Gastro-Oesophageal Reflux Disease (GORD)

Stomach conditions
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Gastro-Oesophageal Reflux Disease (GORD)

Gastro-oesophageal reflux disease (also referred to as acid reflux) is a relatively common condition that is associated with a number of underlying conditions. In this condition the acid contents of the stomach reflux up into the lower part of the oesophagus and can present with heart burn / chest pain and gives an acidic taste. A number of risk factors have been shown to result in GORD, this includes obesity, pregnancy, hiatus hernias and smoking.

A comparison between a healthy and diseased stomach showing the damage caused by GORD to the gastro-oesophageal junction.
The acid contents of the stomach reflux up into the lower part of the oesophagus

The reflux of acidic stomach content is due to a dysfunctional physiological sphincter at the gastro-oesophageal junction which is the point at which the oesophagus food pipe enters the stomach. There are long term complications that have been attributed to GORD, these include Barrett’s Oesophagus (which has the potential to become cancerous), oesophagitis (chronic inflammation of the oesophagus) and oesophageal stricture (this is a narrowing of the gastro-oesophageal junction due to the prolonged period of irritation caused by the acidic content that leads to scarring and stricture formation).

Patients with GORD can often be diagnosed following a detailed history and examination, with management based on life style modifications and medications that either protect the lining of the oesophagus or reduce acid production in the stomach.

Life style modifications include weight loss, avoiding foods that trigger symptoms, not lying down for 3 hours after eating and smoking cessation. Medications include Gaviscon, proton pump inhibitors (e.g. Omeprazole), antihistamine antagonists (e.g. Ranitidine) and prokinetics (these reduce the time food stays in the stomach e.g. Erythromycin).

Medical therapy used to reduce production in the stomach
Proton pump inhibitors such as Omeprazole can be used to reduce the amount of acid that is produced by the stomach

If there is evidence of worrying symptoms such as the inability to swallow or painful swallowing then investigations can be performed these include endoscopic investigations (OGD) or oesophageal pH monitoring.