Gastro-Oesophageal Reflux Disease (GORD)

The symptoms of GORD can vary from person to person. Common symptoms of GORD include:

• heartburn

• bad breath

• damage to your tooth enamel due to excess acid

• feeling like your stomach contents have come back up (regurgitated) to the throat or mouth

• chest pain

• persistent dry cough

• asthma

• trouble swallowing

If you experience GORD and acid reflux at night, you may develop a cough, laryngitis and/or disrupted sleep. If you have asthma and GORD, your asthma symptoms may become worse.

In many cases, there’s no clear cause for GORD. Most cases appear to be due to a problem with the function of the lower oesophageal sphincter (LOS). The LOS is a circular band of muscle at the bottom of the oesophagus that prevents your stomach contents from travelling back up your oesophagus. 

When you swallow, the LOS normally relaxes to allow food and drink to flow into the stomach. The sphincter then closes again. However, if the sphincter weakens or does not work properly, then stomach acid can flow back up into your oesophagus to cause GORD symptoms.

Common causes of gastro-oesophageal reflux disease (GORD) include:

• obesity

• smoking (active or passive)

• low levels of physical exercise

• pregnancy

• alcohol

• wearing tight clothes

• certain foods (chocolate, peppermint, coffee, fruit juices, fatty or spicy foods)

• some medicines (including asthma medications, aspirin, calcium-channel blockers, antihistamines, painkillers, sedatives, and antidepressants)

• a hiatus hernia (when part of the stomach moves up into the chest)

• stress

At your first Welbeck consultation, you’ll be seen by a consultant gastroenterologist. They’ll ask you about your symptoms, general health, family and medical history, and any medications you take regularly. They’ll also perform a physical examination. 

Your consultant may be able to diagnose GORD based on your symptoms and physical examination, but in most cases, you’ll need some tests to confirm your diagnosis and check for complications of GORD. 

Tests for GORD may include:

• endoscopy (gastroscopy) – camera imaging of your oesophagus

• biopsy – taking a tissue sample from your oesophagus for laboratory analysis

• oesophageal manometry – measuring the pressure inside your oesophagus

• impedance monitoring – measuring the rate at which fluid moves along your oesophagus

• pH monitoring – measuring the acidity (pH level) in your oesophagus over a period of time to see how often stomach acid flows back into your oesophagus

• other tests, such as an ECG (heart tracing), chest X-ray or X-ray tests where you are asked to swallow a special dye, may be done to rule out other conditions if your symptoms are not typical

As it isn’t known exactly what causes GORD, preventing the condition may not be possible. However, you can prevent or reduce symptoms of the disease by:

• maintaining a healthy weight

• eating smaller meals

• avoiding foods that trigger your symptoms, such as fatty or spicy foods, chocolate, caffeine, and alcohol 

• not smoking

• not eating for 3 to 4 hours before you go to bed

• wearing loose-fitting clothes 

• elevating the head of your bed 

GORD is usually treatable and not serious, but untreated GORD can lead to complications over time. It’s important to get an accurate diagnosis and the right treatment to prevent complications from developing. 

Complications of GORD can include:

• oesophageal ulcers – painful sores in the lining of the lower part of your oesophagus, which can bleed, cause pain and make swallowing difficult 

• narrowing of your oesophagus, which can make it difficult to swallow, and make you feel like food is stuck in your throat 

• Barrett’s oesophagus – a digestive condition that increases the risk for a type of oesophageal cancer known as adenocarcinoma. It affects around 10% to 15% of people with GORD

GORD treatment is based on whether your symptoms are mild, moderate, or severe. Our doctors will work with you to develop a personalised treatment plan and monitor your progress.

Treatment for GORD includes lifestyle changes, medication and in some cases, surgery. 

Lifestyle changes

The first step in treating mild-to-moderate GORD symptoms is lifestyle changes. Your consultant will recommend changes based on personal factors that may contribute to your symptoms. 

Lifestyle changes to reduce the symptoms of GORD include:

• losing weight if you’re overweight or obese

• improving your posture and sitting up straighter

• avoiding tight-fitting clothes

• giving up smoking

• avoiding stooping, bending, or lying down after eating

• raising the head of your bed by 6 to 8 inches

Medication

For moderate to severe GORD symptoms, your doctor may recommend over-the-counter or prescription medicines based on whether or not acid reflux has damaged your oesophagus. 

Over-the-counter medicines for GORD include:

• antacids – these work by helping to neutralise the acid content of your stomach. They include aluminium hydroxide, magnesium carbonate, and magnesium trisilicate

• alginates – these help to protect the lining of your oesophagus from stomach acid. Alginates include sodium alginate and alginic acid. They are added to various antacid brand medicines

Prescription medications for GORD include: 

• proton pump inhibitors (PPIs) – these work by stopping acid secretion in your stomach wall. They include omeprazole, lansoprazole, pantoprazole, rabeprazole, and esomeprazole

• histamine receptor blockers (H2 blockers) – these reduce stomach acid production and include cimetidine, famotidine, nizatidine, and ranitidine

Surgery

Surgery is only recommended for a small number of people with GORD. 

Your consultant may recommend surgery if you have severe symptoms, your symptoms are not relieved with medicines, or you don’t want to take medication long-term. 

The usual surgical treatment for GORD is a type of laparoscopic (keyhole) surgery known as fundoplication. This operation involves ‘tightening’ your lower oesophagus to prevent acid leaking up from your stomach. 

At Welbeck, our gastroenterologists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialities, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.