What is acid reflux disease?

At the entrance to your stomach is a valve, which is a ring of muscle called the lower oesophageal sphincter (LOS). Normally the LOS closes as soon as food passes through it. If the LOS doesn't close all the way or if it opens too often, acid produced by your stomach can move up into your oesophagus. This can cause symptoms such as a burning chest pain called heartburn. If acid reflux symptoms happen more than twice a week, you have acid reflux disease, also known as gastro-oesophageal reflux disease ( GORD).

What causes acid reflux disease?

One common cause of acid reflux disease is a stomach abnormality called a hiatus hernia. This occurs when the upper part of the stomach and LOS move above the diaphragm, a muscle that separates your stomach from your chest. Normally the diaphragm helps keep acid in our stomach. But if you have a hiatus hernia, acid can move up into your oesophagus and cause symptoms of acid reflux disease.

These are other common risk factors for acid reflux disease:

• Eating large meals or lying down right after a meal
• Being overweight or obese
• Eating a heavy meal and lying on your back or bending over at the waist
• Snacking close to bedtime
• Eating certain foods such as citrus, tomato, chocolate, mint, garlic, onions, or spicy or fatty foods
• Drinking certain beverages such as alcohol, fizzy drinks, coffee or tea
• Smoking
• Being pregnant
• Taking aspirin, ibuprofen, certain muscle relaxants or blood pressure medication

What are the symptoms of acid reflux disease?

Common symptoms of acid reflux are:

• Heartburn - a burning pain or discomfort that may move from your stomach to your abdomen or chest, or even up into your throat
• Regurgitation - a sour or bitter-tasting acid backing up into your throat or mouth

Other symptoms of acid reflux disease include:

• Bloating
• Bloody or black stools or bloody vomiting
• Burping
• Dysphagia - difficulty swallowing or a sensation of food being stuck in your throat
• Hiccups that don't let up
• Nausea
• Weight loss for no known reason
• Wheezing, dry cough, hoarseness or chronic sore throat

How is acid reflux disease diagnosed?

It's time to see your doctor if you have acid reflux symptoms two or more times a week or if medications don't bring lasting relief. Symptoms such as heartburn are the key to the diagnosis of acid reflux disease, especially if lifestyle changes, antacids or acid-blocking medications help reduce these symptoms.

If these steps don't help or if you have frequent or severe symptoms, your doctor may order tests to confirm a diagnosis and check for other problems. You may need one or more tests such as these:

• Barium swallow can check for ulcers or a narrowing of the oesophagus. You first swallow a solution to help structures show up on an X-ray.
• Oesophageal manometry can check the function of the oesophagus and lower oesophageal sphincter by testing the pressure within these structures caused by the contraction of their muscles.
• pH monitoring can check for acid in your oesophagus. The doctor inserts a device into your oesophagus and leaves it in place for one to two days to measure the amount of acid in your oesophagus.
• Endoscopy can check for problems in your oesophagus or stomach. This test involves inserting a long, flexible lighted tube down your throat. First the doctor will spray the back of your throat with anaesthetic and give you a sedative to make you more comfortable.
• A biopsy may be taken during endoscopy to check samples of tissue under a microscope for infection or other abnormalities.