Diagnosis

Diagnosis of GORD

Despite the high prevalence of upper GI disorders, such as GORD (estimated to affect up to 60% of the UK population at some time during their lives) only a small proportion of people ever consult their physician.

The majority of patients only suffer from mild or sporadic symptoms and self-medicate rather than seeking medical advice. A smaller proportion of patients experience frequent symptoms without complications, and are occasionally likely to seek medical help. Fewer than 10% of the population, however, experience chronic or severe symptoms that may be associated with some significant complications and a high tendency to relapse. It is important, therefore, to ensure that patients receive the correct diagnosis, and to differentiate GORD from other upper GI disorders.

The diagnosis of GORD can be reliably made on the basis of clinical signs and symptoms (Table 1), and by taking into account risk factors. The other methods of diagnosis listed can then be used to assess the severity of GORD and investigate complications.

Table 1 – Clinical signs and symptoms of GORD

Most common:

A burning sensation in the chest (heartburn)

A feeling of acid backed up in the oesophagus (regurgitation) and bitter taste

Chest pain that feels like angina: tightness, pressure, heaviness

Trouble swallowing (dysphagia)

Bloating

Belching

Chronic nausea and vomiting (less common)

Feeling like there is a lump in the throat (globus sensation)

Less common:

Loss of tooth enamel