Your GP has referred you to the hospital for symptoms that sound like gastro-oesophageal reflux disease. Gastro-oesophageal reflux (GORD) disease is common and treatments are usually aimed at controlling the symptoms. This information sheet is aimed at giving your more information about this condition to help you manage your symptoms and to help you decide whether you would feel that further investigation from us would be useful.

GORD is caused by stomach contents entering (or refluxing) into the gullet (or oesophagus). The stomach produces acid and digestive enzymes to help to start break down food. The stomach content can therefore be corrosive. The stomach itself has a protective lining to cope with this content. The gullet, on the other hand, does not have this protective lining and so can become irritated and inflamed when in contact with the stomach contents.

There is a muscle at the lower end of the gullet, called the lower oesophageal sphincter, which acts as a valve and is normally closed to prevent reflux of stomach contents into the gullet but it has to relax to allow anything you swallow into the stomach. This muscle can become lax and this is what allows stomach contents to enter the gullet.

You may have heard that a hiatus hernia can be associated with reflux. A hiatus hernia occurs when part of the stomach slips up into the chest above the diaphragm which makes it more likely reflux will occur. However the treatments for GORD are the same whether you have a hiatus hernia or not.

The typical symptom of GORD is a feeling of burning behind your breastbone. This can often be worse after eating, at night or when you bend. It can sometimes be associated with an acid taste coming into the mouth. Because GORD is caused by a weak lower oesophageal sphincter muscle it can be an ongoing or recurrent problem, particularly without treatment. It can vary in intensity and people go through good spells and bad spells. Unfortunately the lower oesophageal sphincter is not a voluntary muscle and so cannot be “trained” to be stronger.

There are other possible causes of symptoms from your gullet. There are national guidelines that suggest certain groups of people should have an endoscopy to look into the gullet to make sure that there are no other problems.(An endoscopy is a procedure where the inside of your gullet and stomach is examined using an instrument called an endoscope).

There are some symptoms that you may have that would definitely need further investigation. Therefore if you have any of the following please phone us on the number on the covering letter and we will arrange an appointment for you.

• Any problems with food or liquids feeling like they stick in your gullet when you swallow
• Unexplained weight loss
• Previous history of strictures (narrowings) or ulcers in the gullet