Quick answer: See a doctor about acid reflux if you have heartburn most days, if you need over-the-counter medicine more than twice a week, or if symptoms do not improve with lifestyle changes and pharmacy medicines. Arrange prompt review if you have trouble or pain when swallowing, persistent vomiting, unexplained weight loss, loss of appetite, or signs of bleeding such as black stools. Chest pain should never be assumed to be reflux.
Emirates European Hospital provides GERD treatment in Sharjah through its gastroenterology team. Many people with reflux improve with simple changes and medicine, and not everyone needs a test. The aim of a consultation is to confirm the likely cause, look for anything that should not be missed, and choose a plan that suits your symptoms.
What Is the Difference Between Heartburn, Acid Reflux and GERD?
Heartburn is a symptom: a burning feeling in the middle of the chest, behind the breastbone, that can rise toward the throat. Acid reflux is what causes it, when stomach contents travel back up into the esophagus, the tube that carries food to the stomach.
Almost everyone has heartburn at some point, especially after a heavy meal. Gastroesophageal reflux disease, or GERD, is the term used when symptoms are frequent, generally two or more times a week, or when reflux has damaged the esophagus. GERD is usually caused by abnormal reflux of stomach contents, and it is almost never caused by the stomach making too much acid.
What Are the Symptoms of GERD?
The two most typical symptoms are heartburn and regurgitation, which is the sensation of food or sour fluid coming back into the throat or mouth. Symptoms are often worse after eating, when lying down, and when bending over. Not everyone with GERD has heartburn, and other symptoms can include:
- An unpleasant sour taste in the mouth
- A cough or hiccups that keep coming back
- A hoarse voice
- Bad breath
- Bloating and feeling sick
- Problems swallowing or pain when swallowing
- Chest pain
When Should I See a Doctor About Acid Reflux?
Book a medical review if any of the following apply to you:
- You have heartburn on most days
- You use an over-the-counter reflux product more than twice a week
- Lifestyle changes and pharmacy medicines are not helping
- Symptoms return soon after you stop treatment
- Reflux is disturbing your sleep or your daily routine
- You have a long-lasting cough or hoarse voice with no clear cause
Warning signs that need prompt attention
Some symptoms can point to a complication of GERD or to a different health problem, so they should not wait for a routine appointment:
- Problems swallowing, pain when swallowing, or food getting stuck
- Persistent or frequent vomiting
- Vomit that contains blood or looks like coffee grounds
- Stools that contain blood or look black and tarry
- Weight loss without trying
- Loss of appetite
When Is Chest Pain an Emergency?
Reflux can cause chest discomfort, but a heart attack can also feel like burning or indigestion, so do not try to tell the two apart on your own. Call an ambulance on 998 straight away if you have sudden chest pain or pressure that does not go away, if pain spreads to your arm, neck, jaw, stomach or back, or if you have chest pain and feel sweaty, sick, light-headed or short of breath.
What Causes or Worsens Acid Reflux?
A ring of muscle at the bottom of the esophagus normally keeps stomach contents in place. GERD may develop when this muscle becomes weak or relaxes when it should not. Many people get heartburn with no obvious reason, but common contributors include:
- Being overweight or having obesity, especially with excess abdominal fat
- Pregnancy
- Smoking or breathing in secondhand smoke
- A hiatal hernia, when the upper part of the stomach moves up into the chest
- Food and drink such as coffee, tomatoes, chocolate, and fatty or spicy food
- Stress and anxiety
- Some medicines, including anti-inflammatory painkillers, certain blood pressure and asthma medicines, sedatives, and some antidepressants
Do not stop a prescribed medicine on your own because you suspect it is causing reflux. Discuss it with your doctor first.
Which Lifestyle Changes Can Help?
Simple changes can reduce or stop symptoms for many people, and they remain useful even when you are taking medicine:
- Eat smaller, more frequent meals
- Avoid food or drink that triggers your symptoms
- Finish eating 3 to 4 hours before going to bed
- Lose weight if you are overweight
- Stop smoking
- Avoid clothes that are tight around the waist
- Find ways to relax if stress worsens your symptoms
- Raise the head of your bed by about 10 to 20 cm, so your chest and head sit above your waist
Raising the bed itself or using a wedge usually works better than stacking pillows under your head, which can increase pressure on your stomach.
