Brief Answer: Both plausible options will have to be considered Detailed Answer: Hello ma'am and welcome. Thank you for writing to us. Well ma'am, to be honest, both possibilities can be considered. There are various approaches and options in treating acid reflux. It starts with the milder options/approaches like lifestyle changes, then moving on to medication and finally surgery. Surgery is considered for those patients in whom medication does not help, or in those patients in whom medication used to help previously and is currently ineffective. So this possibility cannot be ruled out. The second option of a possible second condition complicating the already present condition is encountered less commonly than the previous possibility, but will also have to be considered and accordingly ruled out. An endoscopy would be most appropriate to rule this out. I hope this information helps you ma'am. Please feel free to write back to me for any further clarifications you have, or even if you wish for a more elaborate explanation of content that I have mentioned above. I would be more than happy to help. Best wishes.

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