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The Aberdeen Clinic
The Aberdeen Clinic
Reflux Aberdeen

Reflux Clinic


The Aberdeen Gastroesophageal Reflux Clinic

  Gastroesophageal Reflux Disease (GORD)
At the Aberdeen Clinic we believe that everyone should get the same high standards of investigation and treatment that we would expect ourselves. This led us to our BEST practice promise i.e.

B - Best value
E - Effective care
S - Safe treatment
T - Treatment that patients want, when they want it

For gastro-oesophageal reflux disease (GORD) this means finding the best treatment which provides you a solution to the troublesome symptoms that GORD causes. No two patients with GORD are the same and therefore there is no such thing “as one size fits all”, treatment must be tailored to the individual. Our experienced team of surgeons, nurses, gastroenterologists and specialist physiologists that you will receive the BEST care at every stage for your reflux disease to allow you to put the symptoms of reflux behind you.

About Gastro-oesophageal Reflux disease
Gastro-oesophageal reflux disease (GORD) is a condition caused when the stomach contents backtrack out of the stomach into the lower oesophagus (gullet).
The lining of the oesophagus is not resistant to acid and its presence in the lower oesophagus can cause pain behind the breastbone (sternum). Most commonly this is described as a burning discomfort rising upwards from the stomach area (heartburn). Some people may also experience: regurgitation of food, hoarseness, a cough, nausea and/or excess saliva (waterbrash).

Gastro-oesophageal reflux is very common, indeed everyone is likely to experience some of these symptoms from time to time. However if they are occurring frequently and are starting to interfere with your ability to do every-day activities it becomes gastro-oesophageal reflux disease (GORD).

It has been estimated that about a fifth of adults in the UK consult their doctor for symptoms of reflux. In about 1/3 of these patients the symptoms are severe and difficult to control.
  The Aberdeen Gastroesophageal Reflux Clinic
  GORD Quiz
  Complications of gastro-oesophageal reflux?
The reflux of acid and other noxious stomach contents into the oesophagus may result in damage to the lining of the oesophagus – a condition known as oesophagitis. Oesophagitis is an inflammation of the oesophagus but if more severe it can lead to errosions and ulcers.

As ulcers of the oesophagus heal they may result in the development of a stricture or narrowing of the oesophagus. In other situations errosions of the oesophageal lining heal but with a change in the cells to look more like the cells lining the stomach (Barrett’s Oesophagus). Barrett’s oesophagus has been linked to the development of cancer of the oesophagus but the exact relationship is unclear.

Management of Gastro-oesophageal reflux
For successful management of gastro-oesophageal reflux it is important to approach the problem in a step-wise fashion. As such we follow the following steps in accordance with BEST practice outlined by NICE and the American Journal of Gastroenerology guidelines:

• Ensure the diagnosis is the right one.
• Formulate a treatment plan based on the effects of GORD on each individual
• Deliver the BEST treatment available.
• Continue to follow-up our patients

Although this clinical pathway defines the steps to follow it is essential to ensure that each patient receives an individualized care plan. Our specialist team ensures that everyone we see gets the benefit of our experience and knowledge of this complex problem.

1. Establishing the diagnosis
It is important to establish the correct diagnosis as many other conditions can mimic GORD. It is important to rule out any serious conditions and obviously to ensure that GORD is the cause of your symptoms before starting any specific treatment.

We can establish the diagnosis based on your symptoms and also a number of tests including:
• Our on-line questionnaire

• Testing for evidence of gastric juices in saliva (PEP test)

By testing for the presence of stomach enzymes in saliva we can screen patients for the likelihood of GORD.
In many this will negate the requirement for more invasive investigations

• Endoscopic examination of the oesophagus, stomach and duodenum
We are able to offer all endoscopic services in the purpose built endoscopy suite at the Aberdeen Health Village. Patients benefit from the use of the most up-to-date equipment and Aberdeen’s only specialist endoscopy unit.

