Commonly called just 'reflux', Gastro-Oesophageal Reflux is where acid from the stomach escapes into the oesophagus and causes a burning sensation referred to as 'heartburn' or 'indigestion'. It is perfectly normal for this to occur from time to time, however when it happens very regularly it can cause other symptoms and complications. At this point it is referred to as Gastro-Oesophageal Reflux Disease, sometimes abbreviated to 'GORD' (in the US it is referred to as 'GERD').
GORD can occur at any age, but tends to affect people aged over 40.
There is a valve-like muscle between the oesophagus and the stomach called the Lower Oesophageal Sphincter (LOS), which is designed to keep stomach acid in the stomach and prevent it from escaping into the oesophagus. If the LOS becomes weak it may not be able to close properly and so acid is able to escape.
Certain lifestyle factors and conditions can make someone more prone to this...
- Diets high in fatty foods.
- Diets high in certain food types that tend to relax the LOS (e.g. alcohol, coffee, chocolate).
- Presence of a hiatus hernia.
The following symptoms are common...
- A mild acid taste in the mouth.
- Burning sensation in the mouth or throat.
- Sore throat.
- Sensation of food/fluid rising up the oesophagus.
- Chest pain.
- Abdominal pain.
In some cases, the following symptoms may also be present...
- Hoarseness of voice.
Tests / Diagnosis
Often it will be clear that GORD is present from the symptoms. However sometimes further tests are required if there is any uncertainty about the diagnosis or where the condition does not respond to treatment. This is especially the case where other symptoms such as difficulty swallowing, unexplained weight loss or blood in the vomit are present.
The three most common tests used in diagnosis of GORD are...
- Endoscopy/gastroscopy - where a long thin tube equipped with a small camera and light is inserted via the mouth to examine the gastrointestinal tract.
- 24 hour pH monitoring.
- Barium swallow (see Dysphagia).
Sometimes relatively small changes to lifestyle can greatly improve symptoms of GORD. Some of these are...
- Eating smaller portions.
- Reducing or giving up smoking.
- Reducing or giving up alcohol.
- Losing weight (if overweight / obese).
- Avoiding certain foods - fatty foods, coffee and chocolate are associated with GORD.
- Leaving at least 3 hours between eating a meal and lying down or going to bed.
- Lifting the head of the bed (by around 15cm) so that you head is higher than your feet when you are asleep.
Some medications can also help with the symptoms of GORD.
If these approaches do not help and the condition continues for 10 months or more, you should visit your doctor. If any of the following symptoms occur, you should visit your doctor immediately...
- Chest pain.
- Blood in either vomit or faeces.
- Sensation of food getting stuck after swallowing/difficulty swallowing.
- Unexplained weight loss.
GORD in children
Any symptoms of GORD in children need to be investigated immediately and before using any non-prescription medication.