CLINICAL
GASTROENTEROLOGY
GORD VS HEARTBURN:
KNOW THE DIFFERENCE
Gastro-oesophageal reflux disease (GORD) isn’t just heartburn or bad indigestion.
GORD (or GERD in the US) affects
up to 40% of the population in
Western countries.
Dr Eduan Deetlefs,
Gastroenterologist at Mediclinic
Milnerton, explains that GORD occurs
when the stomach content refluxes
past the lower oesophageal sphincter
up into the oesophagus and even all the
way into the throat or mouth.
Experiencing this kind of reflux
occasionally is normal. However, over
long periods of time, it could be a sign
of GORD.
“GORD develops when the lower
oesophageal sphincter is more open
than it should be or if there is a hiatus
hernia,” says Dr Deetlefs. “Factors
that can lead to a weakened, relaxed
or open valve are: Increased pressure
in the stomach due to obesity,
overeating or pregnancy, certain foods
that can cause relaxation of the valve,
and certain medications.”
As with many other diseases,
not everyone experiences the
condition in the same way. Some
patients have regurgitation and the
burning sensation in the centre of
the chest known as heartburn, while
others develop atypical symptoms
such as upper abdominal pain and
a vague chest discomfort, says Dr
Deetlefs. Sometimes, patients even
experience the pain and symptoms
of GORD as similar to that of a
heart attack.
The condition is most commonly
diagnosed by gastroscopy.
acid the stomach produces. If severe
regurgitation still occurs after
medication, surgery is an option. During
a laparoscopic Nissen fundoplication,
the lower oesophageal sphincter is
strengthened, usually by wrapping part
of the stomach around itself to create a
new va lve. The surgery requires a two-
or three-day hospital stay, and patients
can be back at work within a week
or two. Fortunately, surgery is rarely
required.
Source: Mediclinic Infohub
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AETIOLOGY
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According to Dr Deetlefs, a diet high in
spicy foods, fat and alcohol can most
certainly contribute to the development
of GORD - although patients can still
develop it even if they’re perfectly
healthy. It can ‘run in the family’, but
researchers aren’t sure yet if that’s
because families tend to eat the same
foods or whether it’s in the genes.
TREATMENT
There are three options, depending
on the severity of the disease. Getting
healthy is a good place to start,
although Dr Deetlefs says making
lifestyle changes is helpful for some
patients, but not all. Healthy changes
include regular exercise, losing weight
if necessary, quitting smoking, and
adjusting what and how much you eat. If
these measures don’t ease symptoms,
medication may be necessary.
Proton pump inhibitors (PPIs)
regulate the amount of hydrochloric
References: 1. Kalaitzakis E, Björnsson E. A review of esomeprazole in the treatment of gastroesophageal reflux disease (GERD). Therapeut & Clin Risk Management 2007;3(4):653-663. 2. Scheiman JM,
Yeomans ND, Talley NJ, et al. Prevention of Ulcers by Esomeprazole in At-Risk Patients Using Non-Selective NSAIDs and COX-2 Inhibitors. Am J Gastroenterol 2006;101:701-710. 3. Data on File: Ranbaxy
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sugar. S4 Nexipraz ® 40 Gastro-resistant tablets.Reg. No. 45/11.4.3/0126. Each gastro-resistant tablet contains esomeprazole magnesium 41,4 mg equivalent to esomeprazole 40 mg. Contains sugar. For full
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