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Gastro-oesophageal reflux disease (GORD) is a common condition, where acid from the stomach leaks up into the oesophagus (gullet).
It usually occurs as a result of the ring of muscle at the bottom of the oesophagus becoming weakened. Read more about the causes of GORD.
GORD causes symptoms such as heartburn and an unpleasant taste in the back of the mouth. It may just be an occasional nuisance for some people, but for others it can be a severe, lifelong problem.
GORD can often be controlled with self-help measures and medication. Occasionally, surgery to correct the problem may be needed.
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Symptoms of GORD can include:
Read more about the symptoms of GORD.
You can often control the symptoms of GORD by making some lifestyle changes and taking over-the-counter medication.
See treatments for GORD for more information.
You don't necessarily need to see your GP if you only have symptoms occasionally. Ask your pharmacist for advice on treatments.
Visit your GP if you're worried about your symptoms, or if:
Your GP will usually be able to diagnose GORD based on your symptoms, although they may refer you for some tests.
Read more about diagnosing GORD.
The main treatments for GORD are:
You may only need to take medication when you experience symptoms, although long-term treatment may be needed if the problem continues.
Surgery to stop stomach acid leaking into your oesophagus may be recommended if medication isn't helping, or you don't want to take medication on a long-term basis.
Read more about the treatments for GORD.
If you have GORD for a long time, stomach acid can damage your oesophagus and cause further problems.
Read more about the complications of GORD.
The main symptoms of gastro-oesophageal reflux disease (GORD) are heartburn and acid reflux.
Heartburn is an uncomfortable burning sensation in the chest.
It's usually felt just below your breastbone, but can spread up to the throat in some people.
The discomfort is usually worse after eating, or when bending over or lying down.
Acid reflux is where acid and other stomach contents are brought back up (regurgitated) into your throat and mouth.
It usually causes an unpleasant, sour taste at the back of your mouth.
If you have GORD, you may also experience:
If you also have asthma, the symptoms may get worse as a result of stomach acid irritating your airways.
Gastro-oesophageal reflux disease (GORD) is usually caused by the ring of muscle at the bottom of the oesophagus (gullet) becoming weakened.
Normally, this ring of muscle opens to let food into your stomach and closes to stop stomach acid leaking back up into your oesophagus.
But for people with GORD, stomach acid is able to pass back up into the oesophagus. This causes symptoms of GORD, which can include heartburn and acid reflux.
It's not always clear what causes this ring of muscle to become weakened, but certain things can increase the risk of it happening (see below).
The following factors may increase your risk of developing GORD:
GORD can sometimes affect several members of the same family and it's been suggested that the genes you inherit from your parents may also affect your chances of developing the condition.
Your GP will often be able to diagnose gastro-oesophageal reflux disease (GORD) based on your symptoms.
They may prescribe medication to treat it without needing to carry out any tests. Read more about treating GORD.
You'll usually only need to be referred for tests in hospital if:
Tests can help to confirm the diagnosis of GORD, check for other possible causes of your symptoms and determine whether you may be suitable for surgery.
Tests you may have include:
An endoscopy is a procedure where the inside of your body is examined using an endoscope, which is a long, thin, flexible tube with a light and camera at one end.
The endoscope will be gently inserted into your mouth and down your throat. The procedure is usually carried out while you're awake, but you may be given a sedative to help you relax.
The camera can show if the surface of your oesophagus (gullet) has been damaged by stomach acid, although this doesn't happen to everyone with GORD.
A barium swallow, or barium meal, is a test to assess your swallowing ability and look for any blockages or abnormalities in your oesophagus.
You are first given some barium solution, then some X-rays are taken. Barium is a harmless substance that shows up clearly on X-rays as it passes through your digestive system.
You'll be asked not to eat anything for a few hours before the procedure. Afterwards, you'll be able to eat and drink normally, although you may need to drink more water to help flush the barium out of your body.
Manometry is used to assess how well the ring of muscle at the end of your oesophagus is working, by measuring the pressure in your oesophagus.
This can rule out other possible causes of your symptoms and can help determine whether surgery would be suitable.
During the procedure, a small tube will be passed up your nose and then down into your oesophagus. The tube contains pressure sensors that can detect the pressure in the oesophagus.
It may be necessary to measure the acidity level (pH) in your oesophagus to confirm a diagnosis of GORD if nothing is found during an endoscopy.