• Measurement of acid and gastric reflux into the oesophagus

We work with the Internationally respected functional gut clinic to provide this service with the most up-to-date equipment. An acid-sensitive catheter is placed in the oesophagus and is attached to a small monitoring device that records changes in oesophageal pH over an extended period of time (up to 24 hours). It provides information on the severity and pattern of reflux which in-turn is helpful both to confirm the impression of reflux and to tailor therapy for the individual patient. The impedance measurement detects the direction of liquid flow so we can determine whether the acid sensed by the probe has come from the stomach or has been swallowed. The pH and Impedance probe is very small (2mm in diameter) and you can go home with it in place and continue with your normal daily activities, returning the following day to have the probe removed, which takes only 5-10 minutes.

• Measurement of the functioning of the oesophagus.

Oesophageal manometry provides information about how the muscles in your throat and oesophagus work as food and liquids pass from the mouth to the stomach. As above we work with the Functional Gut clinic and the oesophageal manometry probe is the smallest and most sophisticated on the market. This ensures we can perform the test to the highest standards whilst making the whole procedure as quick and comfortable as possible. It also means that unlike many conventional laboratory tests we are able to find out what is happening
in real time.

Not all of these investigations are required in everyone and our team will advise on the most appropriate according to your requirements.

2. Formulating a treatment plan
Everyone that we see with GORD is different and as such an individualized treatment plan has to be developed. This will depend upon:

• The frequency and severity of your symptoms
• The impact that your symptoms have on your lifestyle and work.
• Your own preferences towards medical or surgical treatments.

Our consultants will provide you with all the options available and work out a plan that works for you.

For more information on treatment options contact us for a free brochure image

3. Delivering the BEST Treatment

Treatment for GORD can be roughly divided into medical treatment or surgical intervention. Much can be achieved by dietetic advice and optimizing medications and our multi-disciplinary team are experts in achieving successful resolution of GORD symptoms.

Although most people are managed with medical treatment of their GORD some will continue to get symptoms or have problems with long-term medications. In these cases there are a number of different surgical options available.

The traditional surgical approach is to create an artificial valve between the oesophaus and the stomach, with the aim of preventing stomach contents refluxing out of the stomach into the gullet. This procedure is known as a fundoplication and can involve wrapping the upper part the stomach completely round the oesophagus or partly round the oesophagus. These operations are done using keyhole (laparoscopic) surgical techniques and are generally very effective in controlling reflux.

Newer techniques are also available through the Aberdeen Clinic. In particular we have been very impressed with the results of the Linx procedure. This is a keyhole operation which augments the normal valve by placing a band of magnets around the junction between the stomach and the oesophagus. The advantage of the Linx procedure is that it results in a more natural swallowing mechanism than the traditional surgery and as such is not associated with side effects such as bloating and inability to belch etc.

As with all treatments at the Aberdeen Clinic our strict governance and audit protocol is followed so you can be assured you well get the very best treatment available.

Aberdeen Clinic Surgeon Ken Park answers questions on the LINX device

4. Follow-up
GORD is a long-term disease and it is important that we offer long-term follow-up. As such we believe that any treatment is not a one off piece of advice or procedure but part of a continuous management. It is important that this process is well co-ordinated and delivered by individuals that know you and you know them.

Meet the team

The GORD team at the Aberdeen Clinic represents one of the most experienced anywhere in the UK. The surgeons have many years of experience in the treatment of `GORD and have pioneered laparoscopic, endoscopic and most recently the use of Linx in the UK.

We work with the Fuctional Gut clinic who are at the forefront of using modern technology to determine what is happing in the GI tract.

This test should be regarded as a guide to the likelyhood that your symptoms relate to GORD but it is possible to have symptomatic reflux without a high score – particularly if symptoms relate to the upper airways. If in doubt you should consult with a doctor.

If you score 7-21 on the unshaded questions it is likely you have symptomatic gastro-oesophageal reflux. You should aim to avoid situations and foods that make this worse and may benefit from dietetic advise. If the symptoms are more troublesome you may wish to consider medical treatment and consult at doctor.

If you score >8 in the grey boxes it is likely that IBS at least partially is responsible for your symptoms

If you Score 1-3 in the red boxes it is important to see a doctor about this as it suggests an narrowing of the oesophagus and may be an indicator of serious disease.

Click here to download the quiz

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