Gastro-oesophageal reflux disease
What is gastro-oesophageal reflux disease?
In gastro-oesophageal reflux disease (GORD), the stomach contents wash back up (reflux) into the oesophagus (gullet), where they may damage the oesophageal lining.
The hallmark symptom of GORD is heartburn, a burning sensation in the stomach or lower chest rising up towards the throat. Heartburn often occurs after eating, or may be brought on by lying down or bending forward. Sometimes there is also regurgitation of food back up into the mouth. GORD can also be a cause of a chronic cough.
Less common symptoms of GORD may also include nausea, excessive belching or chest pain. As it can be difficult to distinguish pain due to reflux from pain due to angina or heart attack, it is very important to seek medical attention if you have any chest pain so that it is correctly diagnosed.
Oesophageal reflux diagnosis
Your doctor will decide which tests or investigations may be required.
Some people will be suitable for a trial of medication first, and only go on to have tests if their symptoms don’t improve. Others will need investigations early on, usually an endoscopy. This procedure involves passing a flexible lighted tube down the oesophagus to view the oesophagus and stomach. It is carried out under sedation.
Other tests may include 24-hour oesophageal pH monitoring. This involves passing a thin wire down the oesophagus where it records the pH or acidity. This is the best test for diagnosing when a cough may be due to GORD.
There are some simple measures you can take to help prevent reflux symptoms. Anything that makes your symptoms worse, such as alcohol, smoking, coffee, spicy or fatty foods, or eating large meals, should be avoided.
If you are overweight, losing weight can help. Some people also find raising the head of the bed helpful.
As some medicines such as aspirin or non-steroidal anti-inflammatory drugs may make symptoms worse, you should discuss any medicines you are taking with your doctor.
For occasional, mild symptoms, antacids or other over-the-counter medicines may help. For more severe or regular symptoms, stronger medicines can be prescribed. These treatments are more effective in both relieving the symptoms and healing inflammation of the oesophagus.
If the response to medication is not satisfactory, surgery may be considered.
2. Gastroenterological Society of Australia; Digestive Health Foundation. Reflux disease, Fifth Edition 2011. http://www.gesa.org.au/files/editor_upload/File/Professional/Reflux_Disease.pdf (accessed Aug 2012).
3. Gastro-oesophageal reflux (revised February 2011). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2012 Jul. http://online.tg.org.au/complete/ (accessed Aug 2012).