Glossary

We've included a glossary of terms related to reflux which we hope you'll find helpful. We would be delighted to add more at your request.

Barrett's Oesophagus

 A condition in which the cells lining the bottom of the oesophagus change from the usual flat (stratified) type to "columnar" type. The condition is thought to be caused by chronic Gastro Oesophageal Reflux. Its importance is that it is considered to be a pre-malignant condition and is associated with the development of oesophageal carcinoma.

Bronchoscopy

An endoscopic technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. Often used during the investigation of respiratory symptoms thought to be caused by GORD.

Bronchoscopy

An endoscopic technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. Often used during the investigation of respiratory symptoms thought to be caused by GORD. 

DeMeester Score

Scoring system that is used to diagnose Gastro Oesophageal Reflux Disease. The score is calculated from six variables recorded during pH tests. A score of over 14.7 diagnoses pathological acid reflux. 

Diaphragm

The large flat muscle used for breathing that separates the chest cavity from the abdominal cavity. 

Dilatation

Stretching of a hollow organ. In oesophageal dilatation an instrument, often an expandable balloon is employed to stretch a narrowing otherwise known as a stricture.

Endoscopy

Generic term for the medical examination of the inside of the body. 

Gas Bloat Syndrome

A recognised side effect of fundoplication operations. Caused by retention of air within the stomach and gut because of an inability to belch following surgery. Symptoms include bloating, colicky abdominal pain and flatus. Thought to affect about 20% of patients

Gastro Oesophageal Reflux Disease

The chronic condition caused by acid and/or other gastric contents refluxing into the oesophagus. The condition can cause a variety of symptoms and is associated with other diseases including oesophageal cancer. Abbreviated to GORD or to GERD in the U.S.A. 

Gastroscopy

The examination of the upper gastro intestinal tract i.e. Oesophagus, stomach and duodenum. Usually performed using a flexible camera under either local anaesthetic or intra-venous conscious sedation.

Globus

The sensation of a lump of sticking in the throat. Can be a symptom of Gastro Oesophageal Reflux Disease.

H2 Blockers

A class of drugs that block the molecule histamine at the H2 receptor in the parietal cells of the stomach and so reduce acid production. They were developed before PPIs which have largely replaced them in the treatment of the symptoms of Gastro oesophageal reflux disease. However they are still sometimes used in combination with PPIs as the affect of the two drugs can be additive. They include Cimetidine and Ranitidine.

Hiatus

The hole in the diaphragm through which the oesophagus passes from the chest cavity into the abdominal cavity. Derived from the Latin word Hiare, to gape.

Hiatus Hernia

The protrusion (herniation) of part of the stomach through the hole in the diaphragm thought which the oesophagus passes (hiatus) from the abdomen into the chest.

Laparoscopy

Minimally invasive surgical technique that employs small holes through which imaging telescopes and instruments are passed into the abdominal cavity. Its primary advantage is more rapid recovery than after open surgery. 

Laryngoscopy

The technique of visualisation of the larynx. Employed as a diagnostic test during the investigation of laryngeal-pharyngeal symptoms including those caused by GORD.

Lifestyle measures

Advise given to patients with GORD aimed at reducing symptoms. These include avoiding actions precipitating these symptoms and include avoidance of certain foods, smoking, elevation of the head of the bed at night and losing weight.

LINX Management System

 A magnetic bead device that is placed around the lower oesophagus to treat Gastro oesophageal reflux disease during a minimally invasive procedure. The device is designed to replace the failing lower oesophageal sphincter or valve which fails in GORD.

Lower Oesophageal Sphincter

The valve mechanism at the bottom of the oesophagus just above the stomach. It's failure is the primary cause of Gastro Oesophageal Reflux Disease.  Abbreviated to LOS or LES in the U.S.A. 

LPR

Laryngo-pharyngeal reflux refers to the condition in which patients experience symptoms secondary to reflux of gastric contents into the upper digestive tract, larynx and airways. Also referred to as “Silent Reflux” or “Atypical Reflux”. Symptoms include chronic cough, post-nasal drip, hoarseness, a sensation of a lump in the throat (globus), wheezing including asthma, sore throat and mouth and dental problems. 

Manometry

The measurement of pressure. In the oesophagus its measurement and assessment allows the identification of deficiencies in the strength of the valve mechanisms at the top and bottom of the oesophagus as well as its neuro-muscular function. 

Mucosa

The lining or innermost layer of the gastro intestinal tract. 

Multi-channel impedance reflux tests

Investigation used to assess oesophageal reflux. The technique measures resistance to alternating current (impedance) of the contents of the oesophagus and can detect solid, liquid and gaseous boluses as well as acidic and non-acidic reflux.

Nissen's Fundoplication

Currently the most common operation performed to treat GORD. Originally performed as an open operation it is now undertaken as a laparoscopic (key-hole) procedure. The operation is named after the Swiss surgeon who originally described the procedure and involves wrapping part of the stomach called the fundus around the bottom of the oesophagus to create a high pressure zone within it. This is called a "Fundoplication" or sometimes a "wrap". In turn this prevents gastric contents refluxing up into the oesophagus. In a Nissen’s Fundoplication the wrap completely encircles the oesophagus around 360o. Other fundoplication operations are over a smaller extent- for instance a "Toupet" encircles the oesophagus posteriorly over 270o

Oesophagago-Gastirc Junction

The point at which the oesophagus joins the stomach. Identified at endoscopy by the "Z-line" where the pale oesophageal stratified mucosa of the oesophagus meets the pink stomach columnar mucosa. Abbreviated to OGJ.

Oesophagitis

Inflammation of the mucosa oesophagus. Reflux oesophagitis is caused by GORD. Can be non-erosive in which case the mucosa is not damaged or erosive when it is. Usually graded 1-4 or A-D according to severity.

Oesophagus

The part of the gastro intestinal tract that passes from the throat (pharynx) to the stomach.

pH test

Investigation in which the acid level within the oesophagus, usually over 24 hours is measured to determine whether or not gastro oesophageal reflux is present. It can be recorded using catheters or a wireless capsule placed in the oesophagus.

PPIs

A class of powerful anti-acid medications. They powerfully suppress production of acid by the stomach and are the mainstay of medical treatment for the symptoms of gastro-oesophageal reflux disease. They include Omeprazole, Pantoprazole, Esomeprazole and Lansoprazole. In recent years there have been several studies published suggesting their association with side-effects including bone fractures, intestinal infections and heart disease

Stricture

A narrowing of a tube. Can be benign or malignant. In the oesophagus benign structures are usually caused by GORD following repeat inflammation and repair causing scarring.

Ulcer

Technically a breach in an epithelium. In the gastro intestinal tract this refers to the mucosa and can be benign or malignant. Benign oesophageal ulcers are usually caused by gastro-oesophageal reflux disease. 

Vagus Nerves

Pair of Xth cranial nerves which supply several organs including the gastro-intestinal tract. These pass from the chest to abdomen alongside the oesophagus. They can be injured during surgical operations on the oesophagus.