Should I take medication or have surgery for my reflux?

It is most important to address lifestyle reasons that may be contributing to reflux. These include avoiding foods that you know cause it (this may be spicy foods, or excessive alcohol or sometimes even more bland foods). Also avoid large meals which excessively distend the stomach. Eating shortly before going to bed leaves food digesting in your stomach when you lie flat, encouraging reflux to occur (if you still get reflux at night you could prop the head of your bed up). Being overweight or obese also causes reflux so losing weight should help.

Beyond these measures it is usually best at trailing medication for reflux in the first instance. This may be on an as needed basis and antacids (such as quickeze, gaviscon or mylanta) act quickly to neutralise the acid that causes heartburn. If more regular medication is necessary the most common medications are from a group called ‘proton pump inhibitors’ (such as nexium or somac). Another group is called ‘H2 blockers’ and includes Nizatidine. These medications reduce the acid that the stomach produces, however they do not stop the reflux itself as the valve at the stomach entrance remains weak. Many patients have surgery for reflux and they must be selected appropriately and counselled well by their doctor. If heartburn persists despite addressing lifestyle factors and taking acid reducing medication then surgery should be considered. If a patient decides they do not wish to take medication long term (for reasons of potential side effects, medication cost or hassle) then surgery can be considered as an alternative.

If medication stops the burning sensation but still leaves the feeling of fluid or food particles rising up towards your throat then surgery is best (as medication cannot stop the presence of fluid or food nor the mechanical reasons for the reflux occur in the first place).

More significant reflux, such as where it travels up and ‘aspirates’ into your lung, would suggest a stronger reason to undergo surgery. As does the presence of a hiatus hernia which may be causing other problems in addition to refux.