Gastro-Oesophageal Reflux Disease (GORD)

Heartburn, regurgitation and how to manage them

What is GORD?

Reflux occurs when acidic stomach contents flow back up into the oesophagus (food pipe). Occasional reflux is normal, but when it is frequent or troublesome — typically causing heartburn or regurgitation more than twice a week — it is called gastro-oesophageal reflux disease (GORD).

Common symptoms

• Heartburn — a burning feeling rising behind the breastbone, often after meals or when lying down

• Regurgitation — sour or bitter fluid coming up into the throat or mouth

• Chest discomfort, chronic cough, hoarseness or a sensation of a lump in the throat

• Waking at night with burning or coughing (nocturnal reflux)

What makes reflux worse?

• Large or late-night meals, and lying down soon after eating

• Excess weight, which increases pressure on the stomach

• Trigger foods: fatty or fried food, chocolate, coffee, alcohol, spicy food, citrus and tomato-based foods (triggers vary between people)

• Smoking, which weakens the valve between the stomach and oesophagus

• Some medications — let us know everything you take

Lifestyle measures that genuinely help

• Finish eating at least 3 hours before bed

• Elevate the head of the bed 10–15 cm (blocks under the bed legs or a wedge pillow — extra pillows alone don't work well)

• Lose weight if above your healthy range — even 5% makes a measurable difference

• Sleep on your left side, which reduces night-time reflux

• Stop smoking and moderate alcohol

Medications

Antacids (e.g. Gaviscon, Mylanta) give quick, short-term relief. Proton pump inhibitors (PPIs) such as esomeprazole or pantoprazole are the most effective treatment and are usually taken 30–60 minutes before breakfast. Many people need only a course of treatment; others with ongoing symptoms benefit from long-term therapy at the lowest effective dose — we will guide this with you.

When do we recommend further tests?

Most reflux does not need testing. We may recommend a gastroscopy if symptoms don't respond to treatment, if there are warning signs, or to check for complications such as Barrett's oesophagus. In selected cases we use pH/impedance monitoring or oesophageal manometry to confirm the diagnosis or plan anti-reflux surgery.

⚠ See a doctor promptly if you have Difficulty or pain when swallowingUnintentional weight lossVomiting blood, or black tarry stoolsPersistent vomitingNew chest pain — if severe or associated with exertion, call 000, as heart problems can mimic reflux

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This information is general and not a substitute for personalised medical advice. Please discuss any questions with your gastroenterologist or GP. If you develop severe symptoms, call 000 or go to your nearest emergency department.