In brief
Most people get heartburn now and then, and that alone is not a disease. What makes it one is how often it happens, how much it affects your life and whether the oesophagus is damaged. The line is not where it is usually drawn.
Stomach contents can flow back into the oesophagus from time to time in healthy people too, especially after a large meal. Gastro-oesophageal reflux disease (GERD) is diagnosed when reflux causes regularly troublesome symptoms, disrupts daily life or sleep, or damages the oesophagus.
The typical symptoms of GERD are heartburn and regurgitation, meaning a sensation of sour or bitter contents coming back up. Chronic cough, morning hoarseness, a lump-in-the-throat sensation and dental enamel erosion may also be linked to reflux, but these symptoms are non-specific and can have other causes.
Current guidelines separate measures with proven benefit from general advice. The most effective are:
There is no universal list of forbidden foods. It only makes sense to cut out what causes symptoms in you specifically.
In Dubai a common reason for things getting worse is a late, heavy dinner: the heat eases in the evening, and social life often shifts closer to night.
Proton pump inhibitors are the mainstay of GERD treatment. With typical symptoms and no red flags, the doctor may prescribe a trial course of treatment, usually lasting eight weeks.
It is important to take the medication correctly: as a rule, once a day 30–60 minutes before a meal, unless your doctor has recommended a different regimen.
Once symptoms are under control, treatment is reviewed. The medication can be stopped, continued at the lowest effective dose or, in some patients, taken on demand.
Antacids and alginates can relieve symptoms quickly, but they do not replace the main treatment when the oesophagus is inflamed. Long-term use of any "stomach" medication should have a clear medical indication and be reviewed by a doctor periodically.
Do not put off investigation if any of the following symptoms appear:
Age on its own does not confirm GERD and is not a universal indication for endoscopy in anyone with heartburn. However, in patients aged 60 and over with new-onset dyspepsia — pain or burning in the upper abdomen, early satiety or a feeling of fullness after eating — the question of endoscopy is considered individually.
Chest pain must be distinguished from cardiac pain. Acute pain, especially if it comes with breathlessness, a cold sweat or marked weakness, or spreads to the arm, back or lower jaw, needs urgent medical help.
We go through the character and duration of your symptoms, their relation to food, sleep, body position and the medication you take, and check for red flags.
Where indicated, we arrange laboratory tests and a breath test for Helicobacter pylori, which can be done at our clinic. The test costs AED 350. Testing for Helicobacter pylori is not required for every case of heartburn and is ordered when there are appropriate indications.
Other investigations, including endoscopy and 24-hour pH-impedance monitoring, are carried out at specialist medical centres. When needed, we determine the indications and put together an individual plan for further investigation.
At GMS a gastroenterologist consultation is AED 750, in Russian and English, daily from 9:00 to 21:00.
Do not delay investigation if you have difficulty or pain on swallowing, vomit blood, pass black stools, vomit repeatedly, lose weight without explanation, have iron deficiency anaemia or get no response to properly conducted treatment. Acute chest pain with breathlessness, a cold sweat or spreading to the arm, back or jaw needs urgent help.
There is no universal list of forbidden foods; it only makes sense to cut out what triggers symptoms in you specifically. Not eating for 2–3 hours before bed is a proven measure — in Dubai a late, heavy dinner is a common reason for things getting worse.
Not in every case. Age on its own is not an indication for endoscopy. In patients aged 60 and over with new-onset dyspepsia the question is considered individually. At GMS the doctor determines the indications and plans further investigation; endoscopy itself is carried out at specialist centres.
This article is for information only and does not replace a consultation. If you have symptoms, see a doctor.
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