About gastro-oesophageal reflux disease (GORD)
Gastro-oesophageal reflux disease (GORD) is a common condition, where acid from the stomach leaks up into for 1 last update 16 Jul 2020 the oesophagus (gullet).Gastro-oesophageal reflux disease (GORD) is a common condition, where acid from the stomach leaks up into the oesophagus (gullet).
It usually occurs as a result of the ring of muscle at the bottom of the oesophagus becoming weakened. Read more about the causes of GORD.
GORD causes symptoms such as heartburn and an unpleasant taste in the back of the mouth. It may just be an occasional nuisance for some people, but for others it the 1 last update 16 Jul 2020 can be a severe, lifelong problem.GORD causes symptoms such as heartburn and an unpleasant taste in the back of the mouth. It may just be an occasional nuisance for some people, but for others it can be a severe, lifelong problem.
GORD can often be controlled with self-help measures and medication. Occasionally, surgery to correct the problem may be needed.
This topic focuses on GORD in adults.
This page covers:
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Symptoms of GORD
Symptoms of GORD the 1 last update 16 Jul 2020 can include:Symptoms of GORD can include:
- heartburn (an uncomfortable burning sensation in the chest that often occurs after eating)
- acid reflux (where stomach acid comes back up into your mouth and causes an unpleasant, sour taste)
- oesophagitis (a sore, inflamed oesophagus)
- bad breath
- bloating and belching
- feeling or being sick
- pain when swallowing and/or difficulty swallowing
Read more about the symptoms of GORD.
What to do if you have GORD
You can often control the symptoms of GORD by making some lifestyle changes and taking over-the-counter medication.
See treatments for GORD for more information.
You don''re worried about your symptoms, or if:
- you have symptoms several times a week
- over-the-counter medications aren''t helping, or you don''s oesophagus) – very occasionally, oesophageal cancer can develop from these cells, so you may need to be closely monitored
Read more about the complications of GORD.
Symptoms of GORD
The main symptoms of gastro-oesophageal reflux disease (GORD) are heartburn and acid reflux.
Heartburn is an uncomfortable burning sensation in the chest.
It''s not always clear what causes this ring of muscle to become weakened, but certain things can increase the risk of it happening (see below).
Who''s been suggested that the genes you inherit from your parents may also affect your chances of developing the condition.
Your GP will often be able to diagnose gastro-oesophageal reflux disease (GORD) based on your symptoms.
They may prescribe medication to treat it without needing to carry out any tests. Read more about treating GORD.
When tests may be needed
You''t controlling your symptoms
Tests can help to confirm the diagnosis of GORD, check for other possible causes of your symptoms and determine whether you may be suitable for surgery.
Tests for GORD
Tests for 1 last update 16 Jul 2020 you may have include:Tests you may have include:
- an endoscopy
- a barium swallow or barium meal test
- 24-hour pH monitoring
- blood tests
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The endoscope will be gently inserted into your mouth and down your throat. The procedure is usually carried out while you''t happen to everyone with GORD.
Barium swallow or barium meal
A barium swallow, or barium meal, is a test to assess your swallowing ability and look for any the 1 last update 16 Jul 2020 blockages or abnormalities in your oesophagus.A barium swallow, or barium meal, is a test to assess your swallowing ability and look for any blockages or abnormalities in your oesophagus.
You are first given some barium solution, then some X-rays are taken. Barium is a harmless substance that shows up clearly on X-rays as it passes through your digestive system.
You''ll be able to eat and drink normally, although you may need to drink more water to help flush the barium out of your body.
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This can rule out other possible causes of your symptoms and can help determine whether surgery would be suitable.
During the procedure, a small tube will be passed up your nose and then down into your oesophagus. The tube contains pressure sensors that can detect the pressure in the oesophagus.
24-hour pH monitoring
It may be necessary to measure the acidity level (pH) in your oesophagus to confirm a diagnosis of GORD if nothing is found during an endoscopy.
