A disorder in which the contents of the STOMACH back up into the OESOPHAGUS because the usual neuromuscular mechanisms for preventing this are intermittently or permanently failing to work properly. If persistent, the failure may cause oesophagitis (see OESOPHAGUS, DISEASES OF). If a person develops HEARTBURN, regurgitation, discomfort and oesophagitis, the condition is called gastro-oesophageal reﬂux disease (GORD) and sometimes symptoms are so serious as to warrant surgery. Gastrooesophageal reﬂux is sometimes associated with HIATUS HERNIA.
Gastro-oesophageal disease should be diagnosed in those patients who are at risk of physical complications from the reﬂux. Diagnosis is usually based on the symptoms present or by monitoring the production of acid using a pH probe inserted into the oesophagus through the mouth, since lesions are not usually visible on ENDOSCOPY. Severe heartburn, caused by the lining of the oesophagus being damaged by acid and PEPSIN from the stomach, is commonly confused with DYSPEPSIA. Treatment should start with graded doses of one of the PROTON PUMP INHIBITORS; if this is not eﬀective after several months, surgery to remedy the reﬂux may be required, but the eﬀects are not easily predictable.