Why reflux happens — a weak lower oesophageal sphincter and delayed gastric emptying let acid back-wash.

When to investigate — red-flag alarms include night-time cough, food sticking, or anaemia. Dr Chandu recommends an upper GI endoscopy if symptoms persist > 8 weeks on PPI therapy.

What endoscopy reveals — erosions, Barrett’s changes and hiatal hernia are graded on the LA system. HD scopes in our Gopalapatnam suite magnify micro-breaks unseen on barium studies.

First-line fixes — weight loss ≥ 5 %, raising the bed-head 6 inches, and limiting late-night biryani.

When surgery helps — Nissen fundoplication or new endoscopic radio-frequency can be discussed if strictures form.