When do I need to seek medical attention for acid reflux?

Hello Janice,

Acid reflux happens to many people and not all reflux episodes require attention. Most people seek medical help only when the condition does not resolve over a period of time.

If there are other symptoms you encounter besides the sour taste, (eg. pain that comes at night or black stools) you may want to get some advice from your GP.

The issue with GERD is that the amount of symptoms and the disease severity may not go hand-in-hand. Long term GERD may result in a condition known as Barrett's oesophagus which carries a small risk of malignancy.

If your condition does not improve after a month or so, or if your symptoms worsen, do pay your GP a visit to get some treatment. If indicated, you may benefit from an upper endoscopy examination.

- Dr Quan

Thank you for your questions. GERD stands for Gastroesophageal Reflux Disorder. It refers to the backflow of stomach contents (which is acidic) up to the foodpipe.

It is a common problem and can be due to lifestyle (e.g taking certain acid-reflux trigerring food, taking large meals, lying down soon after a meal or drink etc) and physical causes (e.g. hiatus hernia, obesity etc)

Common symptoms of GERD include:

• Heartburn
• Frequnet burping
• Bloatedness
• Sour or bitter taste in the mouth
• Chest discomfort or pain
• In some cases, the stomach contents do travel up to the level of the voice box. This is called Laryngopharyngeal reflux (LPR) - also known as the silent reflux due to the lack of stomach or chest symptoms.

Common symptoms of LPR include:

1. Globus sensation (feeling of something stuck in the throat)
2. Sore throat
3. Cough
4. Itchy throat
5. Frequent throat clearing
6. Hoarse voice

In severe cases of acid reflux, some patients may have both symptoms of GERD and LPR. Since your symptom is persistent and lasts throughout the day, you should see a GP, Gastroenterologist or an ENT Specialist for an assessment and treatment.

Treatment of GERD and LPR includes:

1. Lifestyle modifications

1. Avoid or reduce certain food like spicy food, fried food, caffeine, alcohol and chocolates
2. Avoid big meals (you can take multiple small meald but shoulf stop eating when you are 3/4 full)
3. Avoid eating or drinking (including water) at least 3 hours before sleeping or lying down. This allows time for the stomach contents to travel into the intestine and reduce the chances of reflux when you lie down.
4. Sleep with the head-end of your bed elevated.

2. Medications

• To reduce acid in the stomach (e.g. Losec, Pariet, Nexium, Dexilant, Ranitidine)
• To promote gastric emptying (e.g. domperidone)
• Medications to provide a protectivr layer to shield the stomach and foodpipe from the acid (e.g. Gaviscon, Mylanta).

If you have other worrying symptoms (e.g. loss of weight and appetite, stomach pain etc) or if you do not respond to these treatments, your doctor may recommend having a Gastroscopy (a scope passed down to the stomach which is done under sedation) to exclude other conditions of the stomach (e.g. Gastritis, Gastric ulcer and less likely, Gastric Cancer)

Hope this helps and all the best!