Gastro-oesophageal reflux disease (GORD) explained

What GORD is

GORD happens when acid and other contents from the stomach flow back up into the oesophagus, the tube that carries food from your mouth to your stomach. Normally a ring of muscle at the top of the stomach acts like a valve, keeping contents where they belong. If this valve weakens or relaxes at the wrong times, acid escapes upwards and irritates the lining of the oesophagus, which is not built to cope with acid. Occasional reflux is normal, but when it happens frequently or causes symptoms or damage, it is called GORD. Things that can contribute include being overweight, pregnancy, a hiatus hernia, smoking, alcohol, and certain foods. It is a common condition and, for most people, a manageable one.

The symptoms

The classic symptom of GORD is heartburn — a burning feeling in the chest, usually after eating, that can be worse when lying down or bending over. Many people also notice an unpleasant sour or bitter taste in the mouth as acid rises, called regurgitation. Other symptoms can include a persistent cough, a hoarse voice, bad breath, a feeling of a lump in the throat, and pain or difficulty when swallowing. Symptoms often flare after large or fatty meals, or at night. Because chest pain from reflux can sometimes feel similar to heart pain, it is important not to assume — if chest pain is severe, crushing, or comes with breathlessness or sweating, it should be treated as a possible heart problem and needs emergency help.

Self-care that helps

For many people, everyday changes ease reflux. Eating smaller meals and not eating within a few hours of going to bed helps, as does raising the head of the bed so gravity keeps acid down at night. It is worth noticing and cutting back on personal triggers, which commonly include fatty or spicy foods, coffee, chocolate, fizzy drinks and alcohol. Losing excess weight reduces pressure on the stomach and often improves symptoms, and stopping smoking helps too. Wearing loose clothing around the waist and not lying down straight after eating can also make a difference. These measures are the foundation of managing GORD and, for milder cases, may be all that is needed alongside occasional remedies.

Treatments in the UK

When self-care is not enough, several treatments help. Antacids and alginate medicines, available from pharmacies, neutralise or form a barrier against acid and can ease occasional symptoms quickly. For more persistent reflux, medicines that reduce how much acid the stomach makes — such as proton pump inhibitors — are commonly used and are effective, taken as advised by a clinician or pharmacist. A GP can review symptoms, check your other medicines, and decide whether tests are needed. If symptoms persist despite treatment, or there are warning signs, a doctor may arrange a camera test (endoscopy) to look at the oesophagus. In selected cases, surgery to tighten the valve is an option. A pharmacist is a good first port of call for advice.

When to see a doctor

Most reflux is not serious, but some symptoms need checking. See a GP if heartburn keeps coming back, lasts more than a few weeks despite pharmacy remedies, or is affecting your life. Certain features are warning signs that need prompt assessment: difficulty or pain when swallowing, food feeling stuck, unintentional weight loss, repeated vomiting, vomiting blood, or black, tarry stools that can signal bleeding. Persistent symptoms in older adults may need investigation. And because reflux chest pain can mimic heart pain, treat severe or crushing chest pain, especially with breathlessness, sweating or pain spreading to the arm or jaw, as a possible heart attack and call 999. Getting persistent or worrying symptoms checked ensures the right treatment and rules out rarer, more serious causes.