Gastro-Oesophageal Reflux Disease (GORD)

Symptoms of dyspepsia may be caused by retrograde flow of the stomach contents into the oesophagus. Normally this is prevented by a valve like arrangement at the junction of the oesophagus and stomach. Additional symptoms include epigastric pain, heartburn and acid reflux into the mouth that are worse on bending, stooping or lying down. Gastro-oesophageal reflux disease (GORD) is associated with and exacerbated by smoking, alcohol, caffeine, large meals, fatty foods, obesity, pregnancy, tight clothes, drugs e.g. anti inflammatories, and hiatus hernia.

Treatment

A number of drugs are prescribed to treat GORD including antacids, ranitidine, omeprazole, lansoprazole etc. They may be given in courses or used on a long-term basis to treat recurrent or persistent symptoms. In addition people with GORD are advised to lose weight, stop smoking, eat smaller meals, raise the foot of the bed, limit alcohol intake and avoid drugs that exacerbate symptoms.

Surgery to tighten the area at the junction of the oesophagus and stomach may be carried in a small number of cases to reduce reflux.

Hiatus hernia

A hiatus hernia occurs when part of the stomach moves, from its normal position in the upper abdomen, through the diaphragm and comes to lie within the chest. It often causes no symptoms and is found during investigations for other medical conditions. Hiatus hernia is mainly found in people over 50 years. 50% of people with a hiatus hernia experience symptoms of GORD, and they are treated as described above. In a minority of cases with very severe reflux, surgery may be undertaken. At operation, the stomach is put back into the abdomen and the defect in the diaphragm is repaired.

Care and Mobility considerations - GORD & hiatus hernia

Symptoms of these conditions are well controlled by medication and the other measures described above. GORD and hiatus hernia do not cause any significant functional restrictions on a daily basis. Simple measures such as sitting to do tasks avoids any necessity to bend down. It is very unlikely that GORD or hiatus hernia would lead to any long-term need for help with self-care or restrict walking.

Amended April 2008