Severe acid reflux affects 20 per cent of UK adults, according to Imperial College Healthcare NHS Trust. Commonly experienced as heartburn—a burning sensation in the centre of the chest—the condition can trigger severe pain, regurgitation, difficulty swallowing, coughing, asthma, insomnia, voice loss, teeth and gum damage, nutritional problems, and depression.
Heartburn occurs when stomach acid travels up towards the throat. If it persists, it may be diagnosed as gastro-oesophageal reflux disease (GORD). Many people experience heartburn occasionally, often with no obvious cause.
What causes acid reflux?
The NHS website states that certain food and drink can trigger or worsen symptoms, including coffee, tomatoes, alcohol, chocolate, and fatty or spicy foods. Being overweight or smoking can also contribute.
Pregnancy, stress, anxiety, or a rise in hormones such as progesterone and oestrogen can bring it on. Additional causes include certain medications like anti-inflammatory painkillers (e.g., ibuprofen), a hiatus hernia, a stomach ulcer, or a bacterial infection in the stomach.
How is acid reflux treated?
A GP may prescribe a proton pump inhibitor (PPI), such as omeprazole or lansoprazole, which reduces stomach acid production. Treatment typically lasts four to eight weeks, depending on severity. If symptoms return after stopping, a long-term prescription may be needed.
Dr Amir Khan, a TV GP, cautioned users of PPIs this week: "Brilliant medication for acid reflux and protecting the stomach, but if you're taking them for months or years, they can reduce absorption of nutrients like vitamin B12 and magnesium. So they should be reviewed from time to time. Make sure you still need them and that you're on the lowest possible dose to manage your symptoms."
NHS advice for easing symptoms
The NHS recommends three lifestyle adjustments: eating smaller, more frequent meals; losing weight if overweight; and finding ways to de-stress. It also advises avoiding trigger foods, not eating within three or four hours before bed, avoiding tight clothing around the waist, not smoking, limiting alcohol, and never stopping prescribed medication without consulting a doctor.
If heartburn persists, a pharmacist may suggest antacids or alginates, best taken with food or shortly after eating. These offer short-term relief but are not a long-term solution.
You should visit a GP if lifestyle changes and over-the-counter remedies fail, if heartburn occurs most days, or if you experience food becoming lodged in your throat, frequent vomiting, or unexplained weight loss. The NHS website says: "A GP can provide alternative or stronger treatments and help rule out any more serious causes of your symptoms. If at any time you feel your symptoms are getting worse, contact a GP, go to 111.nhs.uk or call 111."
What if treatment does not work?
If medicines fail or symptoms are severe, a GP may refer you to a specialist for tests, such as a gastroscopy (a thin tube with a camera passed into the stomach), tests for bacteria that can cause heartburn (treated with antibiotics and PPIs), or surgery on the stomach or food pipe to stop acid reflux.
