What are the symptoms of GORD, and what should I do about them? Is my cough due to GORD?

In response to a question on healthshare.com.au

GORD, or Gastro-Oesophageal Reflux Disease (sometimes called GERD for those who spell oesophagus without the ‘o’) is a condition which develops when the stomach contents rise into the oesophagus (the food pipe) and causes troublesome symptoms. The stomach contents are usually acidic, but not always so.

At the bottom of the oesophagus there is an anti-reflux valve called the lower oesophageal sphincter. Its job is to stay tightly closed most of the time to prevent escape of the stomach contents, but it also needs to open temporarily to allow food past when swallowing. If this valve is weak, reflux occurs.

The classical symptom of reflux is heartburn, which is a burning sensation behind the breastbone or in the upper abdomen. It results from the acid burning the lower oesophagus. The other common symptom is regurgitation where food is felt to come back up even reaching as far as the mouth. It is a passive event, different to the forceful contraction of vomiting. Heartburn or regurgitation are nearly always a result of GORD.

There are also a group of symptoms called “atypical” symptoms. These can be caused by GORD, but there are also many other possible causes. These atypical symptoms include cough, asthma, hoarseness of the voice, recurrent pneumonias and recurrent sinusitis.

It is quite straightforward to diagnose whether heartburn and regurgitation are due to GORD. Your doctor will likely arrange a gastroscopy (a camera passed into the stomach) to look for damage caused by the acid, and may arrange for testing for acid in the oesophagus (a test called a ‘pH study’)

It is more difficult to determine if the atypical symptoms are due to GORD. A powerful technique to aid your doctor in the diagnosis is a test called an impedance study. This measures the fluid (whether or not it is acidic) going back up the oesophagus and it can determine if it goes so high as to reach the lungs. If so, this could be the cause of the symptoms of cough, asthma, pneumonia and others. Only a few gastrointestinal physiology laboratories perform the impedance study – ask your doctor if this might be helpful for your situation.