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Gastro-oesophageal reflux disease (GORD)

 

What is Gastro-oesophageal reflux disease (GORD)?

Gastro-oesophageal reflux disease or GORD for short is a common condition that occurs when acid from the stomach leaks up into the oesophagus(gullet). The oesophagus is the tube which runs from the mouth to the stomach.

What causes GORD?

When you eat, food passes down the oesophagus, at the lowest part of the oesophagus is a muscle which acts like a valve. This muscle is meant to open to allow food into the stomach and then close again to keep stomach acid inside. However, in people with GORD it doesn’t close fully and so acid can leak out and rise towards the throat. This occurs because the muscle has become weak or relaxes abnormally and so doesn’t work properly. Reflux is common in babies when the muscle is still developing and therefore doesn’t work properly.

What are the symptoms of GORD?

The most common symptom of GORD is heartburn. Heartburn also known as acid reflux feels like a burning pain in your chest or throat. Symptoms of heartburn can last for a few minutes or as long as 2 hours and is often made worse after eating. Other symptoms can include:

  • Difficulty swallowing
  • Bad breath
  • Bloated
  • Belching
  • Feeling or being sick
  • Acidic or bitter taste in the mouth

Some people get heartburn when they bend over or lie down. Heartburn pain is less likely to be associated with physical activity. If you are experiencing chest pains, especially if you also have a shortness of breath, jaw or arm pain and you are unsure then you should always seek urgent medical advice. For information on heart attacks click here.

Am I at risk of suffering with GORD?

It is not always clear why some people suffer with GORD, however, you are more likely to suffer with GORD if:

  • You are overweight – this is because of the increased pressure on the stomach which can then be pushed up into the food pipe.
  • Eat too many fatty foods- the stomach takes longer to digest large fatty meals.
  • You smoke, drink alcohol or coffee – these all can relax the muscle at the bottom of the oesophagus.
  • Your pregnant – hormone changes and increased pressure on the stomach, the same pressure as in people who are overweight.
  • You are stressed
  • Certain medications, such as steroids, ibuprofen and aspirin.
  • You have a hiatus hernia, this occurs when part of the stomach pushes up through a hole in the diaphragm. This prevents the lower part of the oesophagus from working properly.

What is the diagnosis of GORD?

Most people can diagnose GORD themselves without needing to go to your doctor. If you are worried about your symptoms, they are severe or are experiencing symptoms several times a week then you should contact your doctor. You should also see your doctor if you have difficulty swallowing, have unexplained weight loss or have persistent vomiting.

Your doctor might be able to diagnose GORD based on your symptoms. However, they might suggest tests. The first test a doctor would usually recommend is an endoscopy, this is when a thin tube is passed down the oesophagus so the doctor can view the inside and look for signs of inflammation.  Your doctor might also look for signs of a stomach ulcer.

What is the treatment for GORD?

The treatment of GORD depends on the cause but for most people lifestyle and diet changes are all that is required. If you carry out a health diary to find what foods or drink might bring on your symptoms of GORD. Once identified what foods trigger GORD you can eliminate them or cut right down on them.

Common foods and drinks that trigger GORD include:

  • Chocolate
  • Fatty foods
  • Alcohol
  • Coffee
  • Citrus fruits
  • Fizzy drinks
  • Peppermint

 

If you are overweight then you should lose weight and watch your portion sizes, larger meals tend to stretch the stomach and so putting added pressure on the lower oesophagus muscle.

Avoid laying down within 3 hours of eating and if you suffer from symptoms at night try going to sleep with your head elevated with an extra pillow to prevent the acid rising.

Over the counter treatments such as antacids work to relieve symptoms and neutralise the stomach acid and so are effective to relieve symptoms. Antacids come as liquids, or tablets that be chewed or sucked.

There are also drugs such as ranitidine that are available without prescription that work by preventing the stomach from producing too much acid. These should not be taken for more than 2 weeks without consulting your doctor. If your symptoms persist your doctor can prescribe medication.  On occasions surgery might be required to stop stomach acid leaking into your oesophagus.

What are the long-term effects of GORD?

If you have just the odd episode now and then it’s probably not serious. However, persistent heartburn can damage the lining of the oesophagus causing oesophagitis (inflammation of the oesophagus) or ulcers to develop. If damage continues the oesophagus can become scarred and therefore narrow, this can make swallowing painful and difficult.  If after years of repeated episodes of GORD the cells in the oesophagus can change and grow, this is known as Barrett’s oesophagus. Most people who have Barrett’s oesophagus will not suffer any serious problems from the condition. However, it is then estimated that 1 in every 10/20 people with Barrett’s oesophagus will develop oesophageal cancer. If you develop Barrett’s oesophagus then you will have regular tests to monitor you so any changes can be picked up and treated.

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