acid reflux, gastro-oesophageal reflux disease, GORD

What is acid reflux?

Acid reflux means there is abnormal spilling of stomach contents upwards from the stomach into the oesophagus (the passage between your stomach and your throat). This is due to the valve (sphincter) at the top of your stomach not working properly. You may or may not notice any symptoms.

What are the symptoms?

The most common symptom of reflux is heartburn, a burning feeling that rises from the stomach or lower chest towards the throat. Discomfort or even severe pain in the lower chest may also travel around to your back.

Difficulty swallowing food can also be a problem – you may feel that swallowed food gets stuck – or you may get sharp tasting liquid or food spilling up into your throat.

What should be done about reflux?

For some people, antacids can relieve mild, infrequent symptoms. If they continue, or if you need to take antacids often, you should visit your doctor for help with controlling reflux. Your doctor can also rule out causes such as ulcers or, very rarely, stomach cancer.

Controlling reflux is important as the stomach contains strong acid that can irritate or damage the lining of the oesophagus if reflux persists. Medications prescribed by a doctor work for most patients with reflux, but if they are not suitable for you, you can talk to your doctor about being referred for a surgical cure.

What will a surgeon do?

Your surgeon may first check your oesophagus and stomach for structural problems and assess your reflux or any acid damage. This is done using endoscopy and, possibly, motility and pH tests.

An endoscope is a flexible tube attached to a tiny video camera that is passed down into your stomach. This is done while you are under sedation. A motility test checks whether your oesophagus is forcing food downwards properly and a pH test reveals how much acid is spilling upwards over a whole day. These tests determine whether surgery will benefit you.

What can surgery achieve?

Whereas medications control the symptoms of acid reflux by reducing the acid level in the stomach, surgery aims to cure reflux by preventing stomach acid escaping into the oesophagus. The surgeon usually repositions some of the muscle in the stomach wall, wrapping it around the ‘leaking’ lower oesophagus.

Laparoscopic (keyhole) surgery for reflux is now common – it can allow a quicker recovery, shorter hospital stay, less pain afterwards and smaller scars when compared with traditional (open) surgery.

Your reflux symptoms should be gone immediately, so you can again eat freely without needing medication or having heartburn, but you should try to eat slowly for the first week or two.

Being ready for your surgery

Follow your surgeon’s instructions. You may be asked to have a check up a few days before surgery, and you will be told when to stop your usual medications, including pharmacy medicines (eg, aspirin).

You will need to stop eating and drinking, probably on the night before surgery - your surgeon can confirm this. Surgery for reflux lasts one to three hours, and two to ten days in hospital is usual, depending on the surgical technique used.

Click here for information on choosing a surgeon.

Original material provided by UBM Medica (NZ) Ltd. Reviewed in January 2002 by Robert J Fris.