Gastro-oesophageal reflux disease

GORD is a chronic (long-term) condition involving frequent acid reflux - stomach acid escaping into your oesophagus (food pipe) and flowing towards your mouth, which irritates the lining of your gullet.

Acid reflux and heartburn are common in one in three adults from time to time. However, if you’re experiencing mild heartburn at least twice a week or severe heartburn at least once a week, you may have GORD.

Lifestyle changes and over-the-counter heartburn relief can help relieve GORD. However, if your symptoms are severe and affecting your quality of life, you may need medical treatment or surgery.

The main symptom of GORD is heartburn – often after eating or at night – but other common symptoms are:

• A sour taste at the back of your mouth
• Feeling that something’s lodged in your throat
• Regurgitation of food
• Indigestion
• An annoying cough, wheezing, a hoarse voice or a sore throat
• Dysphagia
• Vomiting

Seek medical attention immediately if you have very painful heartburn accompanied by any of the following symptoms, as it could mean a heart attack:

• Shortness of breath
• Chest pain or a burning sensation radiating down your arms or neck
• Dizziness
• A cold sweat

Your GP will discuss your symptoms and examine your stomach. To confirm a diagnosis of GORD, and rule out conditions with similar symptoms, your GP may refer you for tests including:

• Upper gastroscopy (endoscopy) – a tiny camera that films inside your stomach and oesophagus
• X-ray of your digestive system
• pH testing – to check the acidity levels in your oesophagus
• An oesophageal manometry – to measure how well the muscles in your stomach and gullet are working

In some cases your GP may refer you to a gastroenterologist, a consultant specialising in the digestive system.

GORD often occurs for no obvious reason, although it can be made worse by certain foods and drinks, smoking and some medications. It can also be due to:

• Pregnancy
• Obesity
• A hiatus hernia
• Connective tissue conditions

Lifestyle changes

To help relieve and prevent acid reflux, you should:

• Avoid foods and drinks that trigger your symptoms and eat earlier in the evening
• Try to avoid smoking and alcohol, lose excess weight and relieve stress
• Raise the head of your bed, so you lie on a slight tilt
• Avoid clothes with tight waistbands

Medication

Over-the-counter antacids may successfully relieve your symptoms, but you shouldn’t use them on a long-term basis.

Your doctor may prescribe a short course of proton-pump inhibitor (PPI) medication to reduce the amount of acid produced. As well as reducing your acid reflux symptoms, this will help repair the damaged lining of your oesophagus.

Surgery

If lifestyle changes and medication are unsuccessful, or your symptoms are very severe, your doctor might suggest surgery. The two main surgical procedures for GORD are:

• Laparoscopic fundoplication – using keyhole surgery, the top of the stomach is folded and stitched, reducing the amount of stomach acid returning to the gullet
• LINX device implant – a ring of magnetic beads is placed between the stomach and the gullet, helping to stop heartburn and acid reflux