What is Gastroesophageal Reflux Disease (GORD)? What is Acid Reflux?

Gastroesophageal reflux disease (GORD) is a digestive problem caused by stomach acids leaking into the oesophagus (food pipe). This process is known as acid reflux. Any acid that travels up the oesophagus can irritate and burn the lining. If acid reflux occurs frequently enough, you may have GORD. According to the Australian Family Physician, around 7.5% of Australians are diagnosed with gastroesophageal reflux disease [1]. As this condition is often underdiagnosed, it is estimated that GORD may occur in 10-20% of the population [1]. One of the most common symptoms of acid reflux is heartburn, which can be felt as a burning sensation in the chest. However, GORD does not cause all cases of heartburn. Other factors, such as spicy foods, overeating and tight clothes, can also contribute. However, you may have GORD if you have moderate or severe acid reflux occurring at least twice or once a week, respectively. This article will cover everything that you need to know about gastroesophageal reflux disease and how your GP will be able to help you.
 

Acid Reflux Symptoms

As noted earlier, GORD is a condition that occurs with frequent symptoms of reflux. Heartburn is one of the most noticeable and common GORD symptoms. Below will be a list of other symptoms that you may be able to use to identify acid reflux.

• Regurgitation (the sensation of acid/sour liquid leaking to the back of the throat or into the mouth)
• Dysphagia (difficulty swallowing)
• Chest pain
• Dental erosions (wearing away of the smooth coating of enamel on your teeth)
• Chronic cough
• Laryngitis (inflammation of the larynx or voicebox which causes voice loss)
• Asthma

 

What Causes Acid Reflux?

Acid reflux occurs when stomach acids travel back up the oesophagus. There are multiple causes of reflux that could cause symptoms, and these causes are listed and explained in this section.

Poorly Functioning Lower Oesophageal Sphincter

The lower oesophageal sphincter is a flap between the stomach and oesophagus. It acts as a gate to prevent the backflow of stomach content. A poorly functioning lower oesophageal sphincter can cause it to open, which leads to the leaking of the content back upwards [2].

Hiatal Hernia

The oesophageal hiatus is an opening where the oesophagus passes through the diaphragm, a muscle found in the abdomen. A hiatal hernia occurs when a part of the stomach protrudes upwards from the opening [3]. Hiatal hernias can affect how the lower oesophageal sphincter functions and lead to the build-up of acid [2].

Weakened Mucosa

The oesophageal mucosa describes the inner lining of the oesophagus, and it is a protective layer that defends the oesophagus from the body's acids and chemicals. However, the mucosa can be damaged from repetitive exposure to acidic reflux, alcohol or heat [2]. A weakened mucosa is more easily inflamed and sensitive to future episodes of reflux [4].
 

What Causes these Changes?

These are just a few different abnormalities that may lead to acid reflux and gastroesophageal reflux disease. However, certain lifestyle habits and situations may increase the risk of these changes from occurring. Examples include:

• Being overweight or obese
• Eating a high-fat diet
• Being pregnant
• Having gastroparesis (poorer ability to clear stomach acids)
• Smoking
• Alcohol consumption
• Certain medications

 

Tests and Diagnosis

Before further tests, an initial assessment with a doctor is required. Your GP may ask you questions regarding your symptoms and medical history before referring you for additional testing to determine a diagnosis.

Gastroscopy

A gastroscopy is an assessment performed by specially trained doctors, such as gastroenterologists. This involves using a flexible tube with a light and camera attachment to examine the oesophagus, stomach and bowel for any abnormalities or signs of reflux. It can also be used before and after treatment to assess any progress [4].

Barium Swallow

A barium swallow (also known as an oesophagogram) uses x-rays to look for abnormalities in the upper gastrointestinal area (i.e. mouth, throat, oesophagus, stomach, etc.). It is rarely required but may be necessary in some circumstances [4].
 

Acid Reflux Treatment

Treatment for acid reflux will depend on the findings arranged by your GP. The following section will discuss the routinely recommended treatments to manage gastroesophageal reflux disease.

Lifestyle Changes

One of the most important ways to manage gastroesophageal reflux disease is to change lifestyle habits that may be causing your symptoms. Examples include:

• Losing weight
• Avoiding meals for about 2-3 hours before bedtime
• Minimising foods that may trigger reflux (e.g. spicy foods, citrus, caffeine, etc.)
• Reducing or eliminating tobacco and/or alcohol

Your GP may refer you to a counsellor and/or dietitian to help assist with these lifestyle changes.

Acid Reflux Medication

To help with symptoms, your GP can recommend over-the-counter or prescribe certain medications that help reduce acid production. Always follow your GP's advice about taking the medication appropriately [4].

Surgery

Your GP may make a referral to a medical specialist (e.g. gastroenterologist) for other treatments. Surgery may be recommended for those not responding to their current therapies or if medically needed [4].
 

Recovery

With proper and early treatment, most people's symptoms will completely resolve [5]. However, around half of those may experience GORD symptoms again after treatment. Keeping up with lifestyle changes and regular contact with your GP will be necessary for preventing symptoms from recurring.
 

Complications

Some people with gastroesophageal reflux disorder may experience further complications, including:

• Erosive oesophagitis: Inflammation and damage to the oesophagus can lead to ulcers, sores and even perforation (openings in the injured area).
• Oesophageal strictures: Oesophageal strictures cause tightening of the tube leading down to the stomach. This can lead to problems such as difficulty swallowing and pain.
• Barrett's Oesophagus: This is a potentially severe complication of GORD. The repetitive damage from the acid reflux causes the lining along the oesophagus to change. Instead, it becomes similar to the lining seen inside the intestines, which can increase the risk of cancer.

 
 

Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.

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References

1. Miller, G., Wong, C., & Pollack, A. (2015). Gastro-oesophageal reflux disease (GORD) in Australian general practice patients. Australian family physician, 44(10), 701-704.
2. Diamant, N. E. (2006). Pathophysiology of gastroesophageal reflux disease. GI Motility online.
3. De Giorgi F, Palmiero M, Esposito I, Mosca F, Cuomo R. Pathophysiology of gastro-oesophageal reflux disease. Acta Otorhinolaryngol Ital. 2006 Oct;26(5):241-6. PMID: 17345925; PMCID: PMC2639970.
4. https://www.nps.org.au/australian-prescriber/articles/the-management-of-gastro-oesophageal-reflux-disease
5. Min YW, Shin YW, Cheon GJ, Park KS, Kim HS, Sohn CI, Kim TN, Moon HC, Rhee PL. Recurrence and Its Impact on the Health-related Quality of Life in Patients with Gastroesophageal Reflux Disease: A Prospective Follow-up Analysis. J Neurogastroenterol Motil. 2016 Jan 31;22(1):86-93. doi: 10.5056/jnm15124. PMID: 26486229; PMCID: PMC4699725