Reflux and heartburn: when to see a gastroenterologist
Most reflux can be managed with simple changes and your GP. Learn the warning signs that need a specialist or an endoscopy.
What it is
Reflux happens when stomach acid flows back up into the oesophagus (food pipe). It often causes heartburn, a burning feeling behind the breastbone. When it happens often, it is called gastro-oesophageal reflux disease (GORD).
Common symptoms include:
- Heartburn, often after meals or when lying down
- A sour taste or food coming back up
- Burping, bloating or nausea
- A cough, hoarse voice or sore throat that keeps coming back
What helps
Many people improve with simple changes:
- Smaller meals and not eating within a few hours of bed
- Raising the head of the bed
- Cutting back on alcohol, smoking, and foods that trigger your symptoms
- Reaching a healthy weight if you are carrying extra
Your GP or pharmacist can talk with you about medicines. Do not change or stop prescribed medicines without talking to your GP.
When you might see a specialist
Your GP may refer you to Gastroenterology if symptoms are not settling with treatment, keep coming back, or you have warning signs such as:
- Trouble swallowing, or food getting stuck
- Losing weight without trying
- Vomiting, or black or bloody stools
- Ongoing symptoms that start later in life
- Low iron (anaemia)
A gastroenterologist may suggest a gastroscopy (endoscopy). This is a thin camera passed through the mouth while you are sedated, to look at the oesophagus and stomach and take small samples. Some people with ongoing reflux need checks for changes in the lining of the oesophagus. Some people may also be referred to General surgery to discuss reflux surgery, and a dietitian (Dietetics) can help with food triggers and weight.
Referrals and costs
You need a GP referral for a Medicare rebate. Procedures can involve separate fees for the specialist, anaesthetist and hospital, so ask for a quote, see Understanding a surgery quote: what to ask before you agree. Spec Book shows which gastroenterologists have the soonest appointments.
When to get urgent help
Chest pain can be a heart attack. Call 000 if you have chest pain or pressure, especially with shortness of breath, sweating, or pain spreading to the arm, jaw or back. Also call 000 if you vomit blood or food is completely stuck and you cannot swallow saliva.
Common questions
Is heartburn the same as reflux?
Heartburn is the burning feeling. Reflux is the backflow of acid that causes it.
Will I definitely need an endoscopy?
No. Many people are managed without one. It is usually suggested for warning signs or symptoms that don't settle.
How do I know if chest pain is reflux or my heart?
You can't always tell. If you are unsure, especially if the pain is new or severe, call 000.
General information only, not medical advice. Everyone's situation is different, so check with your GP or the provider. In an emergency call 000.