Gastro-oesophageal reflux disease
Gastro-oesophageal reflux disease (GORD) is a condition which develops when the reflux of stomach content causes troublesome symptoms or complications.
This may include:
Common oesophageal symptoms:
- Regurgitation of stomach contents
- Acid taste in the mouth
- Difficulty or pain on swallowing
- Inflammation of the oesophagus
- Barrett’s oesophagus
- Oesophageal cancer
- Dental erosions
GORD may be caused by a hiatus hernia or dysfunction of the lower oesophageal sphincter. Symptoms of GORD may be worsened by certain foods e.g. spicy foods, caffeine, chocolate, high carbohydrate meals.
Sliding hiatus hernia
This occurs when the gastro-oesophageal junction is displaced above the diaphragm, resulting in disruption of the lower oesophageal sphincter function. This often, but not always, causes symptomatic gastro-oesophageal reflux. The cause is usually age-related degeneration, but other factors, such as congenital predisposition and trauma, may contribute.
- Symptoms: GORD is usually diagnosed based on a history of compatible symptoms. A positive response of these symptoms to treatment confirms the diagnosis.
- Gastroscopy can be used to look for complications of GORD (see Oesophageal injury above) or the presence of a hiatus hernia (See Gastroscopy).
- 24 hour pH studies: If the diagnosis of GORD is in doubt, this test can be used to confirm or exclude the presence of GORD (See 24 hour pH studies)
- High resolution oesophageal manometry: When the symptoms of GORD are present, but the diagnosis is in doubt, this investigation can be used to exclude oesophageal motility disorders that can mimic GORD (See High resolution manometry).
Treatment of GORD depends on the severity of the symptoms and complications. This may vary from intermittent symptomatic treatment with antacid, to daily use of acid-suppressing drugs, and even surgery (See Surgery for gastro-oesophageal reflux disease).