GI Motility Disorders Unit

Gastro oesophageal reflux disease (GORD) is a common problem where gastric contents from the stomach travel into the oesophagus. It is also referred to as heartburn, reflux and reflux oesophagitis. In healthy people, a small amount of gastric contents often travel into the oesophagus, however, there are mechanisms that move it back down into the stomach without any harm to the oesophagus.

In patients with GORD, there is either a problem with the mechanisms that move the gastric contents back into the stomach, or there is too much reflux for these mechanisms to handle- this commonly happens when there is overproduction of acid, or the lower oesophageal sphincter, which creates the barrier between the stomach and the oesophagus, loses tone.

Causes

Most commonly, the cause of GORD is an abnormal relaxation of the lower oesophageal sphincter. This can be idiopathic, or due to alcohol or tobacco exposure, pregnancy, hypothyroidism, or systemic sclerosing disorders.

 It can also be a result of hiatus hernias, which causes a weakening of the lower esophageal sphincter.

Pre-existing conditions that cause increased gastric acid production, e.g. Zollinger-Ellison syndrome overpower the body's natural defences and mechanisms against acid reflux, thereby causing the disease.

 Medications, such as prednisolone and some antibiotics have also been reported to cause, or aggravate already established cases of GORD.

Symptoms

The majority of patients feel a burning sensation in the chest, or in the throat, more commonly known as heartburn. This can be accompanied with a sour taste in the mouth- having these symptoms more than twice a week is a cause for concern. Frequent belching and dental erosions can also be a sign that is noticed.

You can also have GORD without heartburn- symptoms felt in these patients would include chest pain, a chronic cough and hoarseness, a feeling that there is something stuck in your throat, and also asthma symptoms such as wheezing, breathlessness and chest tightness.

Infants and children also often get GORD, and it is important to watch out for known symptoms, as they often cannot articulate their own symptoms. Children and infants also suffer from GORD- parents have to watch out for irritable babies who have >1 episode of vomiting or regurgitation a day.