Gastro-oesophageal reflux disease (GORD)
Introduction
What is GORD?
Although ‘heartburn’ is often used to describe a variety of digestive problems, in medical terms, it is actually a symptom of GORD. In this condition, stomach acids reflux or ‘back up’ from the stomach into the oesophagus (food pipe). Heartburn is described as a harsh, burning sensation in the area in between your ribs or just below your neck. The feeling may radiate through the chest and into the throat and neck. Many adults in the UK experience this uncomfortable, burning sensation at least once a month. Other symptoms may also include being sick (vomiting), difficulty swallowing and chronic coughing or wheezing.
What causes GORD?
When you eat, food travels from your mouth to your stomach through a tube called the oesophagus. At the lower end of the oesophagus is a small ring of muscle called the lower oesophageal sphincter (LOS). The LOS acts like a one-way valve, allowing food to pass through into the stomach. Normally, the LOS closes immediately after swallowing to prevent stomach juices, which have a high acid content, coming back up into the oesophagus.
GORD occurs when the LOS does not function properly allowing acid to flow back and burn the lower oesophagus. This irritates and inflames the oesophagus, causing heartburn and may eventually damage the oesophagus.
Some people are born with a naturally weak sphincter (LOS). For others, fatty and spicy foods, certain types of medication, tight clothing, smoking, being overweight, drinking alcohol, vigorous exercise or changes in body position (bending over or lying down) may cause the LOS to relax, causing reflux. A hiatal hernia (a weakness in the diaphragm muscle allowing the top of the stomach to slip into the chest) may be present in many patients who suffer from GORD.
How is GORD treated?
GORD is generally treated in three steps:
Lifestyle Changes
In many cases, changing diet and taking over-the-counter antacids can reduce how often and how harsh your symptoms are. Losing weight, if you are overweight, reducing or eliminating smoking, reducing alcohol consumption, and altering eating and sleeping patterns can also help.
Medication Therapy
If symptoms persist after these lifestyle changes, medication therapy may be required. Antacids neutralize stomach acids and over-the-counter medications reduce the amount of stomach acid produced. Both may be effective in relieving symptoms. Prescription medicines may be more effective in healing irritation of the oesophagus and relieving symptoms. This therapy needs to be discussed with your GP and trialled before considering surgery.
Surgery
Patients who do not respond well to lifestyle changes or medications or those who continually require medications to control their symptoms, will either have to live with their condition or may undergo a surgical procedure.
Minimally-invasive anti-reflux surgery
If you suffer from ‘heartburn’, technically referred to as Gastro-oesophageal reflux disease (GORD), your surgeon may have recommended Minimally-invasive anti-reflux surgery to treat this condition.
Surgery is very effective in treating GORD. Surgery is usually performed as minimally-invasive (or keyhole surgery) with a series of very small cuts on the abdomen. This can either be traditional laparoscopic, or more recently robot-assisted surgery, and your surgeon will discuss the options with you. They are both forms of minimally-invasive (keyhole) surgeries and the actual anti-reflux operation is the same. You may hear anti-reflux surgery referred to as a ‘Nissen Fundoplication’, ‘posterior partial fundoplication (Toupet)’ or a ‘anterior partial fundoplication (Watson)’. They are all variations of the same procedure – namely the wrapping of the upper part of the stomach over the end of the oesophagus to try to stop acid refluxing back into the oesophagus.
Your surgeon will discuss which type of fundoplication is recommended, which will depend partly on your symptoms and partly on which technique your surgeon is more familiar with.
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At EliteSurgix, we believe in empowering our patients with knowledge. Explore our detailed information on various gastroenterology conditions to better understand your health and wellbeing. Learn about symptoms, causes, and when to seek medical advice. Click on each condition to find comprehensive descriptions and personalized treatment options.
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