Gastro-oesophageal reflux disease (GORD) in adults

Key points

• GORD is a chronic condition involving a complex of symptoms.
• Risk factors include stress, smoking and alcohol, trigger foods (coffee, chocolate, fatty foods), obesity, pregnancy, family history, hiatus hernia and the side-effects of some drugs including NSAIDs and antihypertensives.
• Patients who are over 55 and have weight loss combined with upper abdominal pain, reflux or dyspepsia should have an endoscopy within two weeks.
• Treatment for H. pylori and lifestyle changes will often be effective, but refractory symptoms despite optimal treatment should prompt retesting for Helicobacter and consideration of referral.
• Long-term use of PPIs can cause problems, and deprescribing should be considered where appropriate.