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Gastro-Oesophageal Reflux Disease (GORD)

What is GORD?

Gastro oesophageal reflux disease (GORD or GERD) is a common digestive disorder that is closely related to acid reflux; however, the two conditions are not the same.

Acid reflux is the backflow of gastric acids and bile from the stomach up into the oesophagus (food pipe). The main symptom of acid reflux is heartburn. This is a burning sensation in the chest. Many people experience heartburn incidentally, after eating certain foods, lying down or bending over. In most cases, acid reflux can be treated with over-the-counter, pharmacy medicines.

Gastro-oesophageal reflux disease (GORD or GERD) is the chronic (long-term) form of acid reflux and is a more serious condition. GORD is diagnosed when acid reflux happens more than twice a week or causes inflammation in the oesophagus (oesophagitis).

GORD is more common in older people, and it is slightly more common in women compared to men. However, it can affect anyone of any age and any ethnic origin.

Complications of GORD

If GORD is left untreated, it can lead to certain healthcare complications over time. So, this digestive condition requires accurate diagnosis and management from qualified gastro-intestinal specialists.

Complications of GORD can include

  • Oesophageal ulcers: painful sore located in the lining of the lower part of the oesophagus These ulcers can bleed, causing pain and making it difficult to swallow.
  • Narrowing of the oesophagus: can make it difficult to swallow. Food feels like it is stuck in the chest area.

Around 10 to 15 percent of people with GORD will develop Barrett’s oesophagus, which is a digestive condition that increases the risk for a type of oesophageal cancer known as adenocarcinoma.

Causes of GORD

In many cases, there’s no clear cause for gastro-oesophageal reflux disease. Most cases of GORD appear to be due to a problem with the function of the lower oesophageal sphincter (LOS). The LOS is a circular band of muscle at the bottom of the oesophagus.

When you swallow, the LOS normally relaxes, to allow food and drink to flow into the stomach. The sphincter then closes again. However, if the sphincter weakens or does not work properly, then stomach acid can flow back up into your oesophagus to cause GORD symptoms.

Common causes of gastro-oesophageal reflux disease (GORD) include:

  • Obesity
  • Smoking (active or passive)
  • Low levels of physical exercise
  • Pregnancy
  • Alcohol
  • Wearing tight clothes
  • Certain foods (chocolate, peppermint, coffee, fruit juices, fatty or spicy foods)
  • Medicines (including asthma medications, aspirin, calcium-channel blockers, antihistamines, painkillers, sedatives, and antidepressants)
  • A hiatus hernia (when part of the stomach moves up into the chest)
  • Stress

Symptoms of GORD

Symptoms of gastro-oesophageal reflux disease (GORD) can vary from person to person. Common symptoms of GORD include:

  • Heartburn
  • Bad breath
  • Damage to tooth enamel due to excess acid
  • Feeling like stomach contents have come back up (regurgitated) to the throat or mouth
  • Chest pain
  • Persistent dry cough
  • Asthma
  • Trouble swallowing

If you experience GORD and acid reflux at night, you may develop a cough, laryngitis and/or disrupted sleep. If you have asthma and GORD, your asthma symptoms may become worse.

Diagnosis of GORD

Your gastro-intestinal specialist may be able to diagnose GORD based on a physical examination and a medical history of your symptoms. However, in most cases, symptoms alone are not enough, and testing is required for conclusive diagnosis, and to check for complications of GORD.  These tests include:

  • Endoscopy (Gastroscopy): camera imaging of the oesophagus
  • Biopsy: taking a tissue sample from the oesophagus for laboratory analysis
  • Oesophageal manometry: pressure measurement of the oesophagus
  • Impedance monitoring: measuring rate of fluid movement along the oesophagus
  • pH monitoring: acidity testing

 

Treatment of GORD

GORD treatment is based on whether your symptoms are mild, moderate, or severe. Our doctors will work with you to develop a personalised treatment plan and monitor your progress

Lifestyle Changes

The first step in treating mild-to-moderate GORD symptoms is lifestyle changes. You consultant will recommend changes based on personal factors that may contribute to your symptoms. Lifestyle changes to reduce the symptoms of GORD include:

  • Losing weight if you’re overweight or obese
  • Improving your posture, sitting up straighter
  • Avoiding tight-fitting clothes
  • Giving up smoking
  • Avoiding stooping, bending or lying down after eating
  • Raising the head of your bed by 6 to 8 inches

Over-the-counter Medication

For moderate to severe GORD symptoms, your doctor may recommend over-the-counter or prescription medicines based on whether or not acid reflux has damaged your oesophagus. Over the counter medicines include:

  • Antacids: Antacids are a group (class) of medicines which help to neutralise the acid content of your stomach. They include aluminium hydroxide, magnesium carbonate and magnesium trisilicate.
  • Alginates: This group of medicines help to protect the lining of the gullet (oesophagus) from stomach acid. Alginates include sodium alginate and alginic acid. They are added to various antacid brand medicines.

Prescription Medication

Two main groups of prescription medicines are used to treat GORD:

  • Proton pump inhibitors (PPIs): is a prescription include omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole. These medicines stop acid secretion at the source by inhibiting the proton pump in the cells of the stomach wall.
  • Histamine receptor blockers (H2 blockers): include cimetidine, famotidine, nizatidine and ranitidine

Surgery

Surgery is only required for a small number of people with GORD. This includes those people with severe symptoms, or whose symptoms are not relieved adequately with medicines, or who don’t want to take long-term medicines. The standard surgical treatment for GORD is:

  • Laparoscopic surgery (also known as fundoplication) This operation can ‘tighten’ the lower oesophagus to prevent acid leaking up from the stomach. It is usually carried out by ‘keyhole’ surgery.

Other surgical procedure to reduce or suppress gastro-oesophageal reflux disease are currently being investigated. Your gastroenterologist at OneWelbeck will discuss with you your options.

Frequently Asked Questions

Can GORD be cured?

GORD is a chronic condition,  which can be managed by qualified healthcare professionals through a combination of recommended lifestyle changes, over-the-counter medicines, prescription medicines and/or surgery. Speak to our specialists for more information.

How long will I need to take GORD treatments for?

For mild GORD symptoms, your doctor may recommend that you use the following medicines: antacids, alginic acid/antacids combinations, or H2 blockers, as needed. This means that you can use them whenever symptoms start or before symptoms occur.

Long-term treatment may be needed for people who have more severe symptoms of GORD, greater damage to the oesophageal tissues, or whose symptoms return as soon as medication is stopped often need ongoing treatment to control and relieve symptoms.

IBD Specialists

All our private digestive health specialists at OneWelbeck in London are leaders in their field. They are equipped with the latest medical technology, so they can provide the highest quality treatment at custom-built facilities to ensure you receive the best available care.

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