Gastro-Oesophageal Reflux Disease (GORD) is a common digestive condition where stomach acid frequently flows back into the oesophagus, leading to irritation and uncomfortable symptoms such as heartburn, regurgitation, and chest discomfort. While occasional reflux is normal, persistent symptoms may indicate GORD, a condition that requires assessment and management to prevent complications. At The Centre for Gastrointestinal Health, our specialists provide a comprehensive approach to understanding, diagnosing, and treating GORD to help patients improve their quality of life.
How GORD Develops
Two important muscles help prevent the contents of your stomach from rising into your oesophagus: the diaphragm and the lower oesophageal sphincter (LOS). The diaphragm separates the chest cavity from the abdomen, while the LOS is a muscular ring that acts as a valve between the oesophagus and stomach. When these structures function properly, they keep stomach acid where it belongs.
GORD often develops when these muscles are weakened or displaced, allowing acid to escape into the oesophagus. One of the most common causes is a hiatus hernia, which occurs when the upper part of the stomach pushes through the diaphragm into the chest cavity. This movement places the LOS above the diaphragm, reducing its ability to act as an effective barrier and making acid reflux more likely.
In other cases, the LOS may gradually weaken over time, opening more easily and allowing acid to flow backward into the oesophagus. While there is no single cause for this weakening, researchers have identified several factors that increase the likelihood of developing GORD.
Risk Factors for GORD
Some people are more susceptible to GORD due to their lifestyle, health conditions, or a combination of both. Being overweight or obese significantly increases the pressure inside the abdomen, which can push stomach acid upward into the oesophagus. Diet and habits also play a role, as regularly eating fatty or fried foods makes it harder for the stomach to clear acid efficiently. Similarly, substances such as alcohol, tobacco, coffee, and chocolate relax the LOS, making it easier for acid to escape.
Stress may also contribute, as it affects digestive function and can exacerbate reflux symptoms. Certain medications, such as aspirin and anti-inflammatory drugs, can irritate the lining of the oesophagus and worsen symptoms over time. Chronic coughing, often caused by conditions such as asthma or respiratory infections, increases abdominal pressure and can aggravate reflux.
In addition, some medical conditions place individuals at higher risk. People with connective tissue disorders like scleroderma or autoimmune conditions such as eosinophilic oesophagitis are more likely to experience reflux. Those with gastroparesis, a condition commonly linked to diabetes that slows the emptying of the stomach, are also at increased risk. Understanding these factors can help patients make lifestyle adjustments and seek early intervention when needed.
GORD During Pregnancy
GORD is particularly common during pregnancy, with studies estimating that between 17% and 45% of pregnant women experience symptoms. The growing uterus places extra pressure on the stomach, while hormonal changes can weaken the LOS and slow digestion, making reflux more likely. Symptoms often begin in the later part of the first trimester and can worsen as pregnancy progresses.
Most women notice a significant improvement in symptoms after giving birth, as pressure on the stomach decreases and hormone levels return to normal. However, it is still important for pregnant women experiencing reflux to consult with a gastroenterologist, especially if symptoms are persistent or severe, to ensure the wellbeing of both mother and baby.
Recognising the Symptoms of GORD
The most common symptom of GORD is heartburn, a burning sensation that begins in the stomach and rises into the chest and throat. Symptoms are often worse after eating, when lying down, or when leaning forward. Some people may also experience regurgitation, where food or sour-tasting fluid flows back into the mouth.
Other symptoms include persistent nausea, bloating, excessive belching, hiccups, and a noticeable sour taste in the back of the throat. Long-term acid exposure can damage tooth enamel, leading to dental problems such as tooth decay and gum disease, and can also cause bad breath.
GORD can present with less obvious symptoms as well. Some patients develop chronic coughing, hoarseness, or throat irritation. Others experience difficulty swallowing, chest discomfort, or unexplained weight loss. Night-time reflux can also disrupt sleep and contribute to fatigue during the day.
Because GORD can affect individuals differently, recognising a pattern of symptoms is important. Frequent reflux should not be ignored, as untreated GORD can lead to more serious complications.
When to Seek Medical Advice
If you experience GORD symptoms more than twice a week, it is recommended that you see a gastroenterologist for assessment. Persistent reflux can cause inflammation, scarring, and narrowing of the oesophagus. In some cases, prolonged exposure to acid can lead to Barrett’s oesophagus, a precancerous condition that increases the risk of oesophageal cancer. Early diagnosis and treatment are essential to prevent these complications.
Treatment Options for GORD
The treatment for GORD depends on the severity and frequency of your symptoms. For many patients, simple lifestyle changes can significantly reduce reflux. Avoiding alcohol, coffee, chocolate, and tobacco can help maintain LOS strength, while limiting spicy, fatty, or acidic foods can reduce stomach acid levels. Eating smaller meals and avoiding eating three to four hours before bedtime are effective strategies, as is raising the head of the bed to improve night-time symptoms. Weight loss, when necessary, can also have a substantial impact on reducing pressure on the stomach.
For those whose symptoms persist despite lifestyle changes, medications can be highly effective. Over-the-counter options containing antacids and anti-foaming agents can provide short-term relief, while your gastroenterologist may prescribe proton pump inhibitors (PPIs) or H2 receptor blockers to reduce stomach acid production and protect the oesophagus from damage.
In severe or treatment-resistant cases, laparoscopic anti-reflux surgery may be considered. This minimally invasive procedure involves wrapping the upper part of the stomach around the oesophagus to strengthen the LOS and prevent acid from flowing upward. Recovery is usually quick, and most patients notice significant symptom improvement following surgery.
Managing GORD
GORD is a common condition, but with early assessment and tailored management, it can be effectively controlled. At The Centre for Gastrointestinal Health, we provide comprehensive care to help patients identify the underlying causes of their symptoms and select the most appropriate treatment approach. If you are experiencing frequent reflux, discomfort, or any of the symptoms discussed above, seeking professional advice is the best step towards protecting your long-term digestive health.
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