What are the most acidic foods that we don’t know about?
Acidreflux.org.uk: “Can you think of anything else that somebody might not think that this is something pretty acidic and affect you negatively?”
Dr Brown: “ There is a reality and there are a lot of rumours. I think and maybe misperceptions about certain foods people should eat or not eat I think for reflux there’s a little bit of trial and error in that for in any individual so if there are certain things that are bothering you and triggering your reflux it might be a little bit different from somebody else so it’s really hard specifically to say but common sense just dictates that if there’s a certain thing that bothers you try to avoid it but we do know those big triggers that I mentioned before the nicotine the caffeine and alcohol are really the big three.”
What is the next step if over the counter medications do not work?
Acidreflux.org.uk: “So as a surgeon when someone comes to you and says you know Dr I mean I think I have got these symptoms and that you know first do you treat them by trying to see if they can make these lifestyle changes and then if it continues what might be the next steps”
Dr Brown: “If the lifestyle steps haven’t really helped much then there are some medication options that people can then resort to prescription strength medications the prior class of medications were called the h2 blockers or histamine blockers commonly on the market their Zantac, Tagamet, Pepcid and they worked very well their efficacy has waned a little bit through the years and they’re about %90 effective for people the new class of medications called proton pump inhibitors or PPIs are the Prilosec Prevacid some of those are over the counter now as well but those are much more potent antacid medications and those are better than %90 effective”
What to do if over the counter medications don’t work?
Acidreflux.org.uk: “So over the counter medications work very well however if someone tried them and still nothing happens, I mean, they don’t take things under control then what happens?”
Dr Brown: ”The prescription version should be taken every day not just when you need it but every day because that will actually stop the acid from being produced by the lining of the stomach if you’re still having symptoms or if you’re at that point where you’re needing prescription management for your reflux I also recommend that patients have an endoscopy so an EGD is a scope to look at the lining of the oesophagus and the stomach the importance of doing that is to confirm that there is indeed reflux present and that there isn’t some other underlying condition or complication of the acid reflux disease”
Does everyone who has acid reflux need to go through endoscopy?
Acidreflux.org.uk: “When someone would wear do one of the tubes down the throat and that when that’s after they’ve tried over the counter and they’ve tried some of these other medications you just don’t normally want to have somebody have a scope down there”
Dr Brown: “No, not everybody who has occasional periodic heartburn is going to need a scope but if you’re at a point where you’re needing prescription management for it i think you should have the endoscopy to look and the reason being is that reflux can result in some complications it can lead to inflammation or irritation of the oesophagus lining it can lead to scarring developing in the lining of the oesophagus which can narrow it and block it and make it hard to swallow in cases who do have patients who do have inflammation it can result in what’s called Barrett’s oesophagus so of patients with reflux will have Barrett’s oesophagus with it and that’s an abnormal change in the lining of the cells of the oesophagus and that can subsequently predispose people to develop cancer in those areas now it’s very rare it’s uncommon but that’s the importance of having the scope is to make sure you don’t have pre-cancerous conditions or hopefully not cancer.