How is acid reflux treated?

Dr. Tan Chi Chiu discusses treatment options for patients with acid reflux symptoms

 

When faced with a patient with reflux symptoms how we approach treatment depends on how severe the symptoms are and how old the patient is, says Dr. Tan. As with all diseases in the digestive system the older a patient is the more we would have to exclude serious disease, he adds.

For patients who are young and who have typical reflux symptoms we might try using anti-reflux medication, typically an acid inhibitor called a proton pump inhibitor. These drugs when given over a week or two would be like a therapeutic test as to whether it is indeed acid reflux because if it is then the patient will report that they feel a lot better. If the patient does not improve or the symptoms come back again then we would be prompted to do more tests.

The tests we might do to evaluate reflux symptoms include blood tests, it may include some imaging, such as an ultrasound or even a CT scan depending on the symptoms, or an MRI, and it could certainly include a gastroscopy, which is an endoscopic examination of the upper digestive system. This is the most direct way through which we can look at the lining of the oesophagus to see whether or not there is evidence of inflammation, erosions, ulcerations or perhaps even scarring. We will also be looking for symptoms of Barrett’s Oesophagus, which is a kind of cell that develops after prolonged stimulation by acid and it is a risk factor for adenocarcinoma, which is cancer of the lower oesophagus.

Whether we proceed to gastroscopy in the first instance depends on the patient profile. If it is a young patient with very typical symptoms of reflux we might content ourselves with a therapeutic trial of medicines, such as with a proton pump inhibitor, which prevents or slows down acid production in the stomach. If the patient gets better then we can perhaps say that this is most likely due to acid reflux. Some patients don’t get better with this treatment, some patients have symptoms that quickly come back again and so that may prompt us to do further tests such as a