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Gastrointestinal

The most common gastrointestinal condition is Gastro-oesophageal disease (GORD). It is the result of the failure of the mechanisms which retain the acidic gastric contents in the stomach and those which protect the oesophageal epithelium resulting in the washing back (reflux) of food and stomach acid into the oesophagus.

The symptoms include heartburn, which is a painful burning sensation felt behind the breastbone, sometimes accompanied by a bitter taste in the mouth. This typically occurs after eating a large meal or spicy food. Other common symptoms of GORD are regurgitation (where stomach content rise as far as the throat), belching and bloating.

The complications of GORD include:

  • Oesophagitis - inflammation and ulceration of the lining of the oesophagus. It may cause pain when drinking or swallowing food.
  • The narrowing of the oesophagus because of longstanding inflammation.

There are two tests available to find out whether you have GORD.

  • Barium swallow or upper gastrointestinal (GI) series - an x-ray method involving barium where abnormalities of the GI tract are made visible.
  • Endoscopy where a flexible tube is inserted allowing the doctor to directly see the lining of the oesophagus and take samples of the lining tissues.

Managing GORD

Self-help measures – avoid fatty / spicy / acidic foods; avoid alcohol / coffee/ tea; lose weight; stop smoking; eat healthy.

Medication available:

  • Antacids – These are alkaline substances that neutralise the acid in the stomach. They are often used as palliative treatments for dyspeptic symptoms and most can be bought over the counter. The most commonly used antacids are magnesium and aluminium hydroxide compounds.
  • Acid-suppressing agents - Ranitidine, cimetidine and famotidine reduce the acid produced by the stomach. They switch off receptors, which modulate stomach acid secretion therefore lowering the amount of acid that can regurgitate to the oesophagus area and minimise the damage to the mucosal lining.
  • Proton Pump inhibitors - The mechanism by which proton pump inhibitors work is by markedly suppressing acid secretion. They may be used instead of acid-suppressing agents if reflux or oesophagitis persists.
  • Muscular stimulants/Motility agents - Improve the return of refluxed juices back to the stomach and tighten the sphincter.
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