The acidity level is measured over 24 hours, using a thin tube containing a sensor that's passed up your nose and down your oesophagus. This is usually connected to a recording device worn on your waist.
You'll be asked to press a button on the recorder every time you become aware of your symptoms and to record your symptoms in a diary. You should eat as you normally would during the test to ensure an accurate result.
Heartburn and gastro-oesophageal reflux disease (GORD) can often be treated with self-help measures and over-the-counter medicines.
If these don't help, your GP can prescribe stronger medication or refer you to a specialist to discuss whether surgery may be an option.
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You may find the following measures can help reduce heartburn and other symptoms of GORD:
If you're taking medication for other health conditions, check with your GP to find out whether they could be contributing to your symptoms.
Different medicines may be available, but don't stop taking any prescribed medication without consulting your GP first.
A number of different medications can be used to treat symptoms of GORD.
Over-the-counter heartburn and GORD medicines are available from pharmacies without a prescription. The main types are:
These medicines aren't suitable for everyone, so you should check the leaflet first. Ask a pharmacist for advice if you're not sure.
If your symptoms don't get better despite trying self-help measures and over-the-counter medicines, your GP may prescribe a PPI. These work by reducing the amount of acid produced by your stomach.
You'll usually be given enough medication to last a month. Go back to your GP if they don't help or your symptoms return after treatment finishes. Some people need to take PPIs on a long-term basis.
Your GP will prescribe the lowest dose that they think will control your symptoms to reduce the risk of side effects.
If PPIs don't control your symptoms, a medicine known as a H2RA may be recommended for you to take alongside them on a short-term basis, or as an alternative.
Like PPIs, H2RAs reduce the amount of acid produced by your stomach.
Side effects of H2RAs are uncommon, but can include diarrhoea, headaches, dizziness, a rash and tiredness.
Surgery may be an option if:
The main procedure used is called a laparoscopic Nissen fundoplication (LNF). Alternative techniques have been developed more recently, although these aren't yet widely available.
LNF is a type of laparoscopic or "keyhole" surgery. This means it's carried out using special surgical instruments inserted through small cuts (incisions) in the skin.
The procedure is used to tighten the ring of muscle at the bottom of the oesophagus, which helps to stop acid leaking up from the stomach. It's carried out in hospital under general anaesthetic.
Most people need to stay in hospital for two or three days after the procedure. Depending on your job, you may be able to return to work within three to six weeks.
For the first six weeks after surgery, you should only eat soft food, such as mince, mashed potatoes or soup. Some people experience problems with swallowing, belching and bloating after LNF, but these should get better with time.
In the last few years, several new techniques for treating GORD have been developed.
The National Institute for Health and Care Excellence (NICE) says these procedures appear to be safe, but not much is known about their long-term effects.
These techniques include:
Speak to your surgeon about these techniques for more information.
A number of possible complications can occur as a result of having gastro-oesophageal reflux disease (GORD) for a long time.
The stomach acid that leaks into the oesophagus in people with GORD can damage the lining of the oesophagus (oesophagitis), which can cause ulcers to form.
These ulcers can bleed, causing pain and making it difficult to swallow.
Medications used to treat GORD, such as proton pump inhibitors (PPIs), can help ulcers heal by reducing the amount of acid that leaks into the oesophagus. Read more about treatments for GORD.
Repeated damage to the oesophagus by stomach acid can also cause it to become scarred and narrowed.
This is known as oesophageal stricture and it can make swallowing difficult and painful.
If this happens, a procedure to widen the oesophagus using a small balloon or other widening device may be recommended.
Repeated episodes of GORD can sometimes lead to changes in the cells in the lining of your lower oesophagus. This is known as Barrett's oesophagus.
It's estimated that about 1 in every 10 people with GORD will develop Barrett's oesophagus, usually after many years.
Barrett's oesophagus doesn't usually cause noticeable symptoms other than those caused by GORD.
However, there's a small risk that the changed cells could become cancerous in the future (see below). Your doctor may suggest having an endoscopy every few years to check for this.
It's estimated that 1 in every 10-20 people with Barrett's oesophagus will develop oesophageal cancer within 10-20 years.
Symptoms of oesophageal cancer include:
Speak to your doctor if you experience any swallowing difficulties, or any other unusual or persistent symptoms.
Surgery to remove the cancer can be carried out if it's diagnosed at an early stage.
Read more about treatments for oesophageal cancer.