux occurrences.

For many people, eating spicy food can be a common cause of acid reflux as spicy foods contain a compound called capsaicin. It relaxes the lower oesophageal sphincter and make it easier for the stomach acid to flow into the oesophagus. You should avoid eating too many spicy foods if you are prone to acid reflux.

Other food categories that should be restricted or avoided include:

• Chocolate
• Mint
• Tomatoes and tomato-based products
• Citrus fruits and juices
• Fried and fatty foods
• Carbonated drinks
• Caffeine
• Alcohol

To prevent overeating, remember to eat smaller sized meals throughout the day. To minimise the symptoms of acid reflux, avoid eating late at night and give yourself at least three hours between your last meal and bedtime.

Lifestyle modifications that can help reduce acid reflux symptoms include: 

• Losing excess weight and maintaining a healthy weight.
• Sleeping on your left side to guide stomach juices away from the stomach’s upper right section where the oesophagus connects.
• Stop smoking.
• Practising stress-reduction techniques to reduces chronic stress that can potentially increase the risk of acid reflux.

Schedule an appointment at Gleneagles Hospitals

For any questions or concerns regarding acid reflux, contact us to schedule an appointment today for a consultation, or visit our team of Gastroenterologists at your nearest Gleneagles Hospital.