Heartburn

Updated 18 November 2017

What is GORD?

Gastroesophageal Reflux Disease (GORD) is basically when you constantly get heartburn.

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Quick summary

– Sometimes, acidic juices from the stomach flow back (“reflux”) into the gullet, or oesophagus.

– If this happens repeatedly, the acid will damage the lining of the gullet. This common condition is called Gastro-Oesophageal Reflux Disease (GORD).

– Lifestyle changes such as giving up smoking, losing weight and modifying your diet usually prevent reflux from occurring.

– The main symptom of reflux is a painful burning in the chest known as heartburn.

– If you have severe reflux, your doctor might recommend an investigative procedure called a gastroscopy to rule out more serious conditions. In rare cases, surgery is an option, otherwise medication to suppress stomach acid will be used initially.

Read:
What about smoking and GORD?

Alternative names


American spelling: Gastroesophageal Reflux Disease, or GERD.

Definition

Gastro-Oesophageal Reflux is a condition in which the lower oesophageal sphincter (the muscular ring at the lower end of the oesophagus, or gullet, near the diaphragm) is abnormally relaxed and allows the stomach's acidic contents to flow back or "reflux" into the oesophagus.

Usually, the sphincter prevents the stomach contents from flowing upward, working like a one-way valve.

Some degree of reflux is normal in everyone. Sometimes, the sphincter does not close tightly enough after food has passed through it. Then stomach acid, which is essential for digesting food, flows into the oesophagus. This is called “reflux”.

The reflux tendency increases when the stomach contains a lot of gastric juice or food and when there is increased pressure in or on the stomach. Episodes of normal reflux typically occur after meals, are brief and without symptoms, and rarely occur during sleep.

If this happens often enough, the acid can damage the lining of the gullet. This condition is called Gastro-Oesophageal Reflux Disease or GORD. GORD is a very common problem, occurring in people of all ages and both sexes.

Acid reflux becomes pathological (the condition called GORD) when the person develops symptoms or when the oesophagus becomes damaged.

Symptoms of GORD are an indication that potential injury to tissues has resulted from longer and more frequent acid exposure than that which occurs with normal, physiological reflux.

Previously reviewed by Dr Ganief Adams, Gastroenterologist, MBChB (UCT), FCP (SA)

Reviewed by Dr Jenny Edge, General Surgeon, BSc, MB BS, FRCS (Edin), M Med (Stell.)

Epidemiology

Gastroesophageal reflux disease (GORD), the condition most often associated with heartburn, occurs worldwide, and prevalence rates differ widely from country to country.

The condition is particularly prevalent in Western countries, and there’s evidence that GORD is on the increase in developing countries. There may be several causes for this reported increase, but overweight and obesity are quite likely to be the most important factors.

The following prevalence estimates appeared in the June 2014 edition of the journal Gut: 
- North America: 18.1% - 27.8% 
- South America: 23.0% 
- Middle East: 8.7% - 33.1% 
- Europe: 8.8% - 25.9% 
- Australia: 11.6% 
- East Asia: 2.5% - 7.8% 

Unfortunately, no prevalence estimates currently exist for Africa.

- Reviewed by Dr Estelle Wilken, Senior Specialist in Internal Medicine and Gastroenterology at Tygerberg Hospital - March 2017

 

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