Gastro-oesophageal reflux disease (GORD)
Gastro-oesophageal reflux disease, or GORD, happens when stomach acid affects the oesophagus, or gullet, between the mouth and the stomach.
GORD symptoms include heartburn, an acid taste in the mouth and swallowing problems, called dysphagia.
GORD is common, affecting around 1 in 5 people at least once a week.
What causes gastro-oesophageal reflux disease?
In a person with GORD, usually the lower oesophageal sphincter muscle or LOS doesn't work properly. This is supposed to act as a valve keeping stomach acid in the stomach. However, if the LOS doesn't fully close, acid may leak out of the stomach and rise up towards the throat.
Risk factors for GORD include:
- Being obese or overweight
- Eating too many fatty foods
- Excess alcohol consumption
- Coffee or chocolate may relax the LOS
- Hiatus hernia
- Experiencing stress
What are the symptoms of heartburn?
Heartburn, also called acid reflux, is the most common symptom of GORD and usually feels like a burning chest pain beginning behind the breastbone and moving upwards to the neck and throat. Many people say it feels like food is coming back into the mouth leaving an acid or bitter taste.
The burning, pressure or pain of heartburn can last as long as two hours and is often worse after eating. Lying down or bending over can also result in heartburn. Many people obtain relief by standing upright or by taking an antacid.
Heartburn pain can be mistaken for the pain associated with heart disease or a heart attack, but there are differences. Exercise may aggravate pain resulting from heart disease, and rest may relieve the pain. Heartburn pain is less likely to be associated with physical activity.
What is the treatment for GORD?
Doctors recommend lifestyle and dietary changes for most people needing treatment for GORD. Treatment aims at decreasing the amount of reflux and reducing damage to the lining of the oesophagus from refluxed materials.
Avoiding foods and beverages that are identified as triggering symptoms is recommended. These may include chocolate, peppermint, fatty foods, coffee and alcoholic beverages. Foods and beverages that can irritate a damaged oesophageal lining - such as citrus fruits and juices, tomato products and pepper - may also need to be avoided.
Decreasing the size of portions at mealtime may also help control symptoms. Eating meals at least three hours before bedtime may lessen reflux by allowing the acid in the stomach to decrease and the stomach to empty partially. In addition being overweight often worsens symptoms. Many overweight people find relief when they lose weight.
Cigarette smoking weakens the LOS, so stopping smoking is important to reduce GORD symptoms.
Elevating the head of the bed on 15cm (6in) blocks or sleeping on a specially designed wedge reduces heartburn by allowing gravity to minimise reflux of stomach contents into the oesophagus. Do not use pillows to prop yourself up, which only increases pressure on the stomach.