Acidity / GERD Conditions We Treat
Chronic Acidity / Heartburn
Overview
Chronic acidity (persistent heartburn) happens when stomach acid repeatedly flows back into the oesophagus, irritating its lining. Triggers include late-night meals, spicy/fatty foods, caffeine, alcohol, smoking, stress, obesity, and certain medications. If not managed, it may lead to esophagitis, strictures, or Barrett’s esophagus.
Symptoms
- Burning chest pain (heartburn) — Often after meals or at night; may worsen when lying down or bending over.
- Sour taste or throat irritation — Acid creeping up into the throat or mouth.
- Bloating, early fullness, belching — More noticeable after heavy or greasy meals.
- Swallowing discomfort — A sensation of food “sticking” or moving slowly.
- Chronic cough/hoarseness — Especially morning hoarseness or a persistent throat-clearing habit.
Diagnosis
- Clinical evaluation — Review of triggers, meal timing, lifestyle, and medication history.
- Upper GI High Resolution Endoscopy — Checks for esophagitis, ulcers, or Barrett’s changes.
- Esophageal pH or impedance-pH monitoring — Confirms acid/non-acid reflux and correlates with symptoms.
- Esophageal manometry — Assesses muscle function; essential before anti-reflux surgery.
- H. pylori testing (when appropriate) — If dyspepsia features are prominent.
Treatment
- Lifestyle & diet — Smaller meals, avoid lying down 3 hours after eating, elevate head of bed, weight management, limit triggers (spicy/fatty foods, chocolate, citrus, tomato, mint, caffeine, alcohol), stop smoking, manage stress.
- Medications —
- Antacids / alginates for quick relief (useful at bedtime).
- H2 blockers for mild to moderate symptoms.
- PPIs (time-limited course, typically 4–8 weeks) for healing and control; step-down to lowest effective dose.
- Minimally invasive options — For persistent or medication-dependent cases: anti-reflux procedures/surgery to reinforce the valve between stomach and esophagus.
- Ongoing prevention — Trigger control, sustainable diet, and periodic review to prevent complications like Barrett’s esophagus.
Acid Reflux (GERD)
Overview
Acid reflux, often associated with Gastroesophageal Reflux Disease (GERD), occurs when stomach contents flow backward into the esophagus, causing discomfort and irritation. While heartburn is the most common symptom, acid reflux can also present with regurgitation, chronic cough, or throat irritation. Persistent reflux can affect daily comfort, sleep, and, in severe cases, damage the esophagus.
Symptoms
Recognising acid reflux early can help guide treatment:
- Heartburn: A burning sensation in the chest, often after meals.
- Sour or bitter taste in the mouth: Particularly after eating or when lying down.
- Fluid reflux into the throat: Feeling of stomach contents “coming up” or backwash of food.
- Chronic cough, throat clearing, or hoarseness: Caused by acid irritating the upper airway.
- Difficulty swallowing (dysphagia): May develop in advanced or untreated cases.
- Night-time discomfort: Symptoms worsen when lying flat or after heavy evening meals.
Diagnosis
Effective diagnosis ensures proper management:
- Upper GI endoscopy: Detects esophagitis, ulcers, or narrowing from reflux injury.
- 24-hour pH monitoring or impedance-pH test: Measures the frequency and duration of acid (and non-acid) reflux.
- Esophageal manometry: Assesses sphincter strength and esophageal motility.
- Barium swallow X-ray: Sometimes used to visualise reflux, strictures, or other structural issues.
Treatment
Treatment strategies combine lifestyle adjustments, medications, and procedures:
- Lifestyle modifications: Eat smaller meals, avoid lying down immediately after eating, elevate the head of the bed, and avoid triggers like coffee, alcohol, chocolate, mint, tomato, citrus, spicy, or fatty foods.
- Medications:
- Antacids for short-term relief.
- H2 receptor blockers to reduce acid production.
- Proton Pump Inhibitors (PPIs) as the most effective therapy for long-term healing and symptom control.
- Endoscopic or surgical solutions: Minimally invasive anti-reflux procedures may be considered for severe or refractory cases to restore the natural barrier and reduce reflux.
- Long-term monitoring: Prevents complications like Barrett’s oesophagus and ensures ongoing esophageal health.
Esophagitis
Overview
Esophagitis refers to inflammation or irritation of the oesophagus (the food pipe). It is most commonly caused by acid reflux (GERD), but can also result from infections, medications, allergies (eosinophilic esophagitis), or physical injury. If untreated, esophagitis can cause ulcers, bleeding, scarring, or swallowing difficulties.
Symptoms
- Pain or discomfort while swallowing (odynophagia)
- Difficulty swallowing (dysphagia) — Feeling of food “sticking” in the throat or chest
- Burning chest pain or heartburn — Especially after meals
- Acid regurgitation and sour taste in the mouth
- Chronic cough, sore throat, or hoarseness
- Unexplained weight loss (in advanced cases)
Diagnosis
- Upper GI endoscopy — Direct visualization of the esophageal lining; may show redness, ulcers, or narrowing.
- Biopsy during endoscopy — Helps differentiate between reflux-related, infectious, or eosinophilic esophagitis.
- Barium swallow X-ray — Useful to identify narrowing or strictures.
- pH monitoring and manometry — For suspected reflux-related inflammation.
Treatment
- Medication-based care:
- Proton Pump Inhibitors (PPIs) — First-line for reflux-induced esophagitis.
- Antifungal, antiviral, or antibiotic therapy — If infection is the cause.
- Topical steroids or elimination diet — For eosinophilic esophagitis.
- Lifestyle and dietary adjustments — Avoid irritants (spicy foods, alcohol, smoking, caffeine), eat smaller meals, and maintain healthy weight.
