Acid reflux vs GORD: Causes, symptoms and complications

Acid reflux

GORD

Condition

Acid reflux is the condition where stomach acid flows backward into the oesophagus, causing discomfort. Occasional acid reflux is common, but frequent reflux (leading to GORD) can cause more serious issues.

GORD is a more severe form of acid reflux where stomach acid or bile irritates the lining of the oesophagus, leading to symptoms like heartburn, regurgitation, chest pain, and difficulty swallowing.

Frequency of occurrence

Occasional or infrequent reflux episodes.

Chronic condition with frequent or daily symptoms (more than twice a week).

Severity

Mild to moderate symptoms that are temporary.

More severe symptoms that can lead to complications if untreated.

Symptoms

Heartburn

Regurgitation

Sour taste

Mild chest discomfort

Heartburn

Regurgitation

Difficulty swallowing

Chronic cough or hoarseness

Sore throat

Asthma-like symptoms

Oesophageal damage

Generally no significant damage to the oesophagus.

Can lead to inflammation, oesophagitis, narrowing (strictures), and Barrett’s oesophagus.

Timeframe of symptoms

Short-lived episodes that resolve with lifestyle changes or antacids.

Persistent or recurring symptoms, often requiring ongoing treatment.

Complications

Rarely leads to complications.

Can lead to severe complications like oesophageal ulcers, and an increased risk of oesophageal cancer.

Causes

Delayed gastric emptying: Slower digestion can increase the risk of reflux.

Too little HCl (hydrochloride) production: The HCl is too weak, so the body compensates by producing a higher volume, increasing the likelihood of acid reflux.

Dietary triggers: Foods and drinks like fatty foods, chocolate, caffeine, citrus, tomato-based foods, spicy foods, and alcohol can trigger or worsen acid reflux.

Lower oesophageal sphincter (LOS) dysfunction: The LOS is a valve at the bottom of the oesophagus that prevents acid from flowing backward. If it weakens or relaxes improperly, acid can reflux into the oesophagus.

Too little HCl production: The HCl is too weak, so the body compensates by producing a higher volume, increasing the likelihood of acid reflux.

Obesity: Excess weight can increase pressure on the abdomen, pushing stomach contents upward.

Hiatal hernia: This occurs when the upper part of the stomach bulges through the diaphragm into the chest, making reflux more likely.

Dietary triggers: Foods and drinks like fatty foods, chocolate, caffeine, citrus, tomato-based foods, spicy foods, and alcohol can trigger or worsen acid reflux.

Smoking: Smoking weakens the LES and promotes acid reflux.

Pregnancy: Hormonal changes and increased abdominal pressure in pregnancy can lead to acid reflux.

Delayed gastric emptying: Slower digestion can increase the risk of reflux.

Diagnosis

Often self-diagnosed or diagnosed based on symptoms.

Diagnosis typically confirmed with endoscopy or 24-hour pH monitoring.

Occurrence

Common, with most people experiencing occasional reflux.

Affects a smaller group, but is more persistent and may affect up to 20% of the population.