Gastro-Oesophageal Reflux Disease (GORD) Information
Gastro-Oesophageal Reflux Disease (GORD), also referred to as GERD, is a very common chronic condition. It occurs when the stomach contents—including acid—flow back up (reflux) into the oesophagus (the food pipe) and result in bothersome symptoms or complications. GORD can be objectively defined by finding injury to the lining of the oesophagus or an abnormal amount of acid exposure to the oesophagus during a pH monitoring study.
What Causes GORD?
GORD occurs when there is a malfunction at the oesophagogastric junction — the area where the oesophagus (food pipe) meets the stomach. At this important site, the oesophagus passes through the diaphragm (the muscle located below the lungs), forming a tight ring.
This area normally acts as a barrier made up of two main parts: the lower oesophageal sphincter (LES), a ring of muscle at the bottom of the oesophagus, and the diaphragm, the muscle just below the lungs that helps support it. When this barrier becomes weak or relaxes too often, stomach acid and contents can flow back into the oesophagus.
Several factors increase the risk of this happening, including:
Hiatal Hernia: Where part of the stomach pushes up through the diaphragm.
Obesity: Being overweight increases pressure on the abdomen.
Lifestyle Choices: Such as smoking or drinking excessive alcohol.
Common and Less Common Symptoms
The two most common symptoms are:
Heartburn: A painful, burning sensation rising from the upper abdomen or chest, often worse after meals, when bending over, or heartburn worse at night while sleeping.
Regurgitation: The unpleasant sensation of acid or sour food coming back up into the throat or mouth.
Less Common symptoms are often felt outside the oesophagus:
A persistent dry cough.
A hoarse voice, or sore throat not related to a cold.
The feeling of a lump in the throat that won't go away (globus sensation).
How is GORD Diagnosed or Tested
Diagnosing GORD usually starts with a detailed conversation about your symptoms and medical history. Your doctor may first recommend simple treatments. If your symptoms are severe, do not improve, or a specialist suspects damage, further testing may be necessary.
Common diagnostic tests may include:
Upper Endoscopy (Gastroscopy): The most common test, where a thin, flexible scope with a camera is used to look directly at the lining of your oesophagus and stomach to check for injury.
pH Monitoring: Measures the amount of acid reflux into the oesophagus over 24 hours, which helps confirm the diagnosis.
What Can Be Done About GORD?
Effective management of GORD generally starts with patient-led changes and progresses to medical treatments as needed.
Lifestyle Changes: Simple adjustments to your daily routine are the most fundamental step in managing GORD and may include.
Weight Management: Losing excess weight is one of the most effective long-term changes, as it relieves pressure on the abdomen.
Smoking Cessation: Reduction in tobacco products and quitting smoking are vital, as smoking significantly weakens the valve.
Eating Habits: Meals should be avoided within 2 to 3 hours before bedtime.
Trigger Foods: Avoidance of “trigger foods” which may include heavy fatty meals, spicy foods, caffeine, or alcohol.
Medical and Surgical Therapies: For symptoms not fully controlled by lifestyle changes, your doctor may recommend the use of medications that reduce stomach acid. In rare cases where symptoms are severe and persistent, or if there is a specific anatomical issue, a doctor may discuss surgical options.
Authored by Dr Walid Abu Shawish MBBS(Hons) BPharm(Hons) PGCertClinPharm FRACP.
Windsor, Melbourne Located Private Gastroenterologist & Advanced Endoscopist. For referral or contact information click here.