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Communication Station 3
You are a junior doctor working in a GP setting. You have two minutes to read the information sheet provided. Using the information, proceed to explain to the patient about their new diagnosis of acid reflux.
‘’When acid from the stomach leaks up into the gullet (oesophagus), the condition is known as acid reflux. This may cause heartburn and other symptoms. A medicine which reduces the amount of acid made in your stomach is a common treatment and usually works well. Some people take short courses of medication when symptoms flare up. Some people need long-term daily medication to keep symptoms away.
What are reflux and oesophagitis?
Acid reflux means that some acid leaks up (refluxes) into the gullet (oesophagus).
Oesophagitis means inflammation of the lining of the oesophagus. Most cases of oesophagitis are due to reflux of stomach acid which irritates the inside lining of the oesophagus.
Gastro-oesophageal reflux disease (GORD)
This is a general term which describes the range of situations - acid reflux, with or without oesophagitis and symptoms.
What are the symptoms of acid reflux and oesophagitis?
Heartburn: this is the main symptom. This is a burning feeling which rises from the upper tummy (abdomen) or lower chest up towards the neck. (It is confusing, as it has nothing to do with the heart!). Other common symptoms: these include pain in the upper abdomen and chest, feeling sick, an acid taste in the mouth, bloating, belching, indigestion (dyspepsia) and a burning pain when you swallow hot drinks. Like heartburn, these symptoms tend to come and go and tend to be worse after a meal.
Some uncommon symptoms include a persistent cough and chest pain
What causes acid reflux and whom does it affect?
The circular band of muscle (sphincter) at the bottom of the gullet (oesophagus) normally prevents acid leaking up (reflux). Problems occur if the sphincter does not work very well.
What tests might be done?
Tests are not usually necessary if you have typical symptoms. Tests may be advised if symptoms are severe, or do not improve with treatment, or are not typical of GORD.
Gastroscopy (endoscopy) is the common test. A thin, flexible telescope is passed down the oesophagus into the stomach.
What can I do to help with symptoms?
Avoid aggravating foods eg. Spicy foods/caffeine
Avoid lying down after food/late meals
What are the treatments for acid reflux and oesophagitis?
Acid-suppressing medicines - If you have symptoms frequently then see a doctor. An acid-suppressing medicine will usually be advised.
Surgery may be an option for some people whose quality of life remains significantly affected by their condition and where treatment with medicines is not working well
Are there any complications from oesophagitis?
Scarring and narrowing (stricture).
Your risk of developing cancer of the oesophagus is slightly increased compared to the normal risk if you have long-term acid reflux.
It has to be stressed that most people with reflux do not develop any of these complications’’.
(Adapted from: https://patient.info/health/acid-reflux-and-oesophagitis)