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Acid Reflux (GERD)

Seek Treatment with Dr. John Hsiang

What is an Acid Reflux?

Gastroesophageal reflux disease (GERD) or Acid Reflux – is a digestive disorder where the contents or acid in your stomach flows back upwards into the oesophagus.

This can cause symptoms like a heartburn where you feel a burning sensation in your chest. Recurring acid reflux may also damage your oesophagus over time.

Why does Acid Reflux happen?

There is a muscular ring that sits at the bottom of the oesophagus known as the lower oesophageal sphincter (LOS). The function of the LOS is to allow food to enter the stomach, but prevents stomach contents and acid from flowing back up.

GERD happens in people where their LOS muscle have weaken overtime or relaxes (hence opens up) at the wrong time.

What are the symptoms of GERD?

Patients may be diagnosed with gastroesophageal reflux disease (GERD) if they experience these symptoms regularly:

Why should one consider to seek treatment?

Over time, stomach acids may damage the tissues in the oesophagus, causing inflammation, bleeding, ulcers and an increased risk of oesophagul cancer. Damage to the esophagus from stomach acid may also cause scar tissues to form. This narrows the pathway for food to travel, making swallowing a difficult experience.

When to see a Doctor:

If you continue to experience symptoms of GERD and they cannot be relieved by over-the-counter medications or lifestyle changes, it may be time you seek medical help. You may then require a diagnostic evaluation and prescribed treatment by your gastro specialist.

Why see a Gastro Specialist?

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Seeing a Gastroenterologist for your symptoms helps in getting an accurate diagnosis. When you know what is causing your symptoms, it gives you a peace of mind.

Seeing a Gastro Specialist also helps in detecting and ruling out any signs of more serious diseases like ulcers and cancer.

Consulting the right Gastro Specialist and getting an endoscopy done is not as scary as you may think. At Richmond Gastro, you can rest assured that our team will make the process of consultation and diagnosis as smooth and comfortable as possible.

Why see a Gastro Specialist?

Seeing a Gastroenterologist for your symptoms helps in getting an accurate diagnosis. When you know what is causing your symptoms, it gives you a peace of mind. 

Seeing a Gastro Specialist also helps in detecting and ruling out any signs of more serious diseases like ulcers and cancer.

Consulting the right Gastro Specialist and getting an endoscopy done is not as scary as you may think. At Richmond Gastro, you can rest assured that our team will make the process of consultation and diagnosis as smooth and comfortable as possible.

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How is GERD Diagnosed?

Physical Exam and Medical History

Your doctor will begin by discussing your symptoms and medical history with you. They may also perform a physical exam to check for any underlying causes of your symptoms.

Upper Endoscopy

In some cases, an upper endoscopy (also known as gastroscopy) may be recommended to visually examine the lining of your oesophagus, stomach, and duodenum.

In this procedure, a flexible tube with a camera is passed through the mouth into the food pipe and stomach to examine for issues like inflammation or irritation.

Esophageal pH Monitoring

To measure the level of acid in your oesophagus, your doctor may recommend an esophageal pH monitoring test. It involves placing a small tube through your nose and into your oesophagus for 24 hours.

The device will record any acid reflux episodes during this time, providing valuable information for diagnosis and treatment.

X-rays

In some cases, your doctor may recommend a barium swallow or upper GI series to visualise the structure of your upper digestive tract.

These tests involve swallowing a liquid containing barium, which makes it easier to see any abnormalities on X-rays. This is not commonly done nowadays due to the poor sensitivity of the test to detect certain pathologies.

What to Expect When Seeking Treatment

GERD (gastroesophageal reflux disease) is a chronic condition that can have a significant impact on your daily life. Seeking treatment for GERD involves addressing symptoms and managing the underlying causes to improve your quality of life.

Several over-the-counter and prescription medications are available to help relieve the symptoms of GERD. These may include antacids, H2 blockers, and proton pump inhibitors.

Your doctor may also recommend lifestyle changes to help manage your symptoms.

Your doctor may recommend changes to your diet and eating habits, such as avoiding trigger foods, lying down after eating, and eating smaller meals more frequently, There are six lifestyle changes which may help with GERD

  1. Eat slowly
  2. Eat meals on time
  3. Don’t eat too full
  4. Don’t lie down within 3 hours of a proper meal
  5. Reduce stress
  6. Improve good quality sleep

 

Other lifestyle changes that may help include quitting smoking, avoid excess alcohol, avoid oily and spicy foods, maintaining a healthy weight, and elevating the head of your bed while sleeping.

