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Gastro-Oesophageal Reflux Disease (GORD)

Summary

Gastro-oesophageal reflux disease (GORD) occurs when stomach contents flow back into the oesophagus, causing discomfort and sometimes complications. The most common symptoms are heartburn and acid regurgitation, but some children may also experience symptoms like cough, laryngitis, or even dental problems.

To diagnose GORD, a therapeutic trial with proton-pump inhibitors (PPIs) is often used. An upper endoscopy may be necessary to evaluate for complications, especially if symptoms persist or if there are concerning signs like weight loss or anaemia.

Although many children improve with treatment, GORD tends to relapse when treatment is stopped, so ongoing management may be required to keep symptoms under control.

Diagnosis and When to Seek Help

The key symptoms of GORD include:

  • Heartburn (a burning sensation in the chest)
  • Regurgitation (the feeling of acid coming up the throat)
    Other signs that might point to GORD include:
  • Cough or laryngitis
  • Dental erosion
  • Asthma-like symptoms
    If your child experiences any of these symptoms frequently or if they don’t improve with over-the-counter medications, it’s important to seek medical advice. Your child may need a diagnostic trial with medication or further tests like an upper endoscopy to check for complications or other concerns.

Management

GORD is typically managed through a combination of lifestyle changes and medication:

  • Lifestyle modifications: This may include adjusting eating habits (e.g., smaller meals), avoiding certain foods (like spicy or acidic foods), and ensuring that your child doesn’t lie down immediately after eating.
  • Medications: Proton-pump inhibitors (PPIs) are commonly prescribed to reduce stomach acid production, offering relief from symptoms.
  • Ongoing treatment: GORD can relapse after treatment is stopped, so your child may need continuous management to control symptoms.

Follow-Up and Monitoring

If your child is diagnosed with GORD, regular follow-up appointments will help track progress and adjust treatment if needed. In some cases, complications such as oesophageal strictures (narrowing of the oesophagus), Barrett’s oesophagus, or even oesophageal cancer can develop, so it’s essential to monitor and manage GORD symptoms closely to avoid these risks.

If your child experiences persistent symptoms despite treatment, or if they show any of the alarm features mentioned (e.g., unexplained weight loss), further evaluation is essential to rule out more serious issues.

GORD can significantly impact your child’s comfort and health, but with the right treatment and monitoring, most children can manage the condition effectively.

reflux & vomiting
reflux & vomiting

History and Exam

Key diagnostic facto

  • presence of risk factors
  • heartburn
  • acid regurgitation

Other diagnostic factors

  • dysphagia
  • bloating/early satiety
  • laryngitis
  • globus

Risk factor

  • family history of heartburn or GORD
  • older age
  • hiatus hernia
  • obesity

Diagnostic Investigations

1st investigations to order

  • proton-pump inhibitor (PPI) trial

Investigations to consider

  • oesophagogastroduodenoscopy (OGD)
  • ambulatory pH monitoring
  • oesophageal manometry
  • combined impedance-pH testing

Emerging tests

  • endoluminal functional lumen imaging probe

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    Other Related Conditions

    coeliac disease

    Inflammatory bowel disease (Crohn’s disease or Ulcerative Colitis)

    Eosinophilic Oesophagitis

    cow’s milk protein intolerance, food allergies

    irritable bowel syndrome (ibs)

    reflux & vomiting

    failure to thrive

    constipation or diarrhoea

    incontinence

    chronic abdominal pain

    gastroparesis

    liver disease

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      1 Reason for referral *

      2 Parent Surname *

      3 Patient First Name *

      4 Email *

      5 Patient Surname *

      6 Phone *

      7 Child’s date of birth *

      8 Address