Gastro-oesophageal reflux disease (GORD) is a digestive condition that occurs when the lower oesophageal sphincter (LES), a ring of muscle between the oesophagus and stomach, doesn't function properly, allowing stomach contents to flow back into the oesophagus. Also known as acid reflux, the condition often causes one to experience heartburn, a sour taste in the mouth, and difficulty swallowing.
What causes gastro-oesophageal reflux disease?
Reflux arises when the lower oesophageal sphincter (a muscular valve in the gullet) is unable to close properly, allowing the contents of the stomach, as well as the digestive juices, to enter the oesophagus. Several factors can lead to the development of GERD, including:
Hiatal hernia: A condition where the upper portion of the stomach travels up through the diaphragm into the chest cavity, affecting the functioning of the LES.
Obesity: Excess body weight can lead to abdominal pressure, pushing stomach contents back up into the oesophagus.
Pregnancy: Hormonal changes and increased abdominal pressure during pregnancy can cause or worsen GERD.
Lifestyle factors: Eating large meals or lying down right after a meal, consuming certain foods and drinks (such as fatty or fried foods, coffee, alcohol, chocolate, and spicy foods), smoking, and taking certain medications can all contribute to GERD.
Other medical conditions: Conditions like connective tissue disorders, delayed stomach emptying, and certain neurological or muscular disorders can increase the risk of GERD.
The acid-rich contents affect the lungs by 2 mechanisms:
A reflex triggered by the acid in the gullet leading to contraction of the tubes in the lungs and thus causing shortness of breath and or wheezing;
Direct passage of the acid content into the lungs, which leads to lung injury. Factors that may contribute to the development of reflux include stress, the presence of a hiatus hernia, obesity, and particular foods. Foods such as carbonated drinks, coffee and chocolate may often worsen acid reflux.
The diagnosis can be made by questioning, but often, a gastroscopy (camera into the stomach) is necessary.
Treatment of gastro-oesophageal reflux disease:
Treatment consists of important dietary advice from a dietician, together with drugs called proton pump inhibitors (PPIs). Other medications may include:
Antacids: Over-the-counter antacids offer quick relief by neutralising stomach acid.
H2 Receptor Blockers: Medications like ranitidine and famotidine reduce acid production and provide longer-lasting relief.
Prokinetics: These medications help strengthen the LES and improve stomach emptying, though they are less commonly used due to potential side effects.
FAQ
Yes, untreated GERD can lead to several complications, such as:
Esophagitis (inflammation of the oesophagus)
Esophageal stricture (narrowing of the oesophagus due to scar tissue)
Barrett's oesophagus (a condition that raises the risk of oesophagal cancer)
Respiratory issues (such as asthma, chronic cough, or laryngitis)
You should see a doctor if you experience:
Frequent or severe symptoms of GERD
Symptoms that interfere with your daily life
Difficulty swallowing or persistent nausea/vomiting
Unintentional weight loss
Symptoms that fail to improve with over-the-counter medications
While GERD is a long-term condition, it can be effectively managed with lifestyle adjustments, medications, and, in some cases, surgery. The goal of treatment is to control symptoms, heal the oesophagus, and prevent complications.
