Heartburn and reflux

What is reflux?

Reflux is when some of the acidic stomach contents come back up the oesophagus towards the mouth. When this happens, the person can feel heartburn – a burning sensation in the chest because of the acid that's in the stomach. The pain is felt in the chest behind the breastbone, and it may move up towards the throat. Other symptoms include an unpleasant taste in the mouth and swallowing problems.

Reflux is also called acid reflux or gastro-oesophageal reflux disease (GORD).

Treatment for reflux

Drug treatment

Your GP should offer you a course of treatment with a medicine called a proton pump inhibitor (PPI for short). The course should last for 4 or 8 weeks, depending on the severity of the reflux and how quickly your symptoms respond.

If your symptoms come back

If your symptoms come back after you've stopped taking the PPI, your GP should offer the PPI at the lowest dose possible to control your symptoms. They should discuss taking it only when you need it to help your symptoms.

If the PPI doesn't work

If the PPI hasn't helped, your GP may offer another medicine called an H2 blocker.

Treatment for severe oesophagitis (inflammation)

If the reflux has caused severe irritation and inflammation of your oesophagus (the medical name for this is oesophagitis), your doctor should offer you a course of treatment with a PPI for 8 weeks.

If your symptoms come back

If your symptoms come back after you've stopped taking the PPI, your GP should offer you a higher dose or treatment with a different PPI. You may need to take the treatment for a long time to control your symptoms.

If the PPI doesn't work

If the PPI hasn't helped, your GP should carry out a review of your symptoms, lifestyle and treatments. They may offer a different PPI or they may wish to get some specialist advice (for example, from a gastroenterologist - a doctor who specialises in the body's digestive system).

Surgery

Your doctor may talk with you about surgery for reflux. Surgery may be appropriate for people who do not want to take medication long-term, or for those who have unpleasant side effects from their medication.

The most common type of surgery for reflux is called laparoscopic fundoplication. This is a keyhole surgery technique, in which the surgeon stitches and folds the top of the stomach, just below where the oesophagus meets the stomach, to create a smaller opening. The aim is to reduce the amount of stomach contents re-entering the oesophagus.

If your doctor thinks that surgery would help, he or she will be able to discuss this with you in more detail.

Remember – you shouldn't keep taking antacids regularly for long periods. Although they help symptoms in the short term, they won't cure the problem.

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