Many people will take acid reflux treatment without being formally diagnosed by endoscopy, 24 pH studies or BRAVO pH tests. This may work in the short term, but for most people, particularly if the symptoms last for a significant time or don’t completely recover with medicine, it is important to have formal testing to ensure that the diagnosis is correct.
Acid reflux treatment really contains three essential elements. These are:
Some people are able to manage their heartburn or other reflux symptoms by dietary changes alone. Although many people do not realise it, most episodes of reflux occur in the two hours after eating. The more you eat, the more likely you are to suffer. What is more, if you lie down soon after eating, acid which has gone up into your oesophagus is less likely to clear because gravity is not working for you!
If you suffer, try avoiding large meals or eating late at night. Many people find that avoiding coffee makes a very big difference and don’t forget that chewing sugar free chewing gum for a quarter of an hour just after a meal can help settle the stomach.
For about a quarter of all sufferers, particularly younger people, once the symptoms are under control, they can return to normal and don’t suffer any more.
In many people, however, reflux symptoms do not respond to diet alone. These people need medicines to make them feel better. Medicines can be thought of as those which relieve symptoms and those which prevent reflux in the first place. Many of the modern medicines are highly effective and have almost no side effects.
For the very few people who do not respond to medicine, or who do not want to take drugs long term, anti-reflux surgery is an option. No one wants to opt directly for surgery, and with the array of other treatments now available, this option should really be saved for last.
Indeed, there are now new endoscopic and other minimally invasive approaches to managing reflux. See, for example, the Stretta procedure which we now offer. Around half the patients who undergo this simple, low risk, treatment no longer need to take any acid suppression pills at all.
Acid reflux treatment has improved very significantly over the last 20 years. It should now be possible to help the vast majority of sufferers to return to normal life, and most people should be able to eat quite normally with minimal symptoms.