Gastro-oesophageal Reflux Disease (GORD) or as it’s more commonly known heartburn/reflux. Its a condition which develops when the contents of your stomach make their way back into your oesophagus.
You will know if this happens as you get a burning sensation behind your breastbone. It causes a burning sensation, pain and regurgitation.
There is a sphincter between the oesophagus and your stomach called the lower oesophageal sphincter (LOS).The LOS opens to allow food and drinks to make their way to your stomach. When you have GORD the sphincter can open anytime (but generally after meals) allowing the gastric acid to go up into the oesophagus.
Classic reflux or heartburn symptoms are:
- Indigestion, reflux, heartburn
- Fullness, bloating or distension after meals
- Diarrhoea, constipation, flatulence
- Mouth dryness or burning
- Food allergies, sensitivities or intolerances
Symptoms can be worse after lying down and chronic reflux can lead to Barrett’s Oesophagus or severe oesophagitis.
Some other factors which can contribute to GORD:
- Being overweight or obese- as this adds pressure on LOS and can force it open.
- Hypochlorhydria- is low stomach acid. Low stomach acid prevents food from being broken down and it stays in the stomach for longer. This puts pressure on the LOS and causes it to open
- Diet- Foods which aggregate the LOS and increase symptoms- chocolate, caffeine, spicy foods, alcohol, fatty foods, high carbohydrate foods like pasta and bread can also be problematic.
- Stress- Stress can worsen symptoms
- Medications-There are many that can cause heartburn and reflux symptoms. A few common ones are Antibiotics especially tetracyclines, Bisphosphonates – used for osteoporosis,iron supplements, pain killers like aspirin and ibuprofen, Antidepressants, some sedatives and tranquillisers and some opioids like codeine. If you get heartburn or reflux symptoms when you start taking a medication please report it to your doctor.
- Age as we age we start to lose our Hydrochloric acid in our stomach and this leads to hypochlorhydria.
What can you do?
Avoid trigger foods- if you don’t know what they are keep a food diary and take notice when you get the signs and symptoms
Weight loss- if you are overweight try and lose some weight with diet and exercise
Avoid drinking with meals
Eat smaller meals- as this reduces pressure on LOS
Eat bitter greens like dandelion leaf, rocket, endive, raddichio (even though not green) or watercress as this stimulates digestive secretions
Reduce alcohol – as this reduces your hydrochloric acid levels
Restrict and reduce alcohol as these can increase the severity and frequency of reflux
Include Apple Cider Vinegar in water as this is useful to lower pH of the stomach. Start with one teaspoon in water before meals increasing to one tablespoon
Chew food slowly and thoroughly- it is easier to digest when its smaller and broken down
Eliminate trans- fat from diet as they worsen symptoms.
If your a smoker – stop!
Raise the head of the bed
Lying on your left side helps with reflux
Lose weight as it lowers the intra-abdominal pressure
Don’t eat too close to bedtime. Allow 2-3 hours before bed
Don’t over eat as this increases pressure on the LOS
Avoid antacids these don’t fix the problem but bandaid the symptoms
Reduce stress as it worsens symptoms of heartburn and it is also though to increase stomach acid
Regular exercise of moderate intensity has been shown to help with GORD
If you have GORD and its becoming a problem rather than rush off to the doctor to be given a script for proton pump inhibitors which cause a raft of other problems. Consider trying some of these suggestions first.
Have you had GORD? What worked for you. I’d love to hear your feedback.