Gastro-oesophageal reflux disease (GORD)

What is GORD?

When stomach acid leaks back up into the gullet (oesophagus), it’s called acid reflux. This can irritate the lining of your oesophagus and cause inflammation. Most people experience acid reflux from time to time, but when it happens regularly, it’s called gastro-oesophageal reflux disease (GORD).

GORD symptoms

The most common symptom of acid reflux is heartburn, which causes a rising, burning feeling in the middle of your chest and up towards your neck.

Other symptoms can include:

• Repeated hiccups

• Bad breath

• Bloating and indigestion

• Feeling sick

• Belching

• Coughing and wheezing

• Sore throat

What causes GORD?

The sphincter is a circular band of muscle at the bottom of the oesophagus – this usually relaxes as you swallow to let food and drink enter the stomach and then closes to prevent acid flowing back up. But if the sphincter gets weak, or relaxes at the wrong time, stomach acids can leak out, causing ‘backwash’ in the oesophagus and leading to inflammation.

It’s not always clear why this happens, but certain factors can increase your chances of experiencing acid reflux:

• Certain food and drink – Common culprits include fatty or spicy foods, coffee, tomatoes, alcohol and chocolate

• Being overweight

• Smoking

• Pregnancy

• Stress and anxiety

• Certain medication, like anti-inflammatory painkillers

• Hiatus hernia – when part of your stomach protrudes into your chest

Self-help measures for GORD

Mild acid reflux and heartburn can often be managed with some simple lifestyle changes, like:

• Eating smaller meals more often and avoiding big meals

• Avoiding foods that may irritate your symptoms

• Not eating for a few hours before you go to bed

• Sleeping with your head and chest raised above the level of your waist to stop stomach acid from travelling up your throat – you can use pillows or prop one end of your bed up

• If you’re overweight, it can help to lose some weight

• Finding ways to manage your stress levels

• Not smoking and cutting down on the amount of alcohol you drink

GORD treatment

Antacids are medicines that are readily available over-the-counter. These ease the symptoms of heartburn and acid reflux by neutralising the acid in your stomach.

In some cases, the doctor may prescribe a course of medication called a proton pump inhibitor (PPI). This stops the stomach from producing so much acid over several weeks.

If symptoms persist or they are severe, you may be referred to a specialist for further tests or treatment. These can include:

• Gastroscopy – An endoscope (a thin, flexible tube) is passed down your throat to look inside your oesophagus and stomach to see what’s causing the symptoms

• Laparoscopic fundoplication – Keyhole surgery on your stomach (through small incisions in your skin) to wrap the top part of your stomach around your lower oesophagus and stop the acid reflux. If GORD is caused by a hiatus hernia, your doctor may recommend this procedure at the same time as repairing your hernia

• Other tests, like a chest X-ray, may also be used if doctors need to rule out other possible conditions

When to see a doctor

It can be possible to self-manage GORD symptoms with changes to your lifestyle and over-the-counter remedies, but it’s a good idea to see your doctor if:

• Your symptoms are severe or persistent

• You take over-the-counter remedies more than twice a week regularly

If you experience other symptoms, like severe chest pain, and you also have breathlessness or pain that travels from the chest to other parts of the body, see a doctor immediately as these can be signs of a heart attack.