Overview

This information gives advice about your diet to help you manage the symptoms of gastroesophageal reflux disease.

Gastroesophageal reflux disease (GORD, sometimes also called GERD) is a condition that affects your food pipe (oesophagus). The food pipe is a muscular tube that transports food from the mouth to the stomach.

If you have GORD, you may get acid reflux (when stomach acid flows up into the throat and mouth) and heartburn after meals. This can:

• irritate the lining of the food pipe
• cause a burning feeling in the upper tummy (abdomen) and chest

This information covers:

•    the causes of GORD
•    the symptoms of GORD
•    the treatments for GORD
•    keeping to a healthy weight
•    making changes to your lifestyle
•    stopping smoking
•    making changes to your diet
•    avoiding constipation

If you have any questions or concerns, please speak to your gastroenterology dietitian.

Causes of GORD

It is not always clear what causes GORD. However, the following things are thought to contribute to this condition:

• You may have a high pressure in your abdomen if you are overweight or pregnant.
• The valve (lower oesophageal sphincter muscle) between your stomach and food pipe may be weak. This can mean that it does not keep the stomach contents down.
• If you had surgery to the stomach or food pipe, this can result in GORD after the operation.
• You may have a hiatus hernia. This happens when the upper part of your stomach moves into the chest through an opening in the diaphragm muscle below the lungs. The lower oesophageal sphincter muscle may then not work so well. As a result, the stomach contents can move more easily back up into your food pipe.
• Stress can reduce some of your stomach's natural protection from acid (substances called prostaglandins). It can also make you more sensitive to the symptoms of GORD.

Symptoms of GORD

There are different possible symptoms of GORD. Some people report that their symptoms are worse at night or early in the morning.

Common symptoms are:

• heartburn, which is an uncomfortable burning feeling in the chest that often happens after eating
• regurgitation, which is when the stomach contents flow up into the mouth and cause a bitter taste

Less common symptoms include:

• pain in the chest, neck or jaw
• difficulty swallowing or pain when swallowing
• tooth erosion, bad breath, a sore throat or producing more saliva than usual

Treatments for GORD

Treatments for GORD include:

• diet and lifestyle changes
• medicines
• surgery in some cases, depending on the underlying cause

Medicines

Medicines for GORD can include:

• antacids that neutralise the stomach acid, such as Rennie®
• alginates that form a protective foaming barrier on top of the stomach contents, such as Gaviscon®
• a proton pump inhibitor that reduces the amount of acid made in your stomach, such as omeprazole, lansoprazole or pantoprazole

Standard medicines for GORD (antacids and alginates) are available with advice from a pharmacist.

If lifestyle changes and medicines from a pharmacy do not help or your symptoms continue, your doctor may prescribe stronger treatments. You may then need to take a proton pump inhibitor.

Surgery

In some cases, your doctor may recommend an operation. You would need to talk about this thoroughly with your doctor.