Gastroesophageal Reflux Disease (GORD)

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

What causes GORD?

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

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 at night
• 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, especially in the morning
• Coughing: chronic coughing, especially at night
• Sore throat: a sore or irritated throat

Treatments for GORD

Treatment for GORD usually involves lifestyle changes and medications to reduce symptoms and prevent complications. Lifestyle changes include:

• Eating smaller, more frequent meals
• Avoiding trigger foods: citrus fruits, tomatoes, chocolate, spicy or fatty foods
• Raising the head of the bed by 6-8 inches to reduce acid flow
• Quitting smoking and avoiding secondhand smoke
• Losing weight if overweight or obese
• Avoiding tight clothing that puts pressure on the stomach

Medications for GORD include:

• Antacids: over-the-counter medications like Tums, Rolaids, or Mylanta to neutralize stomach acid
• H2 blockers: prescription medications like ranitidine (Zantac) or famotidine (Pepcid) to reduce acid production
• Proton pump inhibitors (PPIs): prescription medications like omeprazole (Prilosec) or lansoprazole (Prevacid) to block acid production
• Alginate: a medication that forms a barrier between the stomach and esophagus to prevent acid flow

Surgical Treatments for GORD

In severe cases of GORD, surgery may be necessary to repair the LES or tighten the lower end of the esophagus. Surgical options include:

• Fundoplication: a procedure that wraps the upper portion of the stomach around the lower end of the esophagus to prevent acid flow
• Linx reflux management system: a ring-like device implanted around the LES to prevent acid flow
• 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:

• Esophagitis: inflammation of the esophagus
• Stricture: narrowing of the esophagus due to scarring
• Barrett's esophagus: a precancerous condition where the lining of the esophagus changes
• Esophageal cancer: a rare but serious complication of long-term GORD

It is essential to seek medical attention if symptoms persist or worsen over time, as early diagnosis and treatment can help prevent complications and improve quality of life.