Symptoms or mucosal damage from retrograde flow of gastric contents into the oesophagus.
Clinical features
- • Heartburn, acid regurgitation
- • Nocturnal cough, hoarseness
- • Chest pain mimicking angina
Investigations
- • Trial of PPI in typical uncomplicated cases
- • Endoscopy if alarm features (dysphagia, weight loss, anaemia, age >55 with new symptoms)
- • pH-impedance and manometry before anti-reflux surgery
Management
- • Weight loss, late-meal avoidance, head-of-bed elevation
- • PPI 8 weeks then step down to lowest effective dose
- • Test and treat H. pylori
- • Fundoplication for refractory volume reflux
Clinical pearls
- • Long-standing reflux → screen for Barrett's oesophagus
- • Deprescribe PPIs once healed to reduce long-term risk
Educational — verify locally.
