Acid Reflux

Overview

Gastroesophageal Reflux Disease (GERD) is commonly called acid reflux. It is an abnormal condition where gastric contents return to the oesophagus.

Symptoms

GERD may present with a burning sensation that runs behind the chest or throat commonly known as heartburn.

Some people may experience regurgitation which is a bitter or sour taste backing up in the throat or mouth. The feeling can last for a few minutes or a few hours and often occurs after a heavy meal.

Symptoms such as pain, hoarseness of voice, and cough may be present in some patients as well.

When to Seek Treatment

It is important to monitor and manage your symptoms of GERD. If left untreated, GERD may lead to serious complications such as inflammation of the oesophagus, narrowing or obstruction of the oesophagus (oesophageal stricture) and bleeding.

Diagnosis

The diagnosis may be based on history and physical examination.

The condition can be further evaluated  by:

  1. A gastroscopy to visualise the lining of the oesophagus. A biopsy can be taken to check for the presence of inflammation or Barrett’s oesophagus.
  2. Ambulatory pH monitoring to assess the frequency and duration of acid reflux.
  3. Barium swallow which allows the imaging of the oesophagus and stomach.

Treatment

The initial treatment for GERD is lifestyle modification which includes dietary adjustments, raising the head of the bed and changing sleeping habits. Medical treatments with antacids and proton pump inhibitors (e.g. omeprazole) may be added as well. If these measures are not effective in managing GERD, a surgical approach can be considered.

Surgery

Laparoscopic fundoplication is the standard surgical treatment for GERD. It is a keyhole operation that requires 3 to 4 tiny incisions and uses the upper part of the stomach to wrap around the lower end of the oesophagus to tighten the closing mechanism.

Laparoscopic Fundoplication

The surgeon will discuss the risks and benefits of the operation during the consultation.

Causes

When the lower oesophageal sphincter (muscle) is weak or defective, acid from the stomach gets to the oesophagus. This acid can irritate the oesophagus and cause symptoms of GERD.

Risk Factors

  • Obesity
  • Hiatal hernia (part of the stomach is pushed up through the diaphragm into the chest)
  • Pregnancy

Consult Our Doctor

Dr Lim Khong Hee
General Surgeon

MBBS (Singapore), M.Med (Surgery), FRCS (Edin), FRCSEd (Gen), FAMS (Surgery)

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