Heartburn is one of the commonest symptoms. This could be as a result of acid refluxing from stomach back into the gullet. A valve at the lower end of the oesophagus (gullet) works in such a way that it lets food and drink pass into the stomach, but not the other way. I some patients this valve is loose and therefore permits acid go back into the gullet.
Some of these patients may have a Hiatus Hernia. This is a condition where part of the stomach has moved into the chest.
Consequences of reflux or heartburn
If the heartburn continues, this can result in inflammation of the bottom end of the gullet. This can lead to a lot of discomfort and some situations can lead to the narrowing of the lumen of the gullet. If the latter happens, you can feel the food sticking at this level. In some patients, the reflux can be so severe that the acid backs up as high as throat and can cause cough and repeated chest infections.
If the reflux carries on for a along time, the lining of the gullet can change into a condition called Barrett’s. Barrett’s is a potentially pre-cancerous condition.
An endoscopy is required to diagnose cause of reflux and assess its severity.
The commonest treatment for reflux is by tablets which decrease the amount of acid secreted by the stomach. If the patient is allergic or not tolerant to the tablets, surgery can be performed to strengthen the valve at the lower end of the gullet.
This involves a keyhole operation to wrap the top end of the stomach around the bottom end of the gullet to strengthen the gullet valve. There are a few more tests that need to be performed before embarking on this surgery.
Mr Jayanthi will explain to you in more detail at the consultation.