GORD: More than indigestion
Gastro-oesophageal reflux disease isn’t just heartburn or bad indigestion. We asked a Mediclinic gastroenterologist to explain exactly what this disease is.
GORD (or GERD in the US) is more common than its odd-sounding acronym would suggest – up to 40% of the population in Western countries is affected by it.
Dr Eduan Deetlefs, a gastroenterologist at Mediclinic Milnerton, explains why and how it happens: ‘GORD occurs when the stomach content refluxes past the lower oesophageal sphincter [the valve at the bottom end of the oesophagus or food pipe] up into the oesophagus and even all the way into the throat or mouth,’ he says.
Experiencing this kind of reflux occasionally is normal, but if it’s happening often or over long periods of time, it could be a sign of GORD.
‘GORD develops when this valve is more open than it should be or if there is a hiatus hernia,’ says Dr Deetlefs. ‘Factors that can lead to a weakened, relaxed or open valve are: increased pressure in the stomach due to obesity, overeating or pregnancy, certain foods that can cause relaxation of the valve, and certain medications.’
What does GORD feel like?
As with many other diseases, not everyone experiences it the same way. Some patients have regurgitation and the burning sensation in the centre of the chest known as heartburn, while others develop ‘atypical symptoms such as upper abdominal pain and a vague chest discomfort,’ says Dr Deetlefs. Sometimes patients even experience the pain and symptoms of GORD as similar to that of a heart attack. If you’re experiencing any of these symptoms regularly, get it checked by your doctor sooner rather than later.
What causes GORD?
It could be a number of things, says Dr Deetlefs. Firstly, a diet high in spicy foods, fat and alcohol can most certainly contribute to the development of GORD – although you can still develop it even if you’re perfectly healthy. Secondly, it can run in the family, but researchers aren’t sure yet if that’s because families tend to eat the same foods or whether it’s in the genes.
How is GORD treated?
There are three options, depending on the severity of the disease. Getting healthy is a good place to start, although Dr Deetlefs says making lifestyle changes is helpful for some patients, but not all. Healthy changes include regular exercise, losing weight if necessary, quitting smoking, and adjusting what and how much you eat. If these measures don’t ease your symptoms, your doctor could recommend medication.
Proton pump inhibitors (PPIs) regulate the amount of hydrochloric acid your stomach produces. And if severe regurgitation still occurs after medication, surgery is an option. Called a laparoscopic Nissen fundoplication, during this procedure the lower oesophageal sphincter (valve) gets strengthened, usually by wrapping part of the stomach around itself to create a new valve. The surgery requires a two- or three-day hospital stay, and patients can be back at work within a week or two. Fortunately, surgery is rarely required.
If regular heartburn and reflux is disturbing your quality of life, visit your GP. You’ll most likely undergo a gastroscopy, during which a thin, flexible tube is used to look inside your oesophagus. This is the most common way to diagnose GORD.