- Endoscopic/surgical intervention — For complications like esophageal strictures, dilation may be performed; refractory reflux cases may require minimally invasive anti-reflux surgery.
- Long-term monitoring — To prevent recurrence and reduce risk of complications such as Barrett’s esophagus.
Barrett’s Esophagus
Overview
Barrett’s Oesophagus is a condition in which the normal lining of the oesophagus changes due to long-term acid reflux (GERD). Over time, the esophageal lining is replaced with tissue similar to the intestinal lining. While Barrett’s itself does not always cause symptoms, it significantly increases the risk of esophageal cancer if left untreated.Esophagitis refers to inflammation or irritation of the oesophagus (the food pipe). It is most commonly caused by acid reflux (GERD), but can also result from infections, medications, allergies (eosinophilic esophagitis), or physical injury. If untreated, esophagitis can cause ulcers, bleeding, scarring, or swallowing difficulties.
Symptoms
Barrett’s Oesophagus often develops without obvious symptoms. However, it is usually seen in people with long-standing GERD, who may experience:
- Chronic heartburn or acid reflux
- Frequent acid regurgitation
- Difficulty swallowing (dysphagia)
- Chest pain not related to the heart
- Chronic cough, hoarseness, or sore throat
Diagnosis
- Upper GI endoscopy — The key test; doctors visually examine the esophageal lining and take biopsies.
- Biopsy (histopathology) — Confirms changes in cell structure (intestinal metaplasia).
- Surveillance endoscopy — Recommended every few years to monitor for progression toward dysplasia (precancerous changes).
Treatment
- Medical management:
- Proton Pump Inhibitors (PPIs) — To control reflux and prevent further damage.
- Lifestyle modifications — Avoiding reflux triggers (spicy/fatty foods, alcohol, smoking, caffeine) and maintaining a healthy weight.
- Endoscopic therapies (for dysplasia):
- Radiofrequency Ablation (RFA) — Uses heat energy to remove abnormal lining.
- Endoscopic mucosal resection (EMR) — Removes early precancerous lesions.
- Surgical care:
- In select advanced cases, anti-reflux surgery or esophagectomy may be considered.
- Regular monitoring:
- Ongoing endoscopic surveillance is critical to detect early changes and prevent progression to esophageal cancer.
Hiatus Hernia
Overview
A hiatus hernia occurs when part of the stomach pushes up through the diaphragm into the chest cavity. This weakens the natural barrier between the stomach and esophagus, making acid reflux more likely and contributing to GERD or chronic acidity. While small hiatus hernias may cause no symptoms, larger ones can significantly affect comfort and digestion.
Symptoms
Symptoms can vary depending on the size of the hernia:
- Frequent heartburn or acid reflux
- Regurgitation of food or sour liquid
- Difficulty swallowing (dysphagia)
- Chest pain or discomfort — Sometimes mimicking heart-related issues
- Shortness of breath — If the hernia is large
- Feeling of fullness or bloating after meals
Diagnosis
Effective diagnosis ensures proper management:
- Upper GI endoscopy: To check for reflux, oesophagitis, or stomach displacement.
- Barium swallow X-ray: Helps visualise the position of the stomach through imaging.
- Esophageal manometry: Measures pressure and movement in the esophagus.
- pH monitoring: Assesses the severity and frequency of acid reflux.
Treatment
Treatment depends on the size of the hernia and the severity of symptoms:
Medical management:
- Proton Pump Inhibitors (PPIs) or antacids — To control acid reflux symptoms.
- Lifestyle changes — Weight management, eating smaller meals, elevating the head of the bed, and avoiding alcohol and smoking.
Surgical Procedures (for persistent or severe cases):
- Laparoscopic hiatus hernia repair — Minimally invasive surgery to reposition the stomach and strengthen the diaphragm opening.
- Often combined with fundoplication (anti-reflux procedure) to prevent recurrence.
Long-term follow-up:
- Monitoring for recurrence and ensuring ongoing symptom control.
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Gastroenterology FAQs
When should I see a Gastroenterologist?
You should visit a Gastroenterologist if you have persistent digestive issues like heartburn, bloating, constipation, diarrhoea, or unexplained abdominal pain.
What are the common causes of Acid Reflux (GERD)?
Acid reflux is often triggered by spicy foods, caffeine, alcohol, smoking, obesity, and late-night eating. Lifestyle changes and medication can help manage symptoms.
What are the signs of Liver Disease?
Symptoms include jaundice (yellowing of skin/eyes), fatigue, swelling in the legs, dark urine, and persistent nausea. Liver disease can be caused by infections, alcohol, or fatty liver.
What is a Colonoscopy, and when do I need one?
A Colonoscopy is a screening test for colon cancer and digestive disorders. It’s recommended if you’re over 45 or experiencing blood in stool, unexplained weight loss, or chronic diarrhea.
What foods help improve digestion?
Fiber-rich foods like fruits, vegetables, whole grains, and yogurt promote gut health, while processed foods, dairy, and fried foods may worsen digestive issues.
What are the symptoms of Gallbladder problems?
Common symptoms include severe pain after eating fatty foods, nausea, vomiting, and bloating. Gallbladder issues like gallstones may require dietary changes or medical treatment.
What is Hernia?
A Hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.
In many cases, it causes no or very few symptoms, although you may notice a swelling or lump in your tummy (abdomen) or groin.
The lump can often be pushed back in or disappears when you lie down. Coughing or straining may make the lump appear.
What is Cancer screening?
Cancer Screening is looking for cancer before a person has any symptoms. This can help find Cancer at an early stage. When abnormal tissue or Cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.
What are the tests used to screen Colon Cancer?
The following types of tests are used to screen for Colorectal Cancer:
- Fecal occult blood test
- Sigmoidoscopy
- Colonoscopy
- CT Colonography
- CEA assay