Gastro-Oesophageal Reflux Disease (GORD)

Gastro-oesophageal reflux disease, also known as GORD, is a chronic condition where stomach acid flows back into the oesophagus, causing symptoms and potentially leading to complications. The oesophagus is the tube that carries food from the mouth to the stomach.

What causes GORD?

GORD occurs when the lower oesophageal sphincter (LES), a ring-like muscle that separates the oesophagus and stomach, does not function properly. The LES normally relaxes to allow food into the stomach and then tightens to prevent acid from flowing back up into the oesophagus. In people with GORD, the LES is weakened or relaxed, allowing stomach acid to flow back up into the oesophagus.

Symptoms of GORD

The symptoms of GORD can vary in severity and frequency, but common symptoms include:

• Heartburn: a burning sensation in the chest and throat, often worse after eating or lying down
• Regurgitation: food or acid flowing back up into the mouth
• Dysphagia: difficulty swallowing
• Chest pain: sharp or dull pain in the chest that may be mistaken for a heart attack
• Bloating and discomfort: feeling full or uncomfortable after eating
• Nausea and vomiting: feeling sick to the stomach or vomiting
• Hoarseness: a raspy or hoarse voice due to acid flowing up into the throat
• Coughing: chronic coughing, especially at night

Treatments for GORD

Treatment for GORD usually involves lifestyle changes and medications. In some cases, surgery may be necessary.

Lifestyle Changes

• Eat smaller, more frequent meals to reduce symptoms
• Avoid trigger foods: citrus fruits, tomatoes, chocolate, spicy or fatty foods, and caffeine
• Raise the head of the bed by 6-8 inches to prevent acid from flowing back up into the oesophagus while sleeping
• Lose weight if overweight or obese
• Avoid tight clothing that can put pressure on the stomach
• Quit smoking and avoid second-hand smoke

Medications

• Antacids: over-the-counter medications that neutralize stomach acid, such as Tums or Rolaids
• H2 blockers: medications that reduce acid production in the stomach, such as ranitidine (Zantac) or famotidine (Pepcid)
• Proton pump inhibitors (PPIs): medications that block acid production in the stomach, such as omeprazole (Prilosec) or lansoprazole (Prevacid)

Surgery

In some cases, surgery may be necessary to treat GORD. Surgical options include:

• Fundoplication: a procedure that wraps the upper portion of the stomach around the lower oesophagus to prevent acid from flowing back up
• Linx reflux management system: a ring-like device that is implanted around the lower oesophagus to prevent acid from flowing back up
• Transoral incisionless fundoplication (TIF): a minimally invasive procedure that uses an endoscope to repair the LES

Complications of GORD

If left untreated, GORD can lead to complications such as:

• Oesophagitis: inflammation of the oesophagus
• Stricture: narrowing of the oesophagus due to chronic inflammation
• Barrett's oesophagus: a precancerous condition where the lining of the oesophagus changes
• Oesophageal cancer: a rare but serious complication of GORD

It is essential to seek medical attention if symptoms persist or worsen over time, as untreated GORD can lead to complications and decreased quality of life.