That burning sensation in the chest that rises towards the throat, the sour taste in the mouth, the constant belching… If this sounds familiar, you probably have gastro-oesophageal reflux. It is one of the most common digestive conditions, affecting 15–20% of the Western adult population, and its prevalence is rising.
But reflux is not merely a nuisance: when it becomes chronic, it can cause damage to the oesophagus and significantly affect quality of life. At Clínica Eupnea in Palamós, the gastroenterology service offers comprehensive diagnosis and personalised treatment for reflux and its complications.
In this article
Key takeaways
- Affects 15–20% of the adult population and is increasing
- The main symptom is heartburn in the chest and acid regurgitation
- Can cause chronic cough, hoarseness and sore throat (silent reflux)
- Lifestyle changes are the first pillar of treatment
- Proton pump inhibitors (PPIs) are very effective
- Medical advice should be sought if symptoms persist beyond 4 weeks of treatment
What is gastro-oesophageal reflux?
Gastro-oesophageal reflux (GOR) occurs when the acidic contents of the stomach rise back into the oesophagus. Normally, a muscular valve at the base of the oesophagus (the lower oesophageal sphincter) prevents acid from travelling upwards. When this valve does not function correctly, acid escapes and irritates the delicate oesophageal lining.
When reflux is frequent (two or more times a week) and causes troublesome symptoms or damage, we refer to it as Gastro-Oesophageal Reflux Disease (GORD).
Typical and atypical symptoms
Typical symptoms
- Heartburn: a burning sensation in the chest that rises towards the throat, typically after meals or when lying down
- Regurgitation: food or acidic liquid rising into the mouth without the effort of vomiting
- Chest pain: can be confused with cardiac pain (a cardiac cause should always be ruled out first)
Atypical symptoms ('silent' reflux)
- Chronic cough: persistent cough, especially at night, with no apparent respiratory cause
- Morning hoarseness: a husky voice on waking due to acid irritation of the larynx
- Lump-in-throat sensation: as if something is stuck (globus pharyngeus)
- Recurrent sore throat: without infection, caused by acid irritation
- Dental erosion: acid can damage tooth enamel over time
- Poorly controlled asthma: reflux can worsen existing asthma
Causes and risk factors
- Hiatus hernia: part of the stomach slides above the diaphragm, weakening the oesophageal sphincter
- Overweight and obesity: excess abdominal fat increases pressure on the stomach
- Pregnancy: hormonal changes and pressure from the foetus promote reflux
- Smoking: tobacco relaxes the oesophageal sphincter and increases acidity
- Large, late meals: eating heavily shortly before bedtime
- Certain foods: coffee, chocolate, alcohol, citrus fruits, mint, spicy foods, fats
- Stress: heightens symptom perception and may alter oesophageal motility
Warning signs requiring urgent consultation
See a doctor urgently if you experience: difficulty swallowing (dysphagia), pain on swallowing (odynophagia), unintentional weight loss, vomiting blood or very dark vomit, anaemia, or if symptoms first appear after the age of 50.
Diagnosis: how it is detected
- Upper GI endoscopy (gastroscopy): allows direct visualisation of the oesophagus and stomach
- 24-hour pH monitoring: measures acidity in the oesophagus over 24 hours — the most accurate test
- Oesophageal manometry: measures the pressure and motility of the oesophagus
- Therapeutic PPI trial: if symptoms improve with trial treatment, the diagnosis is confirmed indirectly
Comprehensive reflux treatment
1. Lifestyle changes
- Raise the head of the bed by 15–20 cm
- Avoid eating 2–3 hours before bed
- Eat smaller, more frequent meals
- Avoid trigger foods: coffee, alcohol, chocolate, citrus fruits, tomato, mint, very fatty or spicy foods
- Lose weight if overweight or obese
- Stop smoking
- Sleep on your left side
2. Pharmacological treatment
- Proton pump inhibitors (PPIs): omeprazole, pantoprazole, esomeprazole — first-line treatment
- Antacids: for rapid symptom relief
- Prokinetics: improve oesophageal and gastric motility in selected cases
- Alginates: form a protective barrier over the gastric contents
3. Follow-up and complication prevention
Untreated chronic reflux can cause oesophagitis, oesophageal stricture or Barrett's oesophagus. That is why proper medical follow-up is essential.
Frequently asked questions
Having occasional reflux (after a large meal, for example) is normal and affects most people. We speak of gastro-oesophageal reflux disease (GORD) when symptoms occur regularly (two or more times a week), affect quality of life or cause damage to the oesophagus. GORD requires medical treatment.
Omeprazole and other proton pump inhibitors (PPIs) are safe in the short and medium term. For long-term use, the doctor should assess the need and seek the minimum effective dose. Prolonged use without medical supervision may be associated with vitamin B12 or magnesium deficiency, or an increased risk of intestinal infections. PPIs should never be self-medicated on a chronic basis.
Yes, laryngopharyngeal reflux (LPR) is a variant of reflux that affects the larynx and pharynx, causing chronic cough, throat clearing, a foreign-body sensation in the throat, hoarseness and the need to clear the voice. Many LPR patients do not experience typical heartburn, which is why it is known as 'silent reflux'. Diagnosis requires assessment by a gastroenterologist and/or ENT specialist.
An upper GI endoscopy is recommended when reflux symptoms do not improve with treatment, warning signs appear (difficulty swallowing, weight loss, vomiting blood, anaemia), symptoms begin after age 50, or for follow-up of complications such as Barrett's oesophagus. It is a safe procedure that can be performed under sedation.
Suffering from gastro-oesophageal reflux?
The gastroenterology service at Clínica Eupnea in Palamós can help you get it under control.
Make an Appointment