2 Indications and current treatments
2.1 Gastro-oesophageal reflux disease (GORD) is a common problem. It is caused by conditions that disturb the sphincter function at the lower end of the oesophagus, such as a hiatus hernia. Symptoms of GORD can be broadly grouped into those directly related to reflux episodes, such as heartburn, regurgitation, chest pain and nausea, and those caused by complications of the disease, including dysphagia and respiratory difficulties. Repeated episodes of GORD can damage the lining of the oesophagus and lead to oesophageal ulceration, oesophageal stricture and Barrett's oesophagus.
2.2 A NICE clinical guideline describes recommendations for the investigation and management of GORD and dyspepsia in adults. The standard treatments for symptomatic GORD are lifestyle modification and drug therapy. Patients who have refractory symptoms, develop complications despite medication or develop intolerance to medication may be considered for anti-reflux surgery (usually laparoscopic fundoplication). Several endoscopic techniques (such as endoscopic radiofrequency ablation or endoscopic injection of bulking agents) have also been used.