The acidity level is measured over 24 hours, using a thin tube containing a sensor that''ll be asked to press a button on the recorder every time you become aware of your symptoms and to record your symptoms in a diary. You should eat as you normally would during the test to ensure an accurate result.
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Heartburn and gastro-oesophageal reflux disease (GORD) can often be treated with self-help measures and over-the-counter medicines.
If these don''t eat or drink alcohol within 3 or 4 hours before going to bed, and avoid having your largest meal of the day in the evening.
If you''t stop taking any prescribed medication without consulting your GP first.
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Over-the-counter heartburn and GORD medicines are available from for 1 last update 16 Jul 2020 pharmacies without a prescription. The main types are:Over-the-counter heartburn and GORD medicines are available from pharmacies without a prescription. The main types are:
- antacids – these neutralise the effects of stomach acid
- alginates – these produce a coating that protects the stomach and oesophagus (gullet) from stomach acid
- low-dose proton-pump inhibitors and H2-receptor antagonists – see below for more information about these
These medicines aren''re not sure.
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If your symptoms don''ll usually be given enough medication to last a month. Go back to your GP if they don''t control your symptoms, a medicine known as a H2RA may be recommended for you to take alongside them on a short-term basis, or as an alternative.
Like PPIs, H2RAs reduce the amount of acid produced by your stomach.
Side effects of H2RAs are uncommon, but can include diarrhoea, headaches, dizziness, a rash and tiredness.
Surgery and procedures
Surgery for 1 last update 16 Jul 2020 may be an option if:Surgery may be an option if:
- the above treatments don''t suitable for you, or cause troublesome side effects
- you don''t yet widely available.
Laparoscopic Nissen fundoplication (LNF)
LNF is a type of laparoscopic or "" surgery. This means it''s carried out in hospital under general anaesthetic.
Most people need to stay in hospital for 2 or 3 days after the procedure. Depending on your job, you may be able to return to work within 3 to 6 weeks.
For the first 6 weeks after surgery, you should only eat soft food, such as mince, mashed potatoes or soup. Some people experience problems with swallowing, belching and bloating after LNF, but these should get better with time.
Newer operations and procedures
In the last few years, several new techniques for treating GORD have been developed.
The National Institute for Health and Care Excellence (NICE) says these procedures appear to be safe, but not much is known about their long-term effects.
These techniques include:
- Endoscopic injection of bulking agents – where special filler is injected into the area between the stomach and oesophagus to make it narrower.
- Endoluminal gastroplication – where folds are sown into the ring of muscles at the bottom of the oesophagus to restrict how far it can open.
- Endoscopic augmentation with hydrogel implants – where implants containing special gel are placed into the area between the stomach and oesophagus to make it narrower.
- Endoscopic radiofrequency ablation – where a tiny balloon is passed down to the bottom of the oesophagus and electrodes attached to it are used to heat it and make it narrower.
- Laparoscopic insertion of a magnetic bead band (LINX) – where a ring of magnetic beads are implanted around the lower part of the oesophagus to strengthen it and help keep it closed when not swallowing.
Speak to your surgeon about these techniques for more information.
Complications of GORD
A number of possible complications can occur as a result of having gastro-oesophageal reflux disease (GORD) for a long time.
The stomach acid that leaks into the oesophagus in people with GORD can damage the lining of the oesophagus (oesophagitis), which can cause ulcers to form.
These ulcers can bleed, causing pain and making it difficult to swallow.
Medications used to treat GORD, such as proton pump inhibitors (PPIs), can help ulcers heal by reducing the amount of acid that leaks into the oesophagus. Read more about treatments for GORD.
Scarred and narrow oesophagus
Repeated damage to the oesophagus by stomach acid can also cause it to become scarred and narrowed.
This is known as oesophageal stricture and it can make swallowing difficult and painful.
If this happens, a procedure to widen the oesophagus using a small balloon or other widening device may be recommended.
It''s oesophagus, usually after many years.
Barrett''t usually cause noticeable symptoms other than those caused by GORD.
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Read more about treatments for oesophageal cancer.