Series (Part One): GORD - An introduction

Written by: Dr Andrew Thillainayagam
Published:
Edited by: Karolyn Judge

Consultant physician and gastroenterology specialist, Dr Andrew Thillainayagam and Dr Neil Galletly, clinical research fellow, consider the impact of gastro-oesophageal reflux disease (GORD) diagnosis and how it can be managed. In part one of this three-part series of articles, read a comprehensive summary of the condition.

Also known as GERD or acid reflux, GORD is a common gastrointestinal disorder. So much so, general practitioners (GPs) find it is one of the most frequently encountered gastrointestinal conditions in the primary care sector.

It can affect patients of all ages. A UK survey of 2,000 households found that 20 per cent of adults have significant GORD symptoms more than twice a week. Up to 44 per cent also said they have symptoms at least once a month and seven per cent have daily symptoms.

 

Young man with heartburn grimacing

 

What is GORD?

GORD refers to the backflow action of gastric contents into the oesophagus. This results in acid and pepsin to attack the oesophageal mucosa (lining of the oesophagus). Reduced pressure and too much of a relaxation of the lower oesophageal sphincter is one factor that can contribute to why GORD occurs.

The acid and pepsin action can result in reflux oesophagitis which leads to inflammation of the lower oesophagus lining, erosion and even ulcers.

However, fewer than half of GORD patients will have oesophagitis and at endoscopy, most have no detectable changes to the lining. These conditions are sometimes referred to as endoscopy-negative reflux disease (ENRD) or non-erosive reflux disease (NERD).

If oesophagitis is found as a result of an endoscopy procedure, its severity is classified by the size and amount of erosion or ulcers and a grading system is used. It’s found that around 80 to 90 per cent of patients have mild to moderate oesophagitis.

 

 

What are the symptoms of GORD?

The main symptom of GORD tends to be heartburn. Even if you don’t have severe oesophagitis or it isn’t present at all because of ENRD or NERD, heartburn can be frequent and severe. Patients with oesophagitis and ERND and NERD have similar symptoms.

Others can include:

  • Acid regurgitation (acid brash)
  • Belching
  • Dysphagia (trouble swallowing)

 

 

Are there any other conditions that are related to GORD?

A minor, but significant, amount of people with GORD have respiratory symptoms like a persistent cough, recurrent asthma, or dysphonia. They may initially be seen by a respiratory specialist.

Other patients may be incorrectly referred to a cardiologist if they have chest pain that is non-cardiac related due to oesophageal spasm.

 

 

How is quality of life for people with GORD affected?

The frequency and severity of heartburn, unrelated to the presence or absence of oesophagitis, as a result of GORD can seriously affect quality of life.

 

  1. 75 per cent of people surveyed experienced low-quality or interrupted sleep
  2. GORD patients have reported worse emotional well-being than patients with diabetes or hypertension

 

However, after treatment, qualify of life rapidly improves.

 

 

Find out about the diagnosis methods for GORD in part two of this GORD series, or living with GORD in part three.  

Want to treat GORD symptoms you may have? Get reassuring, expert advice from one of London’s top gastroenterology specialists, Dr Thillainayagam. Visit his Top Doctors profile here.

By Dr Andrew Thillainayagam
Gastroenterology

Dr Andrew Thillainayagam is a consultant physician and gastroenterologist based in London. He specialises in abdominal pain, colonoscopy and endoscopy alongside gastroscopy, liver disease and inflammatory bowel disease (IBD). He practices privately for The London Clinic in central London and Imperial College Private Healthcare in west London and also works for the Imperial College Healthcare NHS Trust as one of the lead interventional endoscopists. 

Dr Thillainayagam always aims to give the best service to his patients; he makes use of cutting-edge techniques and technologies at the forefront of the field of interventional endoscopy.

Dr Thillainayagam graduated from the University of Manchester's highly-regarded medical school in 1984. He undertook further training in the London region at St Bartholomew's and St Mark's Hospitals and in the Oxford region at John Radcliffe Hospital and the Royal Berkshire Hospital.

Dr Thillainayagam's highly-qualified practical expertise is complemented by his respected clinical academic reputation. He has been a consultant lecturer and was promoted to honorary senior lecturer in medicine at Imperial College Healthcare NHS Trust, where he has remained in this top role since 1996. He also manages an undergraduate teaching firm.

Mr Thillainayagam's clinical interests include therapeutic endoscopy, complex functional disorders of the digestive system and hepatopancreaticobiliary medicine as well as inflammatory bowel disease. At present, he is researching into cholangiocarinoma, iron deficiency anaemia and novel endoscopic imaging alongside bile salt malabsorption and the palliation of GI cancer. 

Mr Thillainayagam is chairman of the NW Thames Gastroenterology Group and has written extensively on the subject of gastroenterology. His work has been featured in prominent peer-reviewed journals. He is also on the Clinical Services committee of the British Society of Gastroenterology and an executive committee member of The Medical Council on Alcohol (MCA).

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