When acid reflux keeps coming back, many people start by changing their diet: less spicy food, no coffee and fewer late-night meals. But if heartburn and reflux continue despite all these restrictions, the problem may not be simply what you eat. The position of the stomach and the structure around the junction between the oesophagus and stomach may also play a role.
Normally, the oesophagus passes through the diaphragm before joining the stomach in the abdomen. A hiatus hernia occurs when part of the stomach moves upwards through the oesophageal opening in the diaphragm and into the chest.
Some people have no symptoms at all. Others may be more prone to acid reflux, heartburn, belching, upper abdominal discomfort or difficulty swallowing.
This is why recurrent acid reflux cannot always be explained by diet alone. Depending on the symptoms and medical history, a doctor may consider gastroscopy, imaging or other investigations before deciding whether medication, lifestyle changes or further treatment are needed.
If reflux is accompanied by difficulty swallowing, unexplained weight loss, persistent vomiting, gastrointestinal bleeding or chest pain, it should not simply be treated as ordinary acid reflux.
