Reflux Disease

Gastro-Oesophageal Reflux disease (GORD) happens when a “valve” between your oesophagus and your stomach is impaired causing heartburn. For example, a hiatal hernia may cause the stomach to slip upwards in the chest, which causes interference with the valve, and this is how stomach acid fluid content flows back up in the oesophagus, causing heartburn.

GORD or Reflux Disease is usually diagnosed based on typical reflux symptoms.  A trial of anti-acid medications can be used to confirm the diagnosis. If your diagnosis is unclear, or if you experience difficulty swallowing, vomiting or blood in stools, then an upper GI endoscopy can be performed. This is mostly to understand the underlying causes of the reflux and to exclude cancer.

If you have had a long standing history of GORD, the endoscopy also checks for complications such as:

• Oesophagitis: Inflammation of the inner lining of the food pipe due to long standing reflux. In severe cases, this could also lead to “ulceration” (shedding of the most superficial layer of the mucosa)
• Stricture: Narrowing of the lower portion of the oesophagus due to ongoing cycles of chronic inflammation from acid reflux injury and healing of the tissue by formation of scar tissue. This increasing accumulation of such scar tissue ultimately leads to progressive narrowing of the lumen of the food pipe which results in having difficulties swallowing (dysphagia).
• Barrett’s Oesophagus: This condition is often associated with GORD, whereby abnormal cells are found in the inner lining (mucosa). If that is the case, a small but significant risk of cancer (oesophageal adenocarcinoma) exists.  This could be identified at the time of endoscopy and biopsies of these abnormal tissues are then examined under a microscope to confirm.
• Hiatal hernia: Check a more detailed description.

Another common test organised by your surgeon includes an oesophageal pH and manometry study. It involves placing a small, thin flexible tube with a specialised sensor into the oesophagus via the nostrils. Its main purpose is to confirm and measure the degree of acid reflux and also to rule out uncommon oesophageal dysmotility conditions (abnormal food pipe muscle contractions or “peristalsis”).  This is vital to define the exact course of treatment.

If your GP has suggested that you may suffer from a Benign Oesophageal Disorder, it is important to consult with a specialist surgeon, who will define the most suitable treatment. At The Surgeons Collective Perth we combine the experience of 3 of Perth’s leading surgeons, and the expertise of our dietitians.  It’s our mission to provide excellence in surgical and clinical outcomes, and to give you a comprehensive and clear diagnosis, as well as genuine care and support.

Quite often, the reflux symptoms will not require surgery, and will disappear with lifestyle changes or in combination with anti-acid drugs known as “Proton-pump inhibitors” ( e.g. Somac, Nexium, Losec, Pariet).

Lifestyle changes generally include:

• A change of diet: avoiding coffee, fizzy drinks, spicy or fatty foods and chocolate
• Reducing your alcohol intake
• Reducing your food portion sizes
• Avoiding late night meals and snacking
• Changing your head position when you sleep, changing the position of the oesophagus and using an extra pillow
• Losing weight