Which Medicines Are Used for Acid Reflux?
The right medicine depends on how often symptoms happen, how severe they are, and whether the esophagus has been damaged.
Antacids and alginates
These can relieve mild symptoms and may work for longer when taken with food or soon after eating. They ease symptoms in the short term but do not cure the problem, so they should not be used regularly for long periods without medical advice.
H2 blockers
These lower the amount of acid the stomach makes. They can help heal the esophagus, although not as well as proton pump inhibitors, and may be tried if a proton pump inhibitor does not help.
Proton pump inhibitors
Proton pump inhibitors, or PPIs, reduce stomach acid and include omeprazole and lansoprazole. They treat GERD symptoms better than H2 blockers and can heal the lining of the esophagus in most people with GERD. A course usually lasts 4 or 8 weeks, depending on how severe the reflux is. See your doctor again if symptoms return when you stop, because you may need longer-term treatment.
Is Long-Term Reflux Medicine Safe?
PPIs are generally safe and effective. Side effects are uncommon and may include headache, diarrhea and upset stomach. Research also suggests they may increase the chance of a bowel infection called C. difficile, and experts are still studying the effects of using them for a long time or at high doses. If you have been taking reflux medicine for months, ask your doctor to review the dose and whether you still need it.
Do I Need a Gastroscopy for GERD?
Often not. Doctors can usually diagnose GERD from your symptoms and medical history, and they may recommend treatment rather than tests. Tests become more useful if your symptoms suggest a complication, if another condition might be causing them, or if they do not improve with treatment.
A gastroscopy in Sharjah, also called an upper endoscopy, uses a flexible tube with a camera to look at the esophagus, stomach and duodenum. The doctor can take small tissue samples during the test. It can show inflammation, ulcers, narrowing, or other causes of your symptoms.
Which Other Tests Might Be Used?
Esophageal pH monitoring
Esophageal pH monitoring is the most accurate way to detect stomach acid in the esophagus. It tracks reflux over time alongside your meals, sleep and symptoms, and it may be used to confirm GERD or to check whether treatment is working.
Esophageal manometry
Esophageal manometry measures the pressure and movement of the muscles in the esophagus. Your doctor may suggest it when the cause of symptoms such as swallowing difficulty is not clear.
Testing for stomach bacteria
A bacterial infection in the stomach can cause heartburn, so your doctor may also test for this. It can be treated with a combination of medicines.
What Can Happen If GERD Is Not Treated?
Stomach contents can irritate the lining of the esophagus when reflux happens regularly. Over time this may lead to inflammation, ulcers, or a narrowing caused by scar tissue, which can make swallowing difficult. Some people with severe reflux develop pre-cancerous changes known as Barrett's esophagus. Most people with reflux do not develop these problems, but ongoing symptoms should be assessed rather than masked with repeated self-treatment.
Is Surgery Ever Needed for GERD?
Most people do not need surgery. A doctor may discuss it if symptoms do not improve with lifestyle changes and medicine, or if you want to stop long-term medicine. The most common operation is fundoplication, in which a surgeon wraps the top of the stomach around the end of the esophagus to help prevent reflux. Complications are more likely with surgery than with medicine, so the decision needs a careful discussion of your test results and your options. If you have obesity as well as GERD, your doctor may also talk to you about weight-loss treatment.
Questions to Ask Your Doctor
- Do my symptoms fit GERD, or could something else be causing them?
- Do I need any tests now?
- Which of my medicines could be making reflux worse?
- How long should I take this treatment, and how should I stop it?
- What should I do if symptoms return?
- Which symptoms mean I should come back sooner?
Reflux Assessment at Emirates European Hospital
Dr. Ghina Kogan is a Specialist in Gastroenterology at Emirates European Hospital, providing care for digestive complaints and gastrointestinal diseases. The consultation starts with your symptoms, medicines and medical history, and tests are arranged only when they are likely to change your care.
If you have frequent heartburn, reflux that keeps returning, or symptoms that have not improved with treatment, you can book an appointment at Emirates European Hospital or call 06 561 9444. The right next step may be lifestyle advice, medicine, a gastroscopy, or further testing.
This article provides general educational information for adults and does not replace a medical examination, diagnostic tests, or personalized medical advice.
