What is acid reflux?

Stomach juices are made up of strong digestive acids and enzymes. It is common for these juices to travel upwards from the stomach back into the food pipe (oesophagus). This can cause symptoms such as heartburn and those listed below. If the symptoms come back repeatedly this is usually referred to as Gastro-Oesophageal Reflux Disease (GORD).

Sometimes, small amounts of these stomach juices can reach as far up as the throat (pharynx) and voice box (larynx). This is known as Laryngo-Pharyngeal Reflux (LPR) and is sometimes called ‘silent reflux’, as many people do not experience the typical reflux symptoms such as heartburn. Both types of acid reflux can occur during the day and at night, even if the person hasn’t eaten anything.

What are the symptoms of reflux?

These can vary but some of the most common symptoms include:

Some of these symptoms can be found with other conditions affecting the oesophagus/food pipe.

What can I do to help?

There are many things you can do to help reduce the risk, frequency and/or severity of attacks of acid reflux.

You can make changes to what you eat:

 There are certain foods and drinks that can worsen symptoms, these vary from person to person. If you notice specific foods/drinks trigger or worsen your symptoms, then reduce or avoid eating them. Keeping a diary can help identify patterns.

You can make lifestyle changes:

• avoid wearing tight clothing around your middle
• raise the head of your bed by putting wood, bricks or books underneath – 10-25cm high – so that your chest, head and neck are higher than your waist when you are lying in bed
• avoid bending from the waist, particularly soon after eating e.g. bend from your knees when putting plates in the dishwasher.

There may be further lifestyle changes that would help manage your symptoms. These can be found on the NHS and Guts UK websites.

Heartburn and acid reflux - NHS

Guts ok Heartburn & Acid Reflux | Causes, Symptoms and Treatment - Guts UK

Is there medical treatment for reflux?

 Changes such as those listed above can be enough for some people. If your symptoms persist you should discuss them with your GP. Your GP may prescribe you some medication such as a PPI (Proton Pump Inhibitor) to reduce the amount of acid produced (e.g. Omeprazole, Lansoprazole). These medications are advised be taken on an empty stomach first thing in the morning, at least 30 minutes before eating.

You may also be advised to take an alginate liquid such as Gaviscon Advance. This works by forming a raft over the top of your stomach contents so needs to be taken after meals and before bed.

How can I manage swallowing difficulties caused by reflux?

Some people report experiencing swallowing difficulties such as:

• a feeling of food getting stuck below the level of your Adam's apple
• food not going down
• needing a drink to clear
• food or drink coming back up

These symptoms may be a result of reflux and/or other oesophageal problems. If you are experiencing these problems, it is important to discuss this with your GP.

It can be helpful to change the consistency of food that you eat to make swallowing easier. Softer foods with extra moisture (e.g. adding sauce, gravy, custard) are much easier to chew and will allow the food to pass more easily thorough the food pipe.

Here are some examples of food you may find easier to manage:

You can make changes to how you eat:  

• eat slowly and in an upright position
• chew food well
• eat smaller meals
• ideally leave three hours after eating before lying down
• drink between bites of food, to help ‘wash’ the food down.

The NHS website suggests speaking with a pharmacist if you keep getting heartburn. You are advised to speak with your GP if lifestyle changes and pharmacy medicines are not helping your heartburn, if you have heartburn most days or you also have other symptoms, like food getting stuck in your throat, frequently being sick, or losing weight for no reason.