Acid Reflux & GORD Treatment

Gastro-oesophageal reflux disease (GORD) is a general term which encompasses acid reflux, heartburn, indigestion and oesophagitis. It may include one or more of these conditions. It is caused by irritation of the stomach or food pipe (oesophagus) by stomach acid.

The stomach naturally makes acid as part of the normal digestion process. Usually the sphincter at the bottom of the oesophagus acts as a valve and keeps this acid in the stomach. Acid reflux can happen if this sphincter is weak, if there is too much acid made in the stomach, if the stomach is not emptying properly, or if there is increased pressure in the stomach, forcing acid back up into the oesophagus.

Many things can trigger Acid Reflux / GORD including:

• Smoking
• Caffeine
• Alcohol
• Hiatus Hernia
• Helicobacter Pylori ( a common infection of the stomach)
• Acidic or spicy food and drink
• Large fatty meals
• Obesity
• Stress
• Pregnancy
• Medications (including anti-inflammatories, certain blood pressure medications, sleeping tablets and painkillers)

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 common symptoms include:

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

Symptoms tend to be worse after or with meals.

If you get any of the following symptoms you should seek immediate medical attention. They may indicate a more serious underlying condition:

• 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 stomach or oesophageal cancer in more than two first degree relatives
  • Barrett’s oesophagus
  • Pernicious anaemia
  • Previous stomach ulcer surgery
  • Pernicious anaemia
  • A previous diagnosis of the following stomach conditions: dysplasia, atrophic gastritis or intestinal metaplasia

Most people are diagnosed with GORD by their GP on the basis of their typical symptoms and their response to treatment. Further tests may be needed 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 oesophagus into the stomach. A normal test helps to rule out more serious causes of reflux symptoms, particularly stomach cancer.

Lifestyle changes may help, such as and avoid triggers- for example avoiding smoking, alcohol and weight gain.  There are over the counter medications which help to neutralise acid, as well as other medications which may be prescribed by doctors, subject to assessment.

Oesophageal stricture– Acid Reflux / GORD can cause scarring and narrowing of the food pipe called an oesophageal stricture if left untreated. This can lead to difficulty swallowing, and problems eating and drinking.

Barrett’s oesophagus – this is a complication of long standing, untreated Acid Reflux / GORD. The excess acid causes a permanent change in the cells that line the oesophagus. It increases the risk of developing cancer of the oesophagus, and thus needs to be managed and monitored.

But most people with Acid Reflux / GORD do not develop any of these complications. If you have any concerns then you should discuss them with your doctor.