Reflux Disease
EDP column by Dr Ketan Dhatariya

“I get a lot of heartburn and my GP has told me I have reflux disease.
Why do I have this?"

The stomach contains a very strong acid called hydrochloric acid. This is to help it to break down some of the food we eat to release the nutrients stored in it. The lining of the stomach of coated with a special mucus to protect the cells lining the stomach from being eaten away by the acid. The rest of the intestines are not protected in this way. The oesophagus – gullet – is the muscular tube that takes food from the mouth to the stomach. At the bottom of the gullet is a strong circular muscle that is usually held tightly closed to stop any food (or acid) from going the wrong way. The only times that this strong ring of muscle relaxes is when we swallow some food – so allowing the food into the stomach – or when we feel very unwell and we vomit.

The are, however, a few ways in which the barrier that these muscles provide can be overcome. The most common way is when the pressure in the abdomen increases. The most common cause for this is pregnancy. If you ask women who are late into the pregnancy, many of them will suffer the symptoms of heartburn because the uterus pushes against the stomach, pushing it up and increasing the pressure within it.

When the acid comes into contact with the lining of the gullet it can cause pain, because the gullet is not lined with the same protective layer as the stomach. If this pain goes on for ling enough it can causes he cells to change and may cause long term problems. This is why it is important to let your GP know that you have these symptoms because they will probably start you on some medication that stops the acid in the stomach being produced. Occasionally your GP may ask for you to have an endoscopy – this is a test where they put a tube with a small camera on the end down into your stomach to have a look to see if there are any other problems that may be causing your symptoms.

Some people may develop symptoms with very little evidence on endoscopy of acid reflux disease, whilst others may have lots and lots of acid in their gullets but very few symptoms.

As always if you do get symptoms of heartburn then see your pharmacist or your doctor who may be able to help you with tablets. If the tablets do not help go back to your doctor.

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