What is acid Reflux?

Acid reflux or heartburn is a burning sensation in the centre of the chest caused by acid travelling up the gullet. Repeated acid reflux can cause one or more symptoms in patients suffering from it, burning sensation in the centre of chest, sour taste of acid in mouth, hoarse voice, cough, bad breath, hiccups, bloating and dental and ear problems.

Why do I have acid reflux?

A weakness in the muscle surrounding the lower end of food pipe called lower oesophageal sphincter causes contents of stomach to move up the food pipe. Few known causes for this weakness of the sphincter are, obesity, Hiatus Hernia, pregnancy, stress, smoking, medications eg diclofenac

investigations for acid reflux


Gastroscopy, a camera test to examine inside of food pipe and stomach will help rule out other causes like ulcer and cancer. It also helps to know if one has Hiatus Hernia and changes related to long term acid reflux like reflux esophagitis and Barrett’s esophagus.

pH manometry

Inserting a fine tube through nose in to food pipe, various pressures and level of acid exposure is measured for a period of 24 hours. This helps confirm the diagnosis and predict if a surgical treatment will be successful.

Barium studies

It is a dynamic study involving x rays where a patient is asked to swallow barium marshmallow which shows up on x ray images. It is performed  in selected patients to assess food pipe motility, confirm acid reflux and Hiatus Hernia.

What are treatment options for acid reflux?



  • Lose excess weight if you are overweight
  • Stop smoking
  • Avoid problem foods eg coffee, alcohol, fizzy drinks, citrus food
  • Eat evening meal 3 hours before going to bed
  • Avoid lying down soon after food
  • Use an extra pillow or raise the bed head to avoid lying flat
  • Eat smaller meals more frequently


Please see a doctor for the advice on medications often a combination of antacids, H2 receptor antagonists and proton pump inhibitors.

Anti-reflux surgery

A surgical procedure performed by keyhole approach under general anaesthetic to create a competent sphincter at the lower end of food pipe using the upper part of stomach. It is indicated in patients who failed to control their symptoms with medications, develop side effects from medications, want to avoid taking long term medications and patient’s wishes.