Gastro-oesophageal reflux disease (GORD) is a common condition whereby the juices in the stomach and sometimes stomach contents backflow into the oesophagus and ultimately cause some symptoms.
The most common symptom of GORD is heartburn, which is a burning sensation in the chest that often occurs after meals. It can also be associated with an unpleasant, sour and acidic taste in the mouth due to reflux of stomach contents in the mouth. This is often worse in the mornings when waking up. They can be associated bloating and belching. Over time reflux of stomach contents into the mouth can cause bad breath and tooth and gum disease. The reflux of acidic contents into the oesophagus can cause it to be inflamed, this can result in pain and difficulty in swallowing of. In some people reflux can lead to a persistent irritating cough and wheezing particularly at night.
The risk factors for developing GORD include being overweight or obese and pregnancy. Other risk factors include cigarette smoking, consumption of alcohol. Certain medications can result in relaxation of the lower oesophageal sphincter and result in ease of gastric contents to backflow into the oesophagus. Individuals who have certain medical conditions such as a hernia at the opening of the stomach and connective tissue diseases are also more prone to developing GORD. Patients with type 2 diabetes as well are known to be at an increased risk.
The diagnosis of the condition is often based on getting a compatible history from individuals know with risk factors. Additionally, they must be an upper endoscopy done to assess the oesophagus to look for evidence of inflammation. The endoscopy procedure also helps to assess for possible complications as a result of the GORD. During that procedure the pressures in the lower oesophagus can also be assessed.
The management of this condition involves some lifestyle adjustments as well as medical treatment. The lifestyle changes include stopping smoking and alcohol. It is also important to lose weight as well. It is also important to avoid food that triggers the symptoms, these are usually fatty foods, acidic food, fizzy drinks, and chili spices. Individuals with GORD are advised to have smaller and more frequent meals to help alleviate the symptoms. Those that have night symptoms can try and raise up the bed at the head side, this will reduce the amount of acid that refluxes to the oesophagus.
The medications used to treat this condition broadly are antiacids, medications that reduce the amount of acid in the stomach and medications that help with movement of stomach contents. It is important to consult a doctor if symptoms are persistent despite taking over the counter medications. Few cases of GORD can be complicated and may require surgery. In general, many patients’ symptoms can be well controlled with lifestyle modification and medications.