Reflux

Reflux is a condition where acid travels up from the stomach into the oesophagus (food pipe) causing: 

• a burning sensation in the middle of your chest (heartburn)
• an unpleasant, acidic taste in your mouth

Reflux happens to most people from time to time and is usually nothing to worry about, but if it happens frequently, you may have a condition known as gastro-oesophageal reflux disease (GERD or GORD). While GERD itself isn’t dangerous, it is unpleasant and can lead to serious health problems such as oesophagitis (inflammation of the oesophagus), and rarely, oesophageal cancer.  

Symptoms of GERD include: 

• pain in the upper abdomen or chest (heartburn)
• food coming back up from your stomach into your mouth 
• cough
• hiccups 
• a feeling that there is food stuck in your throat
• hoarse voice
• bad breath
• sore throat
• vomiting (being sick)
• nausea (feeling sick)
• bloating
• difficulty swallowing

Laryngopharyngeal reflux (LPR) is a similar condition where acid moves up into the larynx (voice box) and pharynx (throat) causing irritation. 

It is often called ‘silent reflux’ because people with the condition usually don’t experience symptoms such as heartburn. 

Symptoms of LPR include: 

• hoarse voice
• excessive throat clearing
• difficulty swallowing
• feeling a lump, or tightness in the throat
• excessive mucus in the throat, especially in the morning
• dryness, or burning sensation in the throat
• chronic dry cough
• episodes of choking, especially at night
• sore throat 
• excessive burping

GERD can also affect babies and children though the symptoms may be different. If you suspect your baby or child may have GERD, make an appointment with your GP or paediatrician. 

Symptoms of GERD in babies and children include: 

• frequent vomiting 
• excessive crying
• not wanting to feed
• breathing difficulties 
• acid taste in the mouth, especially when lying down
• hoarse voice
• waking up frequently due to a feeling of choking
• bad breath
• difficulty sleeping, especially after eating

Reflux occurs when a valve at the entrance to the stomach called the lower oesophageal sphincter becomes weak or relaxed. Normally this valve closes after eating, but with reflux, it doesn’t close properly allowing acid and stomach contents to travel back into the oesophagus. 

Reflux may be caused or made worse by: 

• • pregnancy
  • smoking

• being overweight or obese

• certain food and drinks such as alcohol, dairy, coffee, tomatoes, chocolate, fatty, fried, or spicy food
• stress
• anxiety
• hormonal changes
• some medications such as the painkiller ibuprofen, and some medications used to treat asthma, allergies, high blood pressure, and depression
• having a hiatus hernia —this is where a part of the stomach pushes into the chest through a space in the diaphragm.

While occasional reflux is normal, and not usually a cause for concern, GERD can lead to serious health problems if left untreated. 

See your doctor if you: 

• have had reflux or heartburn every day for 3 weeks or more
• have tried lifestyle changes and over-the-counter medications without success 

have other symptoms such as vomiting, weight loss, or food getting stuck in your throat

For occasional reflux, lifestyle changes, changes to your diet, and over-the-counter medications may be enough to relieve symptoms. 

Some things you can do to help with reflux include: 

• • eat small, frequent meals —having a full stomach can put more pressure on the oesophagus
  • avoid foods that trigger reflux —this may be different for everyone, so keeping a food diary can help you identify foods that cause your reflux 
  • avoid carbonated drinks —fizzy drinks cause you to burp which pushes acid into your oesophagus 
  • stay upright (sitting or standing) for around an hour after eating — this helps keep acid in the stomach
  • eat your last meal at least 3 hours before going to bed
  • avoid vigorous exercise, or bending over for around 2 hours after eating
  • sleep on a steady incline with your head around 10 to 20 cm higher than your feet. You can do this by raising the head of the bed or using a foam wedge support for your upper body. Avoid putting extra pillows under your head as this won’t have the same effect. 
  • lose weight if needed and maintain a healthy weight 
  • avoid wearing clothes that are tight around your middle
  • stop smoking —nicotine is thought to relax the lower oesophageal sphincter 

• avoid drinking too much alcohol

• if anxiety is triggering your reflux, try to find ways to relax 
• check your medications to see if any of them could be causing your reflux. Read the patient information leaflet that comes with the medication or speak to your pharmacist or GP. Never stop taking any prescribed medications without first speaking to your doctor. 
• talk to your pharmacist about trying an over-the-counter treatment for reflux

NHS: Heartburn and acid reflux September 9th 2020 (Accessed October 6th 2022) 

Gastritis – NHS  last reviewed: 20 May 2019 ,Next review due: 20 May 2022

https://www.nhs.uk › conditions › gastritis

 GERD (Chronic Acid Reflux) June 12th 2019 (Accessed October 6th 2022) 

Harvard Health Publishing: 9 ways to relieve acid reflux without medication November 16th 2021 (Accessed October 6th 2022) 

Doncaster and Bassetlaw Hospitals NHS Foundation Trust: Silent Reflux January 2016 (Accessed October 6th 2022)