Gastro-oesophageal Reflux Disease: Causes, Symptoms, Diagnosis and Treatment
September 12, 2016
Gastro-oesophageal Reflux Disease, commonly abbreviated as GORD, is a stomach disorder in which the contents of the stomach backflow into the oesophagus. The disorder can cripple a normal lifestyle through undesirable symptoms – the most common being a burning sensation in the lower chest and upper abdomen, accompanied by burps. Though most cases of GORD can be treated with oral medications and neutralizing antacids, some people may need a visit to a minimally invasive surgery clinic to find permanent relief. The blog post discusses the causes, symptoms, diagnosis and treatment of GORD.
Under healthy digestive conditions, the lower oesophageal sphincter (LOS) acts as a valve and opens up to allow the food contents to pass into the stomach and closes to restrict the stomach contents and acidic juices from back flowing to the oesophagus. When the LES is weak or relaxes in an inappropriate manner, the gastric contents of the stomach starts draining back into the oesophagus causing a sensation of heartburn. Although a number of lifestyle factors account for the disorder, medical studies suggest that a hiatal hernia can be a possible cause, as it impairs the portion of the diaphragm that supports the oesophagus, causing acid reflux. Hiatal hernia occurs when a part of LES moves into the chest through an opening in the diaphragm and is no longer able to prevent the stomach contents from draining back into the oesophagus.
The most common symptom of GORD is heartburn, causing a deep, burning sensation in the lower chest above the abdomen, which radiates to the throat and mouth. A few people also get a feeling of the food coming back to the mouth from the stomach, leaving a bitter and acidic taste. Additionally, GORD is known to exhibit a few more symptoms such as:
- Difficulty in swallowing food, known as Dysphagia
- Regurgitation of stomach fluids into oesophagus
- Sore throat
- Chronic Cough
- Recurrent Chest and Sinus Infections
- Vomiting and respiratory problems in Children
A patient suffering from GORD may also experience chest pain after a meal that can last for more than two hours, which may aggravate on lying down and bending over.
A doctor starts the diagnosis by taking note of the symptoms a patient is exhibiting. Moreover, a doctor may also suggest medical examinations to gauge the damage and rule out the possibility of other underlying conditions. The three common tests to diagnose GORD are as follows:
The method measures the amount of acid in the oesophagus over a 24 hour period, and is helpful in detecting the GORD cases that might require surgery.
In this procedure, the doctor puts an endoscope down the oesophagus to check for inflammation or narrowing of the oesophagus, along with Barrett’s syndrome that causes an abnormal change in oesophageal lining and may lead to cancer.
The method evaluates the contractile function of the oesophagus and helps in detecting GORD and other motility disorders.
Treatment and Prevention
GORD treatment mainly involves three progressive steps, which may vary according to individual and the extent of exhibited symptoms.
Lifestyle changes can greatly help in alleviating the symptoms of GORD. Certain modifications such as avoiding carbonated beverages and spicy foods, abstinence from smoking, eating small meals at regular intervals, maintaining a low-fat diet, and working out regularly can help curb the symptoms.
A doctor may suggest antacids to neutralize the stomach acid. However, prolonged intake of an antacid is unadvisable, as it may cause calcium and magnesium deposits in the body that can impair kidney functions. Therefore, a person needs to consult a doctor, if the problem persists.
If preliminary medications fail to show any improvement or the condition aggravates causing inflammation or bleeding from the oesophagus, the doctor may prescribe Fundoplication to tighten and reinforce the LES. The procedure can be performed as an open or minimally invasive surgery, and may also involve repairing the hiatus hernia, if present.
- A liquid diet 1-2 days before surgery
- Fasting on the day of surgery
- Taking prescribed medications on the day of surgery
For a speedy recovery, patient must avoid strenuous activities, and follow a liquid diet and antireflux medication as prescribed by their doctor.
The Way Forward
GORD can lead to graver issues such as peptic ulcers and even oesophageal cancer. Therefore, shying away from medication or surgery is definitely not a wise option. If you or someone you know has been experiencing the symptoms of the disorder, we, at Perth Surgical & Bariatrics, are here to help. We are a minimally invasive laparoscopic surgery clinic based in Perth with a team of doctors possessing extensive experience in treating GORD with medications and surgery. To book an appointment with one of our experts, give us a call at 08 9370 9686.