Acid Reflux (GORD / GERD)

Medically written by
A/Prof Viraj Kariyawasam
MBBS, FRACP, MRCP, PhD
Gastroenterologist & Hepatologist
Associate Professor – Macquarie University
Head of IBD Service – Blacktown Hospital
Last reviewed: March 2026

1. What is Acid Reflux (GORD / GERD)?

Acid reflux, also known as gastro-oesophageal reflux disease (GORD or GERD), is a condition where stomach acid flows back into the oesophagus. This occurs when the valve between the oesophagus and stomach (the lower oesophageal sphincter) becomes weak or relaxes inappropriately.

Occasional reflux is common, but GORD is diagnosed when reflux symptoms are frequent, persistent, or cause inflammation or complications. GORD affects people of all ages and is increasingly common in Australia.

2. Causes & Risk Factors

GORD develops due to dysfunction of the lower oesophageal sphincter, allowing acid to escape from the stomach. Several factors can contribute to this.

Risk factors include obesity, pregnancy, smoking, alcohol intake, large or late meals, and certain foods such as fatty foods, chocolate, caffeine, and spicy foods. Some medications may worsen reflux. A hiatus hernia can also increase the likelihood of reflux.

3. Symptoms & How It May Present

The most common symptom is heartburn, described as a burning sensation behind the breastbone, often after meals or when lying down.

Other symptoms include acid regurgitation, chest discomfort, chronic cough, hoarse voice, throat irritation, difficulty swallowing, and a sensation of food sticking in the chest. Some people experience reflux without heartburn, particularly older adults.

4. How Is It Diagnosed?

GORD is often diagnosed based on a person’s symptoms and their response to initial treatment, and in many cases no tests are required at first. However, a gastroscopy is recommended if symptoms do not improve with lifestyle measures or medications, if reflux has been present for many years, or if symptoms develop for the first time after the age of 50.

Gastroscopy is also advised when symptoms are severe or persistent, or when there are warning signs such as difficulty swallowing, bleeding, unintentional weight loss, or anaemia. In selected cases, additional investigations such as oesophageal pH monitoring or oesophageal manometry may be used to further assess reflux and oesophageal function.

5. Treatment & Management Options

Treatment aims to reduce acid exposure, heal inflammation, and prevent complications. Lifestyle modification is an important first step.

Medications include antacids for symptom relief and acid-suppressing therapies such as proton pump inhibitors or H2 blockers. In selected patients with severe or refractory symptoms, surgical or endoscopic treatments may be considered.

6. Living With / Managing GORD

Many people with GORD achieve good symptom control with a combination of lifestyle changes and medication.

Maintaining a healthy weight, avoiding late meals, elevating the head of the bed, and identifying individual food triggers can significantly reduce symptoms. Long-term medication should be reviewed periodically with your doctor.

7. Prevention & Risk Reduction

Reducing modifiable risk factors such as excess weight, smoking, and alcohol intake can lower the risk of developing GORD and reduce symptom severity.

Early treatment helps prevent complications such as oesophagitis, strictures, or Barrett’s oesophagus.

8. When to Seek Medical Advice

Medical review is recommended if reflux symptoms occur frequently, interfere with sleep or daily activities, or do not improve with simple measures.

Urgent assessment is required for difficulty swallowing, food sticking, vomiting blood, black stools, unexplained weight loss, or persistent chest pain.