Gastro-oesophageal reflux disease: extinguishing that fire

Today, gastro-oesophageal reflux disease (GORD) is a recognised medical disorder experienced by many, and typified by backflow of gastric contents into the distal part of the oesophagus (Figures 1 and 2).3 In Western countries, it appears that about 40–50% of the population is affected by this condition. The exact prevalence of GORD in South Africa has not been established. Dyspepsia (heartburn) and/or acid regurgitation are common symptoms.4 GORD may be aggravated by various risk factors and comorbidities. Management of GORD is aimed at decreasing the amount of stomach acid that enters the distal oesophagus, usually by increasing the rate at which the stomach empties into the duodenum, and relieving the discomfort caused by heartburn. From a treatment perspective, however, the distinction between the management of GORD and peptic ulceration is purely arbitrary. Both are acid peptic diseases that are characterised by inflammatory and erosive changes in the normal gut mucosa. Currently, the most useful diagnostic examinations are 24-hour impedance-pH monitoring, which allows separation of true non-erosive reflux disease (NERD) from oesophageal functional S Afr Gen Pract ISSN 2706-9613 EISSN 2706-9621 © 2021 The Author(s)