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Gastro-oesophageal reflux disease (GORD) is a condition in which excessive amounts of acid and fluid produced in the stomach overcome the mechanical and functional barriers between the stomach and oesophagus to enter the lower oesophagus. Gastro-oesophageal reflux itself is normal and occurs commonly, with stomach acid being present in the lower oesophagus of normal individuals for up to 1 hour each day; automated swallowing waves in the oesophagus clear the acid back into the stomach. It is only when the acid lingers or cannot be cleared that the condition is referred to as gastro-oesophageal reflux disease.
Acid, however, is only half the problem. In addition to hydrochloric acid, the stomach also produces up to 2 litres of intestinal fluid each day, containing enzymes such as pepsin, which digests protein, and other active components that can irritate the upper aerodigestive tract. Even if acid suppression by regular use of medication such as Losec, Nexium, Somac, or Pariet is successful, the stomach continues to produce fluids with other irritants that can continue to reflux and cause problems, even if the typical symptoms of reflux are not present.