What is Gastroesophageal Reflux Disease (GORD)
Also known as reflux or indigestion, gastroesophageal reflux is a common condition which affects most people from time to time. It can be experienced as a sensation of burning or even pain in the lower chest which may rise up into the neck.
It is caused by stomach acid backwashing up into the oesophagus causing irritation to the oesophageal lining. If symptoms occur regularly or are distressing, investigations such as a gastroscopy or treatment such as antacids, may be required.
Does diet affect heartburn?
Common ‘triggers’ for reflux include large meals, fatty foods, spicy foods, chocolate, coffee, alcohol, carbonated drinks and smoking. Some people know which particular foods cause symptoms whereas others have symptoms regardless of what they eat. Other factors that can trigger symptoms are ‘lifestyle’ factors such as eating a meal just prior to bedtime or late consumption of caffeine. Weight gain can also be a contributing factor.
Do I require any investigations?
This is usually judged on a case by case basis. The diagnosis of reflux can usually be made on a typical history of symptoms. However, if there are symptoms of concern such as difficulty swallowing, weight loss or vomiting, a gastroscopy may be required to assess the symptoms. In people with a prolonged history of reflux, a gastroscopy may be warranted to assess for a change in the oesophageal lining called ‘Barrett’s oesophagus’ (please see the section on Barrett’s oesophagus for further information).
It is important to note that the gastroscopy is only for assessment of the oesophageal anatomy and the degree of inflammation caused by the acid reflux. It does not treat the symptoms.
How is reflux treated?
Treatment depends of the severity and frequency of symptoms. There are different types of antacids ranging from barrier agents that temporarily coat the oesophagus to protect it from irritation to medications that reduce the stomach’s production of acid. Some of these agents are over the counter and others require a prescription.
Avoiding trigger foods and also concentrating on ‘lifestyle factors’ such as eating a smaller, earlier meal for dinner, smoking cessation, weight loss and reducing alcohol consumption can have an effect on the degree of symptoms.
A small percentage of people require keyhole surgery for control of their reflux symptoms if their symptoms are still troublesome despite lifestyle modification and medications.
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