What Is GORD?

Gastro-Oesophageal Reflux Disease (GORD), also known as GERD in the US, is a chronic condition where stomach acid frequently flows back into the oesophagus (food pipe). This backflow, or reflux, irritates the lining of the oesophagus and causes symptoms like heartburn and regurgitation. While occasional reflux is normal, GORD is more severe and persistent.

What Causes GORD?

GORD occurs when the lower oesophageal sphincter (LES), a ring of muscle at the bottom of the oesophagus, becomes weak or relaxes when it shouldn’t. This allows acid and sometimes food to flow back into the oesophagus.

Common causes and risk factors include:

• Weak or relaxed LES
• Hiatal hernia
• Obesity
• Pregnancy
• Smoking
• Eating large meals or lying down after eating
• Certain foods and drinks (e.g. caffeine, alcohol, spicy or fatty foods, chocolate)
• Medications such as aspirin, ibuprofen, or blood pressure drugs

Symptoms of GORD

Symptoms can vary from mild to severe and may worsen after eating or at night:

• Heartburn (burning sensation in the chest)
• Acid regurgitation (sour or bitter taste)
• Difficulty swallowing (dysphagia)
• Chest pain or discomfort
• Chronic cough
• Hoarseness or sore throat
• Sensation of a lump in the throat
• Worsening of asthma symptoms

How Is GORD Diagnosed?

Diagnosis usually begins with a review of symptoms and may include:

• Endoscopy – to view the oesophagus lining and check for damage
• pH monitoring – measures acid levels in the oesophagus over 24 hours
• Barium swallow (X-ray) – shows structural abnormalities
• Oesophageal manometry – measures muscle contractions and LES function

Treatment Options for GORD

Treatment focuses on relieving symptoms and preventing damage to the oesophagus:

Lifestyle Changes:

• Eat smaller, more frequent meals
• Avoid trigger foods and drinks
• Stay upright after eating (avoid lying down for at least 2–3 hours)
• Elevate the head of the bed
• Lose weight if overweight
• Stop smoking

Medications:

• Antacids – for quick relief
• H2-receptor blockers – reduce acid production (e.g. ranitidine)
• Proton pump inhibitors (PPIs) – more effective acid reducers (e.g. omeprazole, lansoprazole)
• Prokinetics – help empty the stomach faster (less commonly used)

Surgery:

• In severe or unresponsive cases, surgical procedures like fundoplication may be done to strengthen the LES and prevent reflux.

Complications of GORD

If left untreated, GORD can lead to:

• Oesophagitis (inflammation of the oesophagus)
• Oesophageal ulcers or bleeding
• Strictures (narrowing of the oesophagus)
• Barrett’s oesophagus – a precancerous condition
• Increased risk of oesophageal cancer

Can GORD Be Prevented?

While not always preventable, the risk can be reduced by:

• Maintaining a healthy weight
• Avoiding overeating and eating late at night
• Limiting trigger foods and alcohol
• Quitting smoking
• Managing stress
• Wearing loose-fitting clothes

Living with GORD

GORD can be a long-term condition but is usually manageable with the right care. Many people find relief with lifestyle changes and medications. Regular follow-up is important to monitor for complications, especially if symptoms persist despite treatment.

Support from a gastroenterologist and possibly a dietitian can be helpful in managing diet and symptoms effectively.