GORD, Acid Reflux, Heartburn
Understanding Acid Reflux and GORD: Symptoms, Causes, and Treatments
Gastro-oesophageal reflux disease (GORD) occurs when stomach contents—such as food, liquids, or acid—leak backward from the stomach into the oesophagus (the "gullet"). While most people experience reflux occasionally, GORD is a chronic condition that can significantly impact your quality of life.
What Causes Acid Reflux and GORD?
Reflux is typically prevented by the lower oesophageal sphincter (LES), a ring of muscle that acts as a one-way valve. GORD occurs when this muscle is weakened or fails to close properly. Common causes include:
- Hiatus Hernia: A condition where part of the stomach slides up into the chest cavity.
- Muscle Defects: A weakened or abnormally relaxed LES.
- Acid Overproduction: The stomach producing more acid than the lining of the oesophagus can handle.
Common Symptoms
While heartburn (a burning sensation behind the breastbone) is the hallmark symptom, GORD can present in several ways:
- Regurgitation: A bitter or sour taste from food or acid coming back up.
- Dysphagia: Difficulty or pain when swallowing.
- Respiratory Issues: Chronic dry cough, wheezing, or hoarseness.
- Nausea & Chest Pain: Often mimicking other conditions.
Managing Your Triggers
Certain lifestyle factors and foods can relax the LES or increase acid production.
Dietary Triggers
Tip: Keep a food diary to identify which of these common triggers affect you personally.
- Caffeine (Coffee/Tea) and Alcohol
- Chocolate and Mint
- Spicy or fatty foods
- Tomato-based products and Citrus fruits
- Onions and Garlic
Lifestyle Factors
- Obesity: Increased abdominal pressure forces acid upward.
- Smoking: Weakens the LES muscle.
- Pregnancy: Hormonal changes and physical pressure often lead to temporary GORD.
Diagnosis: How is Acid Reflux and GORD Tested?
If symptoms persist, your doctor may recommend one of the following diagnostic tests:
| Test | How it Works |
|---|---|
| Endoscopy | A thin, flexible camera (endoscope) examines the lining of the gullet and stomach. |
| Barium X-ray | A swallowable liquid coats the digestive tract to highlight abnormalities on an X-ray. |
| 24-Hour pH Study | A small probe measures acid levels in the oesophagus over a full day. |
| Wireless Capsule | A tiny capsule is attached to the oesophagus to transmit pH data wirelessly. |
| Impedance Study | Measures both acidic and non-acidic (alkaline) reflux. |
Treatment Options
- Medications
- Antacids: Over-the-counter relief for mild, occasional heartburn.
- PPIs (Proton Pump Inhibitors): Medications like Omeprazole or Somac that reduce the amount of acid your stomach produces.
- Surgical Intervention
Surgery, such as Nissen's Fundoplication, may be recommended if:
- You have a large hiatus hernia.
- Symptoms do not respond to medication.
- You experience severe complications like "nocturnal reflux" (vomiting at night).
- Simple Home Remedies
- Eat smaller meals more frequently.
- Avoid eating 3 hours before bed to keep acid levels low during sleep.
- Elevate the head of your bed using a wedge pillow.
- Weight management and smoking cessation.
Why Treatment Matters
Untreated chronic acid reflux and GORD can lead to serious complications, including:
- Oesophageal Ulcers: Open sores in the lining of the gullet.
- Strictures: Narrowing of the oesophagus making it hard to swallow.
- Barrett's Oesophagus: Changes to the lining of the oesophagus that increase the risk of oesophageal cancer.
The Acid Reflux and GORD -Friendly Diet Guide
Managing reflux isn't just about what you stop eating; it's about what you start eating to soothe the oesophagus.
- The "Safe" List (Low-Acid & Non-Triggering)
Focus on these staples to reduce the frequency of "flare-ups":
- Lean Proteins: Skinless chicken, turkey, and white fish (grilled or poached, not fried).
- Complex Carbs: Oatmeal, brown rice, and couscous. These help absorb excess stomach acid.
- Non-Citrus Fruits: Melons, bananas, and pears are low-acid and less likely to trigger symptoms.
- Root Vegetables: Potatoes, carrots, and parsnips are easy to digest and very "low-risk."
- Smart Swaps for Common Triggers
You don't have to give up everything you love. Try these alternatives:
- Instead of Coffee: Try herbal teas like Chamomile or Ginger (avoid Peppermint, as it relaxes the LES muscle).
- Instead of Onions/Garlic: Use fresh herbs like parsley, basil, or a small amount of leek whites for flavor without the burn.
- Instead of High-Fat Dairy: Opt for low-fat feta or hard cheeses in moderation, and avoid creamy, heavy sauces.
- The "Anti-Reflux" Eating Habits
- The 3-Hour Rule: Finish your last meal at least three hours before lying down. This allows the stomach to empty, preventing "nocturnal reflux."
- Hydrate Wisely: Drink most of your water between meals rather than during them. Large amounts of liquid during a meal can increase stomach volume and pressure.
- Chew Thoroughly: Smaller food particles are easier for the stomach to process, requiring less acid production.