Gastro-oesophageal Reflux Disease

Heartburn caused by acid reflux is very common, especially when we have over-indulged in food or have eaten too close to bedtime. Although not usually life-threatening, frequent episodes of acid reflux can damage your oesophagus.


Picture showing Stomach and Oesophagus showing Gastro-oesophageal Reflux

What is Gastro-oesophageal Reflux Disease (GORD)?
Food travels from your mouth through the oesophagus into your stomach via a valve-like muscle(the lower oesophageal sphincter). The food starts to be broken down by the acid in your stomach, while the sphincter helps to prevent food and acid flowing back into the oesophagus. Unfortunately, the sphincter sometimes allows acid to flow back into the oesophagus(acid reflux). Alhtough your stomach is designed to withstand the acid, the lining of the oesophagus is very sensitive to it and when you have acid reflux, you'll be aware of heartburn -- a burning sensation in your chest.

Heartburn affects many pregnant women. The increased pressure in the abdomen from the growing baby has a tendency to force the acidic stomach contents back into the oesophagus. Frequent and recurrent attacks of acid reflux (GORD) may damage the oesophagus, causing inflammation and ulceration. Although it causes discomfort, GORD rarely leads to any life-threatening complications.

Symptoms
You rarely need tests and examinations to diagnose GORD and your doctor will be able to diagnose it from your description of your symptoms. Symptoms vary between people and between episodes. They are most noticeable after eating and may include:

• heartburn (often worse on lying down)
  
• acid taste in mouth
• persistent sore throat
• difficulty or pain during swallowing
• persistent cough

Treatment Options
There are three types of medication that are commonly prescribed in the treatment of GORD. Medication for GORD rarely has side effects. Although not licensed to be taken during pregnancy, most of these drugs have not caused any adverse effects to a developing baby.
1. Antacids: These medications neutralize the acid form the stomach and prevent the oesophagus from being damaged.
2. Histamine receptor blockers (H2 blockers) and proton pump inhibitors(PPIs): These reduce acid output.
3. Pro-motility drugs: These help the oesophagus to empty itself of any stomach contents.
4. Surgery: Occasionally, surgery is necessary to tighten the lower oesophageal sphincter.

Lifestyle changes are the first course of action to improve your symptoms, particularly if they are mild and infrequent. Watch your weight and do not smoke -- losing weight by diet and exercise may help. Don't eat late at night. It may help to have a light meal at night. Coffee, chocolate, and fatty food may trigger symptoms.

See your doctor if your symptoms are persistent, do not respond to self-help remedies, or if heartburn often interrupts your sleep. Lastly, avoid tight-fitting clothing that increases pressure in the abdomen and promotes reflux.