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Innovations in Patient Care Q4 2023

Why reflux disease should not be dismissed as a minor issue

Xray front view of the esophagus or oesophagus 3D rendering illustration with male body
Xray front view of the esophagus or oesophagus 3D rendering illustration with male body
iStock / Getty Images Plus / libre de droit

Mr Nicholas Boyle

Founder of RefluxUK, Consultant Upper GI Surgeon

In the UK, at least 3% of all GP visits are made because of symptoms related to reflux — around 10 million every year.


Reflux disease, or gastroesophageal reflux disease (GERD), is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. It is usually caused by a failure of the valve at the bottom of the oesophagus.

Suffering from reflux disease

Although reflux (and reflux disease) is associated with heartburn after meals or when lying down, it is a much more common problem than generally appreciated. Likely 20–30% of the adult population in Western countries will suffer regular symptoms.

Decades of research reveal how reflux can cause symptoms and diseases beyond the oesophagus, affecting the throat (laryngopharyngeal reflux), airways, lungs, mouth and teeth. For instance, reflux is one of the most common causes of a persistent cough; affecting the voice, causing chest infections and damaging tooth enamel. More severely, reflux can cause cancer as most people with oesophageal cancer will have developed it from Barrett’s oesophagus. 

Treatment options and finding the cause

Treatment options vary from diet/lifestyle changes, over-the-counter medications, prescribed drugs — primarily proton pump inhibitors (PPIs) — and interventional treatments. PPIs, effective in reducing reflux symptoms, may not work in up to 30% of patients.

Furthermore, research suggests PPIs may be associated with conditions including bone fractures, renal failure and even cancer. In other words, relying on anti-acid drugs without undergoing investigation often will not be effective and may miss other causes of reflux symptoms.

Reflux is one of the most common causes of a
persistent cough; affecting the voice, causing
chest infections and damaging tooth enamel.

Getting a reflux disease diagnosis

Reaching the right diagnosis can be difficult with reflux symptoms mimicking other conditions. Proper testing is essential to providing clear diagnostic information, ruling out conditions and confirming others to obtain a good outcome in many patients. 

Accessing the right diagnosis, suitable tests and receiving the optimal treatment is individual. For instance, singers with reflux-related voice issues may require a different approach than athletes with heartburn. This requires the right team, with expertise working collaboratively for the benefit of every patient. These teams collect data from each patient to achieve the best outcomes so that they can also offer the best possible treatment option.

Finding the best approach to reflux

We still don’t know everything about reflux, especially its impact on the gut microbiome. However, evolving technology and the specialist approach are likely to provide the best possible solutions for the many people suffering from reflux symptoms.

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