☉ Doctors online now - 15 minute priority booking available

What is GORD / Acid Reflux?

Gastro-oesophageal reflux disease (GORD) is a general term which encompasses acid reflux, heartburn, indigestion and oesophagitis. It may include one or all of these conditions.

It is caused by irritation of the stomach or food pipe (oesophagus) by stomach acid.

What are the symptoms of GORD?

The main symptom of GORD is heartburn. This is a discomfort or burning sensation which rises from the upper tummy or lower chest up towards the neck.

Other commonly associated symptoms include:

Nausea
Belching
Indigestion
An acid-like taste in the mouth
Persistent dry cough
Feeling of a lump in the throat
Burning pain when you swallow hot drinks

Symptoms tend to be worse after or with meals.

The following symptoms/conditions may indicate serious illness and you must seek medical attention urgently. (Red Flag symptoms)

Chest pain or upper tummy pain worse on exertion
Difficulty swallowing foods or liquids
Persistent pain on swallowing
Persistent vomiting
Vomiting blood or dark brown vomit
Unexplained weight loss
Altered bowel habit (diarrhoea or constipation) for more than 6 weeks
Altered stool (dark or black poo)
Lump in the abdomen (tummy)
Unexplained anaemia
Jaundice
New GORD symptoms in someone aged 55 years or over
GORD symptoms with any of the following:
- Family history of upper GI cancer in more than two first degree relatives
- Barrett’s oesophagus
- Pernicious anaemia
- Previous stomach ulcer surgery
- Pernicious anaemia
- Known dysplasia, atrophic gastritis or intestinal metaplasia

Who gets GORD?

GORD symptoms are very common and can occur more in the following groups of people:

Smokers
Pregnant women
Heavy drinkers
Those aged between 35 and 64 years

What causes GORD?

There is a muscle sphincter at the bottom of the oesophagus (food pipe) which acts as a valve to stop stomach acid from leaking upwards. If this sphincter does not work very well, you can develop symptoms of GORD.

It can also occur if you have a hiatus hernia. This is a common condition where part of the stomach protrudes into the chest through the diaphragm (the sheet of muscle that divides the chest from the abdomen). This can increase the chances of developing GORD symptoms.

GORD symptoms can be caused or aggravated by the following medications:

Anti-inflammatories (E.g. Aspirin, Ibuprofen)
Oral steroids (E.g. Prednisolone)
Calcium channel blockers (E.g. Nifedipine)
Osteoporosis medications
Antidepressant medications

There are several other medications that may lead to worsening of GORD – if you’re on regular medications that you think may be to blame, you should consult your GP

Infection with a bacteria called Helicobacter pylori (H. pylori) may cause symptoms of GORD. It is the most common cause of stomach and duodenal ulcers.

It is important to exclude H. Pylori, especially if your symptoms do not respond to initial treatments.

Do I need any tests to confirm the diagnosis?

Most people are diagnosed with GORD by their GP from their typical symptoms and their response to treatment.

Further investigation and tests may be advised if:

Symptoms are severe
Do not improve with treatment
Are not typical of GORD
There are any red flag symptoms

If further investigation is required a Gastroscopy is usually the next step. This is where a thin, flexible telescope is passed down the food pipe into the stomach. A normal test helps to rule out more worrying causes of reflux symptoms particularly stomach cancer.

What is the treatment for GORD symptoms?

Lifestyle measures

Stopping smoking
Reducing alcohol consumption
Reducing caffeine consumption
Avoiding spicy foods
Avoiding large meals
Weight loss (if you are overweight)

Medications

Antacids

These are medication that reduce the amount of acid in the stomach resulting in quick but short acting relief of symptoms
These are readily available over the counter at any pharmacy or on prescription from your doctor.
Antacids are usually used on an ‘as required’ basis for mild or infrequent episodes of GORD symptoms.

Proton Pump Inhibitors (PPIs) and Histamine Receptor Blocker (H2 blockers)

Proton pump inhibitors (PPIs) and histamine receptor blockers (H2 blockers) reduce the amount of acid that the stomach produces.
They are normally used for more persistent and frequent symptoms
You usually require a prescription for these medications
Usually your doctor will advise that you take a full-dose course of a PPI or H2 blocker for a month.
Symptoms usually resolve with this course of treatment
If you continue to have symptoms or they return soon afterwards, you should see your doctor for review as further investigations may be required.

Prokinetic medicines

These medications speed up the passage of food through the stomach
Common examples include Maxolon (Metoclopramide)
They are less commonly used but can be effective in some cases

Surgery

As medical treatment has become more successful surgical treatment is rarely required
“Nissens Fundoplication” is an example of surgery used to treat resistant cases.

Complications of GORD

Oesophageal stricture
- GORD can cause scarring and narrowing of the food pipe called an oesophageal stricture if left untreated
Barrett’s oesophagus
- This is a complication of long standing, untreated GORD
- The excess acid causes a permanent change to the lining of the oesophagus
- It increases the risk of developing cancer of the oesophagus

Most people with GORD do not develop any of these complications. If you have any concerns then you should consult your doctor.