Causes & Cures

Reflux Reflux

Burn in the Gullet

20 Oct
Stomach acids flowing back into the oesophagus is a condition that can be resolved.

Burn in the gullet is the most typical symptom of reflux, which is an irritation of the oesophagus (gullet) by the acid that comes up from the stomach.

This irritation causes troublesome symptoms
and may result in complications. It happens because the junction between the gullet and the stomach does not function normally.
During swallowing, food passes down the throat through the esophagus into the stomach. Normally, a muscle valve at the end of the oesophagus (called the lower oesophageal sphincter) opens to allow food into the stomach; then it closes again. When this muscle does not close tight enough and remains open (called hiatus hernia), stomach acid can reflux, or wash back, into the oesophagus, causing damage to its lining.
People usually have heartburn pain when reflux happens, while others feel nothing. Other symptoms of reflux include burping, belching, sour or bitter taste in your mouth, coughing at night, dry
throat, sore throat, hoarseness in the morning, or worsening asthma.


  • OESOPHAGITIS, an inflammation of the oesophagus; it may be associated with ulcers (breaks in the lining of the oesophagus).
  • STRICTURE, which is the narrowing of the swallowing tube as a result of longstanding inflammation.
  • BARRETT’S OESOPHAGUS, which may occur when longstanding inflammation leads to changes of the cells of the lower oesophagus. Patients with Barrett’s oesophagus have higher risk
    of oesophageal cancer compared to general population.

How is Reflux Detected

When duration of symptoms is short and reflux improves after medication, no diagnostic tests are required. If the symptoms persist even with medication, further investigation is mandatory.


  • GASTROSCOPY. This allows the inspection of the gullet and stomach and detection of inflammation at the lower oesophagus. Tissue sample could be obtained for further testing of cell changes
    to rule out Barrett’s oesophagus.
  • 24-HOUR PH MONITORING is to test the acidity of the oesophagus.

How is Reflux Treated

The most important components for treatment are lifestyle and dietary changes. The purpose is to minimise acid refluxing from the stomach and reduce the potential damage to the oesophageal
lining. Certain food may worsen reflux. Medications are prescribed to reduce acid secretion in the stomach, and to improve motility and stomach emptying (prokinetics). Antacids may be given to
neutralise gastric acid. Most patients do not need surgery.

Food That Should Be Avoided During Reflux Episodes

These foods can relax the muscle responsible for stomach closure (lower oesophageal sphincter), allowing stomach juice and acid to reflux into the oesophagus:

  • Chocolate, sweet deserts, high-fat or spicy foods, curry, citrus fruits, garlic, onion and tomatoes or tomato-based products
  • Certain beverages, including citrus juices, alcohol, coffee, black tea

Lifestyle Habits That Improve Reflux

Eat regular meals and small portions at each time, and avoid eating for 2-3 hours before going to bed. If you are overweight, lose some weight, and stop smoking. When you sleep, elevate the head of
your bed 6 to 8 inches. Lastly, avoid stress.
In today’s hectic lifestyle, many are affected by stress which may lead to development of digestive problems affecting the stomach, oesophagus and bowel. To minimize these stress related digestive
problems, avoid fast food and gulping the food due to lack of time, eat regular meals and find some time to relax.

 Published in This Qarterly, 2011

Dr. Andrea

Dr. Andrea Rajnakova is our Consultant Gastroenterologist and Physician.

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