Acid reflux is a common occurrence that affects many people at some point in their lives. For some, it presents as occasional heartburn after a heavy meal. For others, it becomes a persistent condition that disrupts sleep, causes chronic throat discomfort or leads to ongoing chest pain.
While many patients rely on lifestyle changes or medication for relief, not all cases of acid reflux respond the same way. Some cases can be effectively controlled with non-surgical treatment, while others may require procedural intervention for long-term symptom control. Understanding the full range of available options allows patients to make informed decisions about their care.
What is Acid Reflux?
Acid reflux occurs when stomach acid flows backward into the oesophagus. This happens when the lower oesophageal sphincter, a ring of muscle that normally prevents backflow, becomes weakened or relaxes inappropriately.
Common symptoms include:
- Heartburn
- Regurgitation of sour or bitter fluid
- Chest discomfort
- Chronic cough
- Hoarseness or throat irritation
- Difficulty swallowing
Why Proper Treatment for Acid Reflux Matters
If acid reflux only occurs occasionally, it may be managed conservatively. However, if acid reflux becomes chronic, it is referred to as gastroesophageal reflux disease (GERD),which is a long-term condition characterised by frequent reflux episodes that can irritate and inflame the lining of the oesophagus, sometimes leading to complications if not properly managed.
Repeated exposure to stomach acid can damage the lining of the oesophagus, resulting in oesophagitis. Over time, chronic inflammation may cause scarring and narrowing known as strictures, which can lead to difficulty swallowing. In some patients, prolonged reflux can cause cellular changes in the oesophageal lining called Barrett’s oesophagus, a condition associated with an increased risk of oesophageal cancer.
Acid reflux may also affect the throat and airways. Some patients experience chronic cough, persistent throat clearing, hoarseness or a sensation of a lump in the throat. These symptoms are sometimes overlooked or mistaken for respiratory conditions when reflux is the underlying cause.
A comprehensive evaluation of acid reflux symptoms can help determine the most appropriate course of action.
Common Acid Reflux Treatment Options
Treatment for acid reflux depends on the patient’s symptom severity, their body’s response to medication and the presence of structural abnormalities in their throat. Management strategies typically follow a step-by-step approach, beginning with conservative measures and progressing to surgical intervention when necessary.
Non-Surgical Treatment Options
Non-surgical treatment is often the first line of management, particularly for patients with mild to moderate symptoms. These options focus on reducing acid production, minimising reflux episodes and controlling inflammation.
Medication
Medication is commonly prescribed to reduce stomach acid and relieve symptoms.
- Antacids: Quick, short-term relief by neutralising existing stomach acid. This type of medication is suitable for occasional symptoms or flare-ups, but does not have any preventive effects.
- H2 receptor blockers: A type of medication that reduces acid production and provides longer relief than antacids. They may be used for mild to moderate reflux.
- Proton pump inhibitors (PPIs): A more potent type of acid suppression medication. They are often prescribed for persistent symptoms or oesophagitis and are effective in healing acid-related inflammation.
While medications can be highly effective, they may not address the underlying mechanical cause of reflux. Some patients experience recurring symptoms once medication is reduced or stopped. Long-term use of acid-suppressing medication should be monitored, especially if high doses are required for symptom control. In such cases, further evaluation may be needed to determine whether procedural or surgical treatment is more appropriate.
Endoscopic Treatment
Endoscopic procedures offer a minimally invasive option between medication and surgery. These techniques aim to strengthen the barrier between the stomach and oesophagus or reduce reflux without external incisions.
Endoscopic treatment may be considered for patients who respond to medication but prefer to avoid long-term drug therapy, or for those with persistent symptoms despite medical management. Suitability depends on individual anatomy and the severity of reflux cases.
Surgical Treatment Options
Surgical treatment is generally considered for patients with severe GERD, inadequate symptom control despite optimal medication or complications such as strictures or Barrett’s oesophagus. It may also be recommended for individuals with significant anatomical abnormalities, such as a large hiatal hernia.
The most common type of surgical treatment is Laparoscopic Fundoplication. This procedure is performed using keyhole techniques, and requires a surgeon to create small abdominal incisions.
During the procedure, the upper part of the stomach is wrapped around the lower end of the oesophagus. This strengthens the lower oesophageal sphincter, reduces acid backflow and helps prevent reflux episodes. If a hiatal hernia is present, it is usually repaired at the same time.
Recovery time for laparoscopic fundoplication operations is typically short, as only small incisions are made.
When Is Surgery Recommended for Acid Reflux?
Laparoscopic fundoplication is typically recommended for patients who respond to acid suppressing medication but require long-term therapy, those with persistent regurgitation despite medication or individuals with confirmed reflux on diagnostic testing.
Surgical treatment is often necessary when there are structural abnormalities, such as a large hiatal hernia, or when complications develop, including recurrent oesophagitis, strictures or Barrett’s oesophagus. By addressing the underlying mechanical cause of reflux rather than simply reducing acid production, surgery can provide more durable symptom control in appropriately selected patients.
Choosing the Right Treatment for Your Acid Reflux
Acid reflux can range from a mild inconvenience to a chronic condition that significantly affects daily life. While many patients achieve control of it with lifestyle measures and medication, others may require surgical intervention for lasting relief. The most appropriate approach depends on the severity of your symptoms and your unique circumstances, making it important to undergo a careful evaluation by a gastroenterology specialist.
At The Digestive Centre, our priority lies in resolving the root cause of your acid reflux, rather than dealing with symptoms as they crop up. Each patient undergoes a thorough clinical assessment, with management tailored to individual findings. Our senior consultant surgeon, Dr Shanker Pasupathy, adopts a structured and evidence-based approach to evaluating and treating GERD, with the goal of providing safe and durable symptom control.
If acid reflux is interfering with your comfort or quality of life, early specialist evaluation may help prevent progression and complications. Contact us today to arrange an appointment and discuss the next steps in your care.
Meet Our Gastroenterology Specialist in Singapore
Dr Shanker Pasupathy
Senior Consultant Surgeon
MBBS (Singapore), FRCS (Glasgow), FRCS (Edinburgh), FAMS (General Surgery)
Dr Shanker Pasupathy is a highly experienced upper gastrointestinal and bariatric surgeon based in Singapore with broad expertise in digestive, metabolic and minimally invasive surgery. He has undergone advanced training in general, gastrointestinal and vascular surgery in Singapore, Germany, the United Kingdom and France, including a dedicated fellowship in advanced laparoscopy and robotic surgery. Dr Shanker pioneered the laparoscopic sleeve gastrectomy and laparoscopic gastric bypass at the Singapore General Hospital (SGH) in 2008.
Dr Shanker has held senior leadership roles, including Director of the Lifestyle Improvement and Fitness Enhancement Centre and Chief of the Metabolic-Bariatric Surgery Service at Singapore General Hospital, where he helped establish comprehensive metabolic and bariatric surgery services. He is President of the Obesity and Metabolic Surgery Society of Singapore, a member of the American Society for Metabolic and Bariatric Surgery and an international faculty member at the Asian Institute of Telesurgery, Taiwan.
With his depth of experience, Dr Shanker is committed to guiding each patient towards the safest and most effective treatment for their digestive and metabolic health needs.
We offer comprehensive, personalised care for acid reflux and obesity.
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Mount Elizabeth Hospital3 Mount Elizabeth #12-14 Mount ElizabethMedical Centre Singapore 228510
Tel: +65 6737 5388Whatsapp: +65 8799 2791
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