Gastro-oesophageal
reflux disease (GORD)
Gastro-oesophageal reflux disease (GORD) is a common condition, where acid
from the stomach leaks up into the oesophagus
(gullet). It usually occurs as a result of the ring of muscle at the bottom of
the oesophagus becoming weakened. Read more about the
causes of GORD. GORD causes symptoms such as heartburn
and an unpleasant taste in the back of the mouth. It may just be an occasional
nuisance for some people, but for others it can be a severe, lifelong problem.
GORD can often be controlled with self-help measures and medication.
Occasionally, surgery to correct the problem may be needed.
Symptoms
Everyone
has experienced gastroesophageal reflux. It happens
when you burp, have an acid taste in your mouth or have heartburn. However, if
these symptoms interfere with your daily life it is time to see your physician.
Other
symptoms that occur less frequently but can indicate that you could have GERD
are:
·
Acid
regurgitation (retasting your food after eating)
·
Difficulty
or pain when swallowing
·
Sudden
excess of saliva
·
Chronic
sore throat
·
Laryngitis
or hoarseness
·
Inflammation
of the gums
·
Cavities
·
Bad
breath
·
Chest
pain (seek immediate medical help)
Causes
GERD
is caused by frequent acid reflux.
When
you swallow, a circular band of muscle around the bottom of your esophagus
(lower esophageal sphincter) relaxes to allow food and liquid to flow into your
stomach. Then the sphincter closes again. If the sphincter relaxes abnormally
or weakens, stomach acid can flow back up into your esophagus. This constant
backwash of acid irritates the lining of your esophagus, often causing it to
become inflamed.
Risk factors
·
Conditions
that can increase your risk of GERD include:
·
Obesity
·
Bulging
of the top of the stomach up into the diaphragm (hiatal
hernia)
·
Pregnancy
·
Connective
tissue disorders, such as scleroderma
·
Delayed
stomach emptying
·
Factors
that can aggravate acid reflux include:
·
Smoking
·
Eating
large meals or eating late at night
·
Eating
certain foods (triggers) such as fatty or fried foods
·
Drinking
certain beverages, such as alcohol or coffee
·
Taking
certain medications, such as aspirin
Complications
Over
time, chronic inflammation in your esophagus can cause:
Narrowing
of the esophagus (esophageal stricture). Damage to the lower esophagus
from stomach acid causes scar tissue to form. The scar tissue narrows the food
pathway, leading to problems with swallowing.
An
open sore in the esophagus (esophageal ulcer).
Stomach acid can wear away tissue in the esophagus, causing an open sore to
form. An esophageal ulcer can bleed, cause pain and make swallowing difficult.
Precancerous changes
to the esophagus (Barrett's esophagus). Damage from acid can cause changes in the tissue
lining the lower esophagus. These changes are associated with an increased risk
of esophageal cancer.
Esophageal
impedance test (measures the movement of substances in the esophagus)
Diagnosis
Several
tests may be used to diagnose GERD including:
X-ray
of the upper digestive system
Endoscopy
(examines the inside of the esophagus)
Ambulatory
acid (pH) test (monitors the amount of acid in the esophagus)
Treatments for GORD
The
main treatments for GORD are:
self-help
measures – this
includes eating smaller but more frequent meals, avoiding any foods or drinks
that trigger your symptoms, raising the head of your bed, and keeping to a
healthy weight
over-the-counter
medicines – ask
your pharmacist to recommend an antacid or an alginate
stronger
prescription medicines
– including proton-pump inhibitors (PPIs) and H2-receptor antagonists (H2RAs)
You
may only need to take medication when you experience symptoms, although
long-term treatment may be needed if the problem continues. Surgery to stop stomach
acid leaking into your oesophagus may be recommended
if medication isn't helping, or you don't want to take medication on a
long-term basis.