Gastro-oesophageal reflux disease (GORD) – what are the signs and symptoms?

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Heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat (acid reflux). If it keeps happening, it’s called gastro-oesophageal reflux disease (GORD).

Check if you have acid reflux

The main symptoms of acid reflux are:

heartburn – a burning sensation in the middle of your chest

an unpleasant sour taste in your mouth, caused by stomach acid

You may also have:

a cough or hiccups that keep coming back

a hoarse voice

bad breath

bloating and feeling sick

Your symptoms will probably be worse after eating, when lying down and when bending over.

Causes of heartburn and acid reflux

Lots of people get heartburn from time to time. There’s often no obvious reason why.

Sometimes it’s caused or made worse by:

certain food and drink – such as coffee, alcohol, chocolate, and fatty or spicy foods

being overweight

smoking

pregnancy

stress and anxiety

some medicines, such as anti-inflammatory painkillers (like ibuprofen)

hiatus hernia – when part of your stomach moves up into your chest

How you can ease heartburn and acid reflux yourself

Simple lifestyle changes can help stop or reduce heartburn.

Do

eat smaller, more frequent meals

raise one end of your bed 10 to 20cm by putting something under your bed or mattress – make it so your chest and head are above the level of your waist, so stomach acid doesn’t travel up towards your throat

try to lose weight if you’re overweight

try to find ways to relax

Don’t

do not have food or drink that triggers your symptoms

do not eat within 3 or 4 hours before bed

do not wear clothes that are tight around your waist

do not smoke

do not drink too much alcohol

do not stop taking any prescribed medicine without speaking to a doctor first

A pharmacist can help with heartburn and acid reflux

Speak to a pharmacist for advice if you keep getting heartburn.

They can recommend medicines called antacids that can help ease your symptoms.

It’s best to take these with food or soon after eating, as this is when you’re most likely to get heartburn. They may also work for longer if taken with food.

See a GP if:

lifestyle changes and pharmacy medicines aren’t helping

you have heartburn most days for 3 weeks or more

you have other symptoms, like food getting stuck in your throat, frequently being sick or losing weight for no reason

Your GP can provide stronger treatments and help rule out any more serious possible causes of your symptoms.

Treatment from a GP

To ease your symptoms, your GP may prescribe medicine that reduces how much acid your stomach makes, such as:

omeprazole

lansoprazole

ranitidine

You may be prescribed one of these medicines for a month or two to see if your symptoms stop.

Important

Go back to your GP if your symptoms come back after stopping your medicine. You may need a long-term prescription.

Tests and surgery for heartburn and acid reflux

If medicines don’t help or your symptoms are severe, your GP may refer you to a specialist for:

tests to find out what’s causing your symptoms, such as a gastroscopy (where a thin tube with a camera is passed down your throat)

an operation to stop acid reflux – called a laparoscopic fundoplication

Acid reflux – what are the signs, symptoms, causes and treatments of Gastro-oesophageal reflux disease (GORD)?

Acid Reflux

Acid Reflux

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

he 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.

 

[Original article on NHS Choices website]