Overview
GERD is a chronic digestive disorder where stomach acid or bile flows backward into the esophagus, irritating its lining. This backward flow is called acid reflux, and when it occurs regularly (usually more than twice a week), it's diagnosed as GERD. The condition weakens the lower esophageal sphincter (LES), which normally acts as a one-way valve between the esophagus and stomach.

Why It’s Important
Though common, untreated GERD can lead to serious complications, such as esophagitis, esophageal ulcers, narrowing of the esophagus, or Barrett’s esophagus, a precancerous condition. GERD also greatly impacts quality of life due to persistent discomfort, sleep disruption, and dietary limitations. Early management helps prevent long-term damage and improves day-to-day well-being.

Quick Facts

• Affects up to 20% of adults in the U.S.

• Can affect people of any age, though more common in adults and pregnant women

• Chronic condition; symptoms may come and go or persist

• Often worsens after large meals, lying down, or bending over

• Associated with obesity, smoking, and certain medications

What Happens in the Body
The lower esophageal sphincter (LES) normally closes after food enters the stomach. In GERD, the LES becomes weakened or relaxes inappropriately, allowing acid and partially digested food to flow back into the esophagus. This causes irritation, inflammation, and damage over time, especially if frequent.

Common Signs and Symptoms

• Heartburn (burning sensation in the chest)

• Acidic or bitter taste in the mouth

• Regurgitation of food or liquid

• Chest pain (can mimic heart attack)

• Chronic cough, hoarseness, or sore throat

• Difficulty swallowing (dysphagia)

• Worsening symptoms at night or when lying down

Diagnosis

• Medical history and symptom discussion

• Upper endoscopy to examine the esophagus

• 24-hour pH monitoring to measure acid levels

• Esophageal manometry to assess LES function

• Barium swallow X-ray to visualize reflux
  See a doctor if:

• You have frequent heartburn, especially if it interferes with sleep

• You experience difficulty swallowing, vomiting blood, or unintentional weight loss

• OTC treatments don’t work or symptoms worsen

Treatment and Management

• Lifestyle changes:

  • Avoid trigger foods (spicy, fatty, citrus, caffeine, chocolate, etc.)

  • Eat smaller meals and don’t lie down for 2–3 hours after eating

  • Elevate head of bed at night

  • Lose weight if overweight

  • Quit smoking

• Medications:

  • Antacids (temporary relief)

  • H2 blockers (e.g., famotidine)

  • Proton pump inhibitors (PPIs) (e.g., omeprazole) for longer relief

• Surgery (in severe cases):

  • Fundoplication to strengthen LES

  • LINX device (magnetic ring) implantation

Risks and Complications

• Esophagitis (inflammation of the esophagus)

• Esophageal ulcers or bleeding

• Strictures (narrowing of the esophagus)

• Barrett’s esophagus (increased cancer risk)

• Respiratory issues like chronic cough or asthma-like symptoms

Who Is at Risk

• Individuals who are overweight or obese

• People with hiatal hernia

• Pregnant women

• Those who smoke or drink excessive alcohol

• People who frequently use NSAIDs, anticholinergics, or calcium channel blockers

Related Conditions

• Barrett’s esophagus

• Esophageal cancer

• Hiatal hernia

• Peptic ulcer disease

• Laryngopharyngeal reflux (LPR)

When to See a Doctor

• If you have heartburn more than twice a week

• If symptoms persist despite OTC medications

• If you experience swallowing difficulties