GORD

What is GORD?

Gastro-oesophageal reflux disease (GORD) is a condition where the stomach acid leaks into your food pipe (oesophagus) causing a burning sensation in your chest and other associated symptoms.

Everyone experiences acid reflux once in a while after a heavy meal or when lying down. However, people with GORD experience acid reflux on a regular basis, often more than twice a week, and it could lead to serious health concerns and negatively impact quality of life.

What causes GORD?

GORD occurs as a result of weakening of the lower oesophageal sphincter (LOS) which is a muscular ring that connects the lower part of the oesophagus to the stomach. The function of the LOS is to prevent the backing up of food and stomach acids into the oesophagus, but when the sphincter is weak, it fails to close tightly enough resulting in acid reflux. The other common way it occurs is due to the LOS opening too frequently.

Risk Factors for GORD

Factors that may contribute to the development of GORD include:

Obesity
Hiatal hernia
Loose lower oesophageal sphincter
Natural weakness of the lower oesophageal sphincter. Consuming too much of oily and spicy foods
Transient relaxation of the lower oesophageal sphincter
Certain types of food
Some medications
Drinking alcohol
Lying down after a heavy meal

What are the Symptoms of GORD?

You may experience the following symptoms:

A harsh, burning sensation in your chest rising from your stomach
Regurgitation of partially digested food
Sour taste in the mouth
Nausea and vomiting
Chronic coughing or wheezing
Difficulty swallowing
Hoarseness of voice
Sore throat
Bad breath
Sinusitis

What if GORD is left untreated?

If left untreated, GORD can cause bleeding, perforation, ulcer, scarring, or precancerous changes in the mucosal lining of the oesophagus.

Diagnosis of GORD

To diagnose your condition, Dr Thiruchelvam will discuss the frequency of your symptoms as well as the aggravating and relieving factors and perform a physical examination.

The following diagnostic tests may be ordered:

Endoscopy: A small camera is placed through your mouth to look at the oesophagus and stomach and to assess the causation and potential complications of Reflux. This is a day procedure.
Radiology: Contrast study, barium swallow, CT, volumetric studies, oesophageal and gastric emptying studies.
Oesophageal Manometry: Is a method of testing the strength and effectiveness of oesophageal contraction and a thin tube is placed down through your nose and into the oesophagus. The pressure is measured in the oesophagus.
pH Study: check the acid levels in your oesophagus.
Impedance Testing: checking for non-acid reflux in your oesophagus

Treatment of GORD

The three progressive stages of treatment of GORD are:

Lifestyle Modifications:

The first line of treatment would be lifestyle changes such as:

Avoid foods that aggravate GORD symptoms
Eat smaller meals
Do not lie down for at least 3 hours after a meal
Maintain a healthy body-mass index
Elevate the head of your bed while lying down
Stop smoking
Reduce alcohol consumption

Medication Therapy:

If lifestyle changes do not resolve symptoms, you may have to use medications such as:

Antacids – These are medications that neutralize the effect of stomach acids.
Acid-suppression medications – These medications suppress the production of stomach acids. H2 Antagonists and PPIs

Keyhole Anti-Reflux Surgery:

If medications and lifestyle treatments fail to resolve your reflux symptoms, surgery should be considered Dr Thiruchelvam offers the latest surgical treatments such as robotic surgery and laparoscopic anti-reflux surgery to ensure positive outcomes and quick return to activities of daily living.

This is usually done via keyhole and you have a short hospital stay usually just overnight. You can return to work after one week and will have a modified diet for 4 weeks post op.