Dr Oli: Diving and GORD

Q: I've been getting some symptoms during and after diving which are worrying me. I went on a Red Sea liveaboard a month ago, which I've done many times before. The first couple of days were fine, great in fact, but from day three, after each dive I started to notice slight bubbling/gurgling sounds in my chest. These got worse over the week, and I started getting burning pains as well. By the end I had to bail out of the last two dives as my chest was so sore. I felt sick too, and half the time couldn't sleep as lying down made it worse. I'm only 40 years old so I was looking forward to a lot more diving. Hopefully this doesn't mean the end?

A: Don't panic, this is actually quite a common complaint and thankfully it's unlikely to terminate your diving career prematurely. These are the typical symptoms of gastro-oesophageal reflux disease (GORD), which are often exacerbated by diving. Think of your stomach as a wine bottle filled with acid, and your oesophagus (food pipe) the long neck of the bottle. Normally a handy little sphincter at the base of the bottle neck stops acid entering the oesophagus. However, in some situations (for example lying down, or being horizontal in the water), the acid refluxes through this sphincter, up the long neck of the bottle, and causes your typical heartburn and nausea. Pretty unpleasant during a dive. The risk factors for GORD are numerous: certain foods (fatty or spicy stuff, chocolate, caffeine, citrus fruits), certain drugs (nicotine, alcohol, anti-inflammatories), obesity, advancing age and tight clothing are those most prevalent in the diving community. If any of these apply then address them. Luckily there are also plenty of medicines to help. Some coat the lining of the oesophagus, others stop the acid secretion from the stomach, and sometimes a course of "triple therapy" will eradicate pesky bacteria that can contribute to the symptoms. So before your next dive ask your GP to give your gullet the once-over.

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