Gastro-oesophageal reflux: what is it?
Gastro-oesophageal reflux disease (GORD) — often just called reflux or reflux disease — is a condition in which the acidic contents of your stomach, called chyme (partially digested food and acid), regurgitate or reflux (wash back) into the oesophagus (the gullet). It is the most common cause of heartburn and indigestion in Western society.
The oesophagus, which is more commonly known as the gullet, is a long cylindrical tube that leads from the throat to the stomach. The walls of the oesophagus contract (squeeze) in rhythmic waves to move food down into the stomach.
Where the throat joins the oesophagus there is a one-way valve which doctors call a sphincter. Under normal circumstances this sphincter lets food from the throat down into the oesophagus but doesn’t let it back up.
At the other end of the oesophagus, where it joins onto the stomach, there is another sphincter (the lower oesophageal sphincter). This allows food to pass into the stomach and, under normal circumstances, prevents it from coming back up the oesophagus again.
The oesophagus and the stomach
When the oesophagus isn’t being used, the sphincters contract so that the contents of your stomach don’t flow back up to your mouth. When you swallow, these sphincters expand or relax to let food pass into your stomach.
When food reaches the stomach, it is partially digested by stomach acid and enzymes and then passed into the small intestine for further digestion. People who suffer from reflux have the acidic stomach contents regurgitate back up into the oesophagus. The stomach acid can cause inflammation and damage to the oesophagus. This is because the oesophagus does not have such a protective lining as the stomach.
Heartburn and reflux oesophagitis
Reflux is sometimes referred to as heartburn (heartburn is actually a symptom of reflux). Heartburn is the burning pain that can be felt in the chest and moves upwards during an episode of reflux. It can sometimes be felt in the throat. Though the discomfort of occasional heartburn is not serious, frequent bouts of reflux can damage the lining of your oesophagus. This is called reflux oesophagitis. Oesophagitis just means inflammation of the oesophagus.
If the reflux oesophagitis is allowed to continue there can be serious consequences as the oesophagus sustains more and more damage. Regular exposure to the acidic stomach contents may cause the cells in the oesophagus to change. A gastroenterologist can see these changes when they carry out an endoscopy (where a long tube is passed down your throat to view the oesophagus and stomach).
The oesophagus may become ulcerated or scarred. Build up of scar tissue can lead to the oesophagus being narrowed. This narrowing is called a stricture and can lead to difficulty in swallowing.
Barrett's oesophagus
Regular exposure of the oesophagus to acid from the stomach can change the lining of the oesophagus so that it is more like the lining of the stomach and so more resistant to acid. This is called Barrett’s oesophagus, after the doctor who discovered it. However, these changes in the cells can increase the likelihood of cancer of the oesophagus.
Other reflux symptoms
Reflux can also cause your stomach’s contents to move into your throat and then irritate your breathing passages. The acid can cause hoarseness of the voice, a chronic dry cough or even provoke an asthma attack in a person who has asthma.
Another problem associated with reflux is that it can cause a crushing pain in your chest and this can feel the same as the pain of angina or a heart attack, and as such these conditions can be confused and misdiagnosed. Never ignore a pain in your chest, disregarding it as reflux or heartburn. Always have any chest pain checked with your doctor.
Last Reviewed: 19 July 2001
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