What is GORD?

Gastro-oesophageal reflux disease (GORD) happens when stomach acid leaks from your stomach and moves up into your oesophagus (food pipe). This is also known as 'reflux' or 'acid reflux.'

You may experience heartburn from time to time due to acid reflux. GORD is when reflux happens more than twice a week. If left untreated, it may lead to complications.

GORD is common in Australia and can affect people of all ages, including children.

Read about reflux in babies.

What are the symptoms of GORD?

The most common symptoms of GORD include heartburn and regurgitation.

• Heartburn is a burning pain or discomfort in your chest that may rise towards your neck.
• Regurgitation is when stomach acid or food comes back up into your mouth or throat, leaving a bitter or acidic taste.

Other symptoms may include:

• difficulty swallowing (dysphagia)
• vomiting, bloating, burping or indigestion
• chest pain
• a cough that happens at night, wheezing and hoarseness
• a feeling of a lump in your throat
• tooth decay

If you have asthma and GORD, your asthma symptoms may worsen.

Is it heartburn or a heart attack?

It can sometimes be hard to tell the difference between heartburn and a heart attack. A heart attack can only be confirmed by medical tests.

Chest pain is a common reason for people to go to the hospital emergency department. While some people are having a heart attack, others may be having severe heartburn.

Sometimes, chest pain may be your only symptom of GORD. It may feel like you are having a heart attack.

What causes GORD?

GORD usually happen when your lower oesophageal sphincter is weak and does not close properly. This is the muscle at the bottom of your oesophagus (food pipe) and at the top of your stomach.

Normally, this muscle allows food to go down to your stomach. It stops stomach contents from rising back up into your throat. When this muscle doesn't close properly, stomach contents can leak up into your oesophagus.

Issues with how food moves through your stomach (peristalsis) or slow stomach emptying may contribute to GORD.

Certain risk factors and lifestyle choices may increase your risk of developing GORD or trigger its symptoms.

Risk factors

You may be more likely to develop GORD if you:

• are older than 50 years
• smoke cigarettes
• are female
• are pregnant
• take certain medicines, such as nonsteroidal anti-inflammatory medicines (NSAIDs) or epilepsy medicines
• live with obesity, hiatus hernia, diabetes, scoliosis, cerebral palsy or Down syndrome

Foods and drinks

Large meals and some foods and drinks can trigger symptoms of GORD, including:

• fatty foods
• tomatoes
• hot drinks
• spicy foods
• alcohol
• tobacco

When should I see my doctor?

Seek urgent medical attention by calling triple zero (000) if you have any of these heart attack warning signs:

• chest pain that lasts for more than a few minutes
• shortness of breath
• pain in your jaw, arm, back or neck
• sudden sweating
• nausea
• feeling lightheaded or dizzy

If you are unsure about if your symptoms are caused by heartburn or a heart attack, you should call triple zero (000).

See your doctor if you:

• notice a change in the colour of your poo, such as black or red
• have symptoms that get worse or change
• have repeated vomiting or are vomiting blood
• feel unusually tired

How is GORD diagnosed?

To diagnose GORD, your doctor may:

• ask about your symptoms
• prescribe medicines to treat heartburn and regurgitation — if your symptoms go away, this confirms your diagnosis
• perform an endoscopy if your symptoms could be caused by other conditions or if they don't improve with medicines.

An endoscopy is a long, thin flexible tube with a light source and video camera attached. This tube is inserted down your throat. It will check and take images of the inside of your oesophagus and stomach.

If you are pregnant, your doctor will diagnose GORD by checking your symptoms.

How is GORD treated?

Your treatment for GORD may include making lifestyle changes. Depending on how severe your GORD is, you may also be prescribed medicines. Sometimes, your doctor may recommend a medical procedure or surgery.

Diet, eating habits and other lifestyle changes

Making changes to your diet and lifestyle can help manage symptoms of GORD. Most people find that their symptoms are affected by what, how and when they eat and drink.

Foods and drinks to avoid — it is a good idea to avoid foods and drinks that may trigger your symptoms. Different foods affect people differently. Try to adapt your diet. Foods and drinks that may trigger GORD symptoms include:

• coffee and other drinks holding caffeine
• alcohol
• fatty or spicy foods, including pepper
• soft drinks
• citrus fruit juices
• chocolate
• peppermint

Eating habits — you may want to make changes to your eating habits, try to:

• eat smaller, more frequent meals
• eat your evening meal at least 2 to 3 hours before going to bed or exercising
• stay upright during and after your meal to prevent reflux

Lifestyle changes — other lifestyle adjustments may also help you, try to:

• lose weight, even a small amount if you are living with overweight or obesity
• quit smoking
• change how your sleep by raising the head of your bed with a pillow or wedge and sleep on your left side

Medicines

If lifestyle changes do not help control your symptoms, you may need to take medicines.

Your doctor may recommend:

• antacids
• H2-receptor antagonists (blockers)
• proton pump inhibitors (PPIs)

If your symptoms mostly happen during the day, you should take PPIs at least 30 minutes before breakfast. If your symptoms happen mostly in the evening, take your PPIs at least 30 minutes before dinner.

Your doctor may prescribe PPIs for 4 to 8 weeks. Once your symptoms are under control, your doctor will slowly reduce your dose to the lowest possible amount. Long-term use of PPIs is not recommended.

Talk to your doctor or pharmacist about which medicine is best for you. Always follow the instructions. Let your doctor know what over-the-counter medicines you are taking.

Surgery

Your doctor may recommend surgery if you:

• have severe symptoms
• have symptoms that do not get better with medicines
• do not want to take long-term medicines
• have a hiatus hernia

It is performed through a technique called laparoscopy, often referred to as a 'key-hole' procedure.

Read more on preparing for surgery.

What are the complications of GORD?

For most people, GORD is a fairly straightforward condition. For some, it can eventually lead to complications, such as:

• Barrett's oesophagus
• oesophageal stricture
• oesophageal cancer

If your doctor thinks you may be at risk of developing GORD complications, they may refer you for an endoscopy.

Barrett's oesophagus

Long-term GORD can damage the cells lining the lower part of your food pipe. This condition is called Barrett's oesophagus.

Barrett's oesophagus can also:

• cause inflammation (oesophagitis)
• cause oesophageal ulcers to form
• increase your risk of oesophageal cancer

Oesophageal stricture

If the lining of your food pipe is continuously damaged, scar tissue can form. If the scar tissue builds up, it can cause your throat to become narrow and can make swallowing difficult. This is called an oesophageal stricture.

It's possible to have a surgical procedure to widen your food pipe.

Oesophageal cancer

In some people Barrett's oesophagus can develop into oesophageal cancer. The symptoms of oesophageal cancer are:

• pain and difficulty swallowing
• heartburn and reflux
• unexplained weight loss
• vomiting and vomiting blood
• tiredness (fatigue)
• black or bloody stool (poo)

Can GORD be prevented?

Lifestyle changes that manage your symptoms can help prevent GORD.

Resources and support

• NPS MedicineWise provides more information about GORD.
• The Gut Foundation provides information about different GORD treatments.
• Quit provides resources and tools to help you start to quit smoking today.
• You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Do you prefer to read in languages other than English?

• The Royal Women's Hospital Victoria offers translated information about coping with heartburn during pregnancy in several languages.

Looking for information for Aboriginal and/or Torres Strait Islander people?

• Healthy Eating Active Living offers free programs to help Aboriginal and/or Torres Strait Islander people get healthy.
• Quitline offers services for Aboriginal and/or Torres Strait Islander communities. Call for support when you are ready to yarn about quitting.