Heartburn (burning discomfort felt behind the breastbone) is common and usually the result of a condition known as gastro-oesophageal reflux disease ('GORD' or 'acid reflux'). Other symptoms can include regurgitation, chest pain, upper abdominal discomfort, excessive burping, nausea or vomiting, and persistent cough. GORD can usually be successfully managed by diet and lifestyle changes, and drugs to reduce acid. People with persistent symptoms despite treatment, those with symptoms developing the first time over the age of 45 or those with so-called 'alarm' symptoms such as discomfort on swallowing, food sticking or weight loss should consult their doctor and may need a specialist opinion. Longstanding reflux can lead in a minority of people to the development of a change in the lining of the oesophagus known as Barrett's oesophagus, which can increase the risk of oesophageal cancer.
Investigation of patients with GORD symptoms usually involves Gastroscopy (sometimes called upper endoscopy), which can identify inflammation of the oesophagus from acid reflux, as well as complications of reflux such as Barrett's oesophagus. Patients with difficult-to-treat reflux problems sometimes require more detailed testing with Oesophageal Manometry and 24 hour pH-monitoring techniques.
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