Heartburn and gastro-oesophageal reflux disease 

Introduction  

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How common is GORD?

GORD is a common digestive condition. About 1 in 5 people are thought to experience at least 1 episode of GORD a week, with 1 in 10 people experiencing symptoms of GORD on a daily basis.

GORD can affect people of all ages, including children. However, adults aged 40 years or over are mainly affected. The condition affects both sexes equally, although males are more likely to develop complications.

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Gastro-oesophageal reflux disease (GORD) is a common condition where acid from the stomach leaks out of the stomach and up into the oesophagus (gullet).

The oesophagus is a long tube of muscle that runs from the mouth to the stomach.

Common symptoms of GORD include:

  • heartburn  burning chest pain or discomfort that occurs after eating
  • acid reflux  you may have an unpleasant taste in the mouth, caused by stomach acid coming back up into your mouth
  • pain when swallowing (odynophagia)
  • difficulty swallowing (dysphagia)

GORD occurs only occasionally for some people, but if the symptoms persist it's usually regarded as a condition that needs treatment.

Read more about the symptoms of GORD.

What causes GORD?

It's thought that GORD is caused by a combination of factors, but the most common is the failure of the lower oesophageal sphincter (LOS)  a ring of muscle towards the bottom of the oesophagus.

This acts like a valve, opening to let food fall into the stomach, then closing to prevent acid leaking out of the stomach.

In GORD, this sphincter doesn't close properly, allowing acid to leak up out of the stomach.

Known risk factors for GORD include:

  • being overweight or obese
  • being pregnant
  • eating a high-fat diet

Read more about the causes of GORD.

Diagnosing GORD

Your GP should be able to diagnose and treat GORD by asking you about your symptoms.

Further testing is usually only required if you have pain or difficulty swallowing, or if your symptoms don't improve despite taking medication.

Testing usually involves using an instrument called an endoscope, which is a long, thin, flexible tube with a light and camera at one end. It will be gently lowered down your throat so that any acid damage to the oesophagus can be seen.

Endoscopy is usually used if the diagnosis of GORD is in doubt, to check for any other possible causes of your symptoms, such as functional dyspepsia (an irritable stomach or gullet) or irritable bowel syndrome (IBS).

Read more about diagnosing GORD.

Treating GORD

A step-by-step approach is usually used for treating GORD. This means that simple treatments, such as changing your diet, will be tried first.

If this proves ineffective in controlling your symptoms, medication  such as antacids, proton-pump inhibitors (PPIs) or H2-receptor antagonists (H2RAs) – may be recommended.

Antacids neutralise the effects of stomach acid, and PPIs and H2RAs reduce the amount of acid that the stomach produces.

Surgery may be required in cases where medication fails to control the symptoms of GORD.

Read more about the treatment of GORD.

Complications

A common complication of GORD is that the stomach acid can irritate and inflame the lining of the oesophagus. This is known as oesophagitis.

In severe cases of oesophagitis, ulcers (open sores) can form, which can cause pain and make swallowing difficult, particularly if the gullet becomes narrowed (stricture).

Cancer of the oesophagus, known as oesophageal cancer, is a rarer and more serious complication of GORD.

Read more about the complications of GORD.

Outlook

Most people initially respond well to treatment with medication, but symptoms can often return quite quickly (within days or weeks).

People with recurring GORD may need to take medication on a long-term basis.




Page last reviewed: 29/05/2014

Next review due: 29/05/2016

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The 4 comments posted are personal views. Any information they give has not been checked and may not be accurate.

DuncanJB said on 29 January 2014

As "chasprit" said below " If PPIs do not work then you are abandoned".
3 years now i have been suffering and getting worse. PPIs seem to work intermittently at best yet even if i eat anything with a tiny bit of garlic or pepper in then i'm in agony. I also have problems with extreme pain in my bowels, spasms, cramps. 3 months ago i had a colonoscopy and biopsies taken. My Consultant has not written, sent any report or responded to any of my doctors letters!
So yet again i have been abandoned and left to suffer in pain, feeling sick, lethargic and at times suicidal.
Thanks NHS for once again failing me.

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chasprit said on 10 February 2013

Unfortunately my experience of the NHS in the diagnosis and treatment of this disease has been poor. If PPIs do not work then you are abandoned. I wake in pain every night (for the last three years), and a GP at my health centre even recommended that I should drink milk! He needs to read the latest peer reviewed papers published on the internet!

I was always a solid supporter of the NHS but not any more.

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Romadean said on 07 January 2013

I have been recommended to undergo a Laparoscopic Nissen Fundoplication surgery to correct my Hiatus Hernia. Any views would be welcome.

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championbob said on 03 December 2011

Would like to read medication recommended for GORD ......as the same is available from Supermarket quite easily and with x-mas approching it would help a lot of people.

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