Acid reflux (GORD)

GORD (gastro-oesophageal reflux disease) occurs when the lower oesophageal sphincter (the valve between oesophagus and stomach) relaxes abnormally, letting stomach acid rise. Symptoms: burning behind the breastbone, acid regurgitation, sometimes a chronic cough, hoarseness, a feeling of a lump in the throat.

An original angle (the myth of excess acid): people often believe GORD comes from an excess of stomach acid. The reality is more nuanced: the problem is often mechanical (a relaxed sphincter) or sometimes linked to a lack of acid (hypochlorhydria), which slows digestion and increases pressure in the stomach.

This is why acid-suppressing drugs (PPIs) relieve symptoms but can, in the long term, make the underlying problem worse: they reduce absorption of B12, magnesium and calcium, and promote bacterial overgrowth. They are useful in the short term but often over-prescribed long term.

Dietary and lifestyle aggravating factors:

• Meals that are too large, too fatty or too late (going to bed on a full stomach)
• Coffee, alcohol, chocolate, mint (they relax the sphincter)
• Being overweight (abdominal pressure)
• Stress, smoking

Non-drug approaches: split your meals into smaller ones, have dinner early and light, raise the head of the bed, lose weight, avoid your personal triggers. These are often more effective in the long run than medication alone.