(GP)

Overview

• Chronic condition in which stomach contents flows back into the oesophagus
• Affects 10-30% of people in developed countries
• Caused by transient relaxation of the LOS
• Risk Factors → Smoking, Alcohol, Stress, Obesity, Pregnancy, Hiatus Hernia, Older Age

Making Diagnosis

Clinical Features:

• Heartburn (burning retrosternal pain) → burning sensation in the chest after meals, Can be worse after patient has been lying down or bending over
• Acid Regurgitation → reflux of acid into mouth, leaves sour/bitter taste in mouth, mainly after meals
• Halitosis → bad smelling breath
• Waterbrash → increased salivation
• Dysphagia & Dyspepsia

Investigations:

• Resolution of symptoms after 8 week PPI Trial → Gold Standard, 1st order. Further tests (eg. endoscopy) are indicated if symptoms do not improve with therapeutic 8-week PPI trial, or if patients has alarm symptoms