In some cases, lifestyle changes and medications may not be enough to manage GERD symptoms. Your doctor may recommend procedures or surgery to help alleviate symptoms and improve quality of life.

Some options include:

  • Endoscopic treatments to tighten or repair the LES (lower esophageal sphincter) such as ARMS or ARMA
  • LINX device placement to help prevent stomach acid from entering the oesophagus
  • Fundoplication surgery to strengthen the LES

GERD is a chronic condition that may require ongoing management. Your doctor will work with you to develop an individualised treatment plan and schedule follow-up appointments as needed.

It is important to continue taking any prescribed medications and making lifestyle changes to effectively manage your GERD symptoms. Be sure to discuss any concerns or questions you may have with your healthcare provider.

Common Questions about GERD

GERD is a common digestive disorder that can affect anyone, but certain factors may increase your risk, such as obesity, pregnancy, smoking, and consuming alcohol or spicy foods. Conditions like hiatal hernia and delayed stomach emptying can also contribute to the development of GERD.

Those with six lifestyle patterns mentioned above are more likely to have GERD such as eating too much, lie down within three hours of a meal, those with poor sleep and too much stress, as few of the examples.

If you experience frequent heartburn or other symptoms of GERD, it is important to speak with your healthcare provider for proper diagnosis and management.

In some cases, milder forms of GERD can be managed at home with lifestyle changes and over-the-counter medications. However, it is important to consult with your doctor for an accurate diagnosis and recommended treatment plan.

If your symptoms are severe or do not improve with home care, your doctor may recommend further medical interventions or procedures. It is essential to follow their guidance for proper management of GERD.

Yes, if left untreated, GERD can lead to serious complications.

These may include inflammation and scarring of the oesophagus, which can make it difficult to swallow. Long-term acid reflux can also increase the risk of developing Barrett’s oesophagus, a condition that increases the risk of esophageal cancer. Oesophageal ulcers and strictures (narrowing) can occur causing pain and difficulty swallowing.

Other complications may include respiratory issues, such as asthma or constant coughing, due to acid reflux irritating the airways. It is important to seek treatment and manage GERD symptoms to avoid potential complications.

There is no one specific diet for managing GERD, as triggers and food sensitivities may vary from person to person.

However, some general dietary guidelines that may help include avoiding trigger foods, such as spicy (chilli, curry) or acidic foods (citrus fruits, tomatoes), eating smaller meals more frequently throughout the day, and incorporating anti-inflammatory foods like leafy greens and healthy fats.

It is also important to stay hydrated and avoid eating close to bedtime. Your healthcare provider may also recommend keeping a food diary to track any potential triggers and help you manage your symptoms.

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About Dr. John Hsiang

MBChB (NZ), FRACP (Australasia), MD (Doctorate), FRCP (Edinburgh), FAMS (Gastro)

Dr. John Hsiang is a gastroenterologist and hepatologist with more than 20 years of clinical experience in public and private practice.

Dr John Hsiang’s special clinical interests are gastroesophageal reflux disease, stomach conditions, fatty liver, and gastrointestinal cancer screening

Dr John Hsiang spent more than five years in the Singhealth cluster serving in the Gastroenterology Department at Changi General Hospital and Sengkang General Hospital.

Clinical interests:

Indigestion, gastroesophageal reflux disease, helicobacter pylori infection, irritable bowel syndrome, constipation, diarrhoea, hepatitis B, fatty liver disease, management of abnormal liver tests.

Dedicated Insurance Support

We understand that navigating the financial aspect of healthcare can be overwhelming. We welcome all patients with or without insurance and can assist with claims regardless of your personal or corporate insurance plan.

Here at Richmond Gastroenterology Centre, we strive to ensure the most efficient claims process for our patients. To that end, our team works diligently with their insurers to obtain Letters of Guarantee and pre-authorization certificates prior to any procedures.

Make an appointment to consult our Doctor.

We understand your anxieties and we are here to support you throughout your health journey. If you have questions or would like to seek a 2nd opinion, send us your message via the form below.

To get an immediate response, you may also call us at: 6517 9958

Dr. John Hsiang is an Accredited Specialist Across All Private Hospitals in Singapore.