Acid reflux is one of the most common digestive complaints today. Almost everyone has experienced that unmistakable burning feeling behind the breastbone after a heavy meal, late-night snack, or stressful day. While most cases of acid reflux are harmless and easily managed with lifestyle changes or over-the-counter medication, persistent or severe symptoms may point to something more serious.

For many patients, the biggest question is: How do I know when it’s just heartburn—and when it’s time to consider a gastroscopy?

Understanding the difference can make a major impact on your digestive health, early diagnosis, and treatment outcomes.

This article explores the signs, risks, and red flags of chronic reflux, and explains when a gastroscopy—performed by specialists like Dr. Deetlefs, who has extensive experience in gastroscopy treatments—may be recommended.

 

What Is Acid Reflux?

 

Acid reflux occurs when stomach acid flows upward into the oesophagus (food pipe). This happens when the lower oesophageal sphincter (LES), a small ring of muscle that acts like a valve, weakens or relaxes at the wrong time.

Common triggers include:

• Fatty, spicy, or acidic foods
• Alcohol and caffeine
• Smoking
• Obesity
• Eating too late at night
• Stress
• Certain medications

Most people experience reflux occasionally, and it usually settles quickly. But when it becomes frequent, persists for weeks, or interferes with daily life, it may indicate gastro-oesophageal reflux disease, also known as GERD.

 

Symptoms of Acid Reflux

 

Not every patient experiences reflux the same way. Classic and common symptoms include:

• Burning sensation in the chest (heartburn)
• Sour taste at the back of the throat
• Regurgitation of food or fluid
• Bloating
• Belching
• Chronic cough
• Hoarse voice
• Difficulty swallowing

These symptoms can range from mild to severe. Importantly, reflux symptoms should respond to simple interventions—like diet changes, weight management, or over-the-counter antacids. When they don’t, it’s time to investigate further.

 

When It Might Be More Than Acid Reflux

 

While reflux is common, some symptoms may suggest a more serious underlying condition. These include:

1. Persistent or Worsening Symptoms

If your reflux symptoms continue for several weeks despite medication or lifestyle changes, it may signal complications such as:

• Inflammation of the oesophagus (oesophagitis)
• Narrowing (strictures)
• Barrett’s oesophagus

These conditions cannot be confirmed without a gastroscopy.

2. Pain That Mimics Heart Disease

Chest pain is a symptom that doctors take extremely seriously. While reflux can cause chest discomfort, it’s important to seek urgent medical evaluation to rule out cardiac causes.

Once heart disease is excluded, persistent chest discomfort may need investigation through gastroscopy.

3. Difficulty Swallowing (Dysphagia)

A feeling that food is getting “stuck” or slow to pass down the oesophagus is a major red flag. This can be caused by inflammation, scarring, or growths within the oesophagus.

4. Unexplained Weight Loss

Losing weight unintentionally may indicate a more serious problem in the upper digestive tract. A gastroscopy helps detect structural problems and early signs of disease.

5. Vomiting, Especially With Blood

Regular vomiting or vomiting that contains blood, requires immediate investigation. These symptoms suggest irritation or bleeding somewhere in the upper gastrointestinal tract.

6. Anemia

If a patient develops iron-deficiency anaemia, it may be due to chronic bleeding from the stomach or oesophagus. A gastroscopy helps identify the source.

 

What is a Gastroscopy?

 

A gastroscopy, also known as an upper endoscopy, is a minimally invasive procedure that allows a specialist to examine the oesophagus, stomach, and the first part of the small intestine (duodenum).

It is performed using a thin, flexible tube with a light and camera at the end. The images are projected onto a screen so the specialist can look for:

• Inflammation
• Ulcers
• Abnormal growths
• Bleeding
• Structural problems
• Infection (including Helicobacter pylori)

Dr. Deetlefs, who specialises in gastroscopy treatments, uses this advanced diagnostic tool to accurately identify the causes of persistent reflux or other upper-GI symptoms, ensuring patients receive the correct diagnosis and treatment plan.

Why a Gastroscopy May Be Recommended

 

A gastroscopy is not typically the first step in evaluating reflux. However, it becomes essential when symptoms suggest complications or an underlying disease.

Here are the main reasons your doctor—such as Dr. Deetlefs—may advise a gastroscopy:

1. Your Reflux Is Long-Standing

Patients with reflux lasting five years or more, especially those over 50 or with risk factors like obesity and smoking, may require screening for Barrett’s oesophagus, a condition linked to chronic acid exposure.

2. Symptoms Do Not Respond to Treatment

When antacids, proton pump inhibitors (PPIs), or lifestyle changes don’t provide relief, gastroscopy helps identify why.

3. Alarm Symptoms Are Present

These include:

• Difficulty swallowing
• Vomiting
• Bleeding
• Persistent pain
• Weight loss

Alarm symptoms are never ignored and require prompt investigation.

4. You Have a Family History of Oesophageal or Stomach Cancer

In such cases, early screening is important, especially if reflux is present.

5. To Diagnose or Confirm Hiatal Hernia

A hiatal hernia is a common contributor to reflux. A gastroscopy allows the specialist to assess its severity.

 

 

What Conditions Can a Gastroscopy Detect?

 

Gastroscopy is one of the most valuable tools in digestive health because it allows direct visualisation—and often biopsy—of tissues.

Some conditions it helps diagnose include:

1. Oesophagitis

Inflammation caused by acid damage.
If left untreated, it can progress to scarring and strictures.

2. Barrett’s Oesophagus

A change in the lining of the oesophagus due to chronic reflux.
Although Barrett’s oesophagus does not cause symptoms on its own, it increases the risk of oesophageal cancer. Early detection is critical.

3. Peptic Ulcers

Ulcers can occur in the stomach or duodenum and may cause pain, bleeding, or anaemia.

4. Hiatal Hernia

A structural issue where part of the stomach pushes upward through the diaphragm. Gastroscopy helps assess its impact on reflux.

5. Gastritis

Inflammation of the stomach lining, sometimes caused by medications or infection.

6. H. pylori Infection

A common bacterial infection linked to ulcers, gastritis, and even stomach cancer.

7. Cancers of the Upper GI Tract

Although not common, early detection through gastroscopy dramatically improves treatment outcomes.

 

 

What to Expect During a Gastroscopy

 

Many patients feel anxious before their first gastroscopy, but the procedure is quick, safe, and done under sedation to ensure comfort.

Here is what typically happens:

Before the Procedure

• You’ll be asked not to eat or drink for 6–8 hours.
• Your medical team will discuss any medications you’re taking.

During the Procedure

• You’ll receive sedation so you remain relaxed and comfortable.
• A thin endoscope is gently guided through the mouth and down the oesophagus.
• The specialist examines the lining of the oesophagus, stomach, and duodenum.
• Small tissue samples (biopsies) may be taken if needed. Biopsies are painless.

After the Procedure

• You’ll rest briefly while the sedation wears off.
• Most patients can go home the same day.
• Your doctor will explain the findings and discuss next steps.

As an experienced endoscopist, Dr. Deetlefs ensures that patients receive safe, thorough, and compassionate care throughout the process.

 

Why Early Investigation Matters

 

Ignoring symptoms, especially persistent reflux, can lead to long-term complications. Early gastroscopy can:

• Prevent progression to more serious disease
• Detect conditions at their earliest and most treatable stage
• Provide peace of mind
• Guide the correct treatment pathway
• Reduce the risk of complications like strictures or bleeding
• Screen for conditions like Barrett’s oesophagus

When in doubt, it is always safer to investigate.

How Dr. Deetlefs Helps Patients with Chronic Reflux

 

As a specialist in gastroscopy and digestive disorders, Dr. Deetlefs has extensive experience diagnosing and managing:

• Chronic acid reflux
• Oesophagitis
• Barrett’s oesophagus
• Stomach and duodenal ulcers
• Hiatal hernia
• Gastritis
• H. pylori infection

His patient-centred approach ensures that individuals receive personalised care—from assessment and testing to long-term management and follow-up.

If your reflux symptoms are persistent, severe, or accompanied by red-flag signs, consulting a specialist like Dr. Deetlefs is one of the best steps you can take.

 

When Should You Book a Gastroscopy?

 

You should consider a gastroscopy if:

• Your reflux symptoms have lasted more than a few months
• Medications are no longer helping
• You have difficulty swallowing
• You experience unexplained weight loss or vomiting
• You have a family history of digestive cancers
• You’re over 50 and have long-standing reflux
• You’ve experienced bleeding or anaemia

If you are unsure, a consultation with Dr. Deetlefs can help determine whether a gastroscopy is the right next step.

 

Final Thoughts

 

Acid reflux is common and often harmless—but it can also be a warning sign of something more serious. Being aware of your symptoms, recognising red flags, and knowing when to seek further investigation is essential for protecting your digestive health.

A gastroscopy is a safe, effective tool that provides clear answers and early diagnosis. With the expertise of specialists like Dr. Deetlefs, who focuses on gastroscopy treatments, patients can receive an accurate diagnosis and tailored care to restore comfort and improve long-term health.

If your reflux symptoms are interfering with your quality of life, don’t ignore them. Early investigation can make all the difference.

 

About Dr. Eduan Deetlefs – Cape Town Gastroenterologist

 

Dr. Eduan Deetlefs is a highly experienced gastroenterologist based in Cape Town, specializing in the diagnosis and management of gastrointestinal disorders such as IBS, IBD, acid reflux, Crohn’s disease, ulcerative colitis, and liver conditions.

He provides a comprehensive range of diagnostic procedures, including colonoscopy, gastroscopy, endoscopic dilatation, and stent placement, using advanced technology to ensure accurate diagnosis and effective treatment.

If you’re struggling with chronic digestive symptoms or uncertain whether your condition is IBS or IBD, book a consultation with Dr. Deetlefs for expert evaluation and compassionate care.

📍 Visit: www.gidoc.co.za
📞 Call: 021 202 0626
📧 Email: info@gidoc.co.za