Treating GORD

Occasional heartburn is not a serious condition and can be treated with over-the-counter antacids or lifestyle changes.

If you have chronic heartburn or acid reflux, you may be suffering from GORD (gastro-oesophageal reflux disease) and need to see a doctor for a professional diagnosis. You may have other symptoms like cough, sore throat laryngitis and a tight chest.

Constant GORD can cause permanent damage to the oesophagus and even lead to cancer.

Medication

Gastro-oesophageal reflux disorders are mainly treated by medication. Most people find that antacids, taken before and after meals and at bedtime, successfully control the symptoms. Antacids neutralize acids in the gastrointestinal system. They combine with hydrochloric acid in the stomach to form salt and water.

Antacids differ in their reaction time, neutralizing capacity, side-effects, complications and price. Their main side-effect is that they can change bowel habits, resulting in flatulence, constipation or diarrhoea.

If simple antacids are insufficient to control the symptoms, tablets to reduce acid secretion will usually be tried. This often starts with drugs called histamine antagonists. If these are unsuccessful, a class of drugs called proton pump inhibitors are used. These are powerful and very effective. They work by preventing the stomach from producing any acid at all, and will also prevent the complications of gastro-oesophageal reflux. 

If your symptoms don’t respond to any of the above, you may benefit from a short-term dose of a prokinetic. Prokinetics accelerate the emptying of the stomach, which means that there is less time for acid to irritate your oesophagus.

Lifestyle changes

Certain activities make incidences of heartburn much more likely, such as smoking.

Surgery

Surgery is usually only recommended as a last resort when all else has failed, or if patients need to or want to avoid taking chronic medication.

Nowadays, however, many experts regard laparoscopic surgery as preferable to long-term maintenance drug therapy. The argument is that medication only treats the symptoms, and that only surgery eliminates or improves regurgitation.

Laparoscopic surgery is the standard surgical treatment of severe gastro-oesophageal reflux disease.

Laparoscopic surgery is minimally invasive and does away with the need for large incisions. A laparoscope is a thin instrument with a miniature video camera which transmits images to a video monitor. The surgeon watches the video screen while using instruments that are small enough to enter the patient's body through small incisions. Another name for laparoscopic surgery is keyhole surgery.

The procedure involves wrapping the upper section of the stomach around the oesophagus and fixing it in place, which tightens the lower oesophageal sphincter and prevents any acid moving up from the stomach.

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