Gastro-oesophageal reflux disease - Caidr
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Gastro-oesophageal reflux disease

Written by Caidr's team of doctors and pharmacists based in UK | Updated: 04.04.2022 | 3 min read
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If you have repeated indigestion or acid reflux, you may be at risk of developing gastro-oesophageal reflux disease (GORD). This is where the corrosive acid our stomach produces to break down food moves up to the oesophagus (the food pipe), where the lining is much more sensitive and can get damaged over time.

With GORD, you’ll experience ongoing heartburn, where you may feel a gnawing or burning pain in your central chest and traveling up to the throat after eating. While you may have suffered indigestion before, symptoms with GORD may be much more easily triggered, more severe, and lasting longer after eating or drinking. Usual treatments that previously may no longer be effective.

How is it diagnosed?

GORD is diagnosed on endoscopy (or gastroscopy), a test where a small flexible camera tube is passed down your throat to view the oesophagus and stomach, and possibly into the small bowel. You’re awake throughout but are given medication to help you relax. It sounds awful, but it’s a common test, and well-tolerated by most.

Tissue samples or biopsies may be taken, and tests run for a bacteria called H Pylori, which can increase acid production. The team will look for any damage to the lining or stomach ulcers.

Your doctor may organise an endoscopy or refer you to a specialist team who then organise it.

What puts me at risk of GORD?

GORD has the same risk factors as for acid reflux and heartburn, including obesity, pregnancy, alcohol, smoking, spicy or oily foods, large meals, and caffeinated or fizzy drinks, or if you have a hiatus hernia.

GORD has a tendency to run in families, so if this is the case for you, you should take care to address any diet or lifestyle factors that can prevent it, and seek help early if symptoms develop.

Certain drugs may affect the proper functioning of the oesophagus to neutralise stomach acid, such as tricyclic antidepressants like amitriptyline, or antipsychotics. Other drugs increase acid production, like ibuprofen, naproxen, aspirin, or steroid tablets, if taken for several weeks or months.

Neurological conditions such as diabetic neuropathy from uncontrolled diabetes mellitus, Parkinson’s disease, or a skin condition called systemic sclerosis can put you at risk.

Caidr Pharmacist top tips

We have shortlisted a range of treatments that you can try in the short term.

Gaviscon Liquid is a good first option, as it can provide quick relief and does not interact with most medicines. As an antacid, it works to neutralise acidity, which soothes the upper gastric area quickly, and it forms a protective coating to prevent further acid reflux throughout the day. Gaviscon Advance tablets can also be helpful.

Low-dose proton pump inhibitors are available to buy, such as esomeprazole as in Nexium Control, or H2-receptor antagonists, such as Zantac. These work in a different way to reduce the amount of acid produced – they don’t have an immediate effect but once working, they provide longer-lasting relief. Nexium Control can provide up to 24 hours relief plus protection for the gut lining. Gaviscon Advance or other alginate antacids can be used alongside these acid suppression medications.

If there is no improvement, or the constant need to neutralise the acid speak to your doctor.

When should I see my doctor?

If acid reflux treatments from your pharmacist or doctor have not helped after a couple of months, and your doctor has either ruled out or treated the bacteria H Pylori, you should book to see them again so they can review your symptoms and consider if you need further tests like an endoscopy.

You should book an urgent appointment if you have difficulty swallowing or a sensation of something blocking the windpipe. Your doctor would also want to see you urgently if you have any sign of bleeding from the gut lining, including vomiting blood or a brown substance that looks like ground coffee, if you have black stools or severe abdominal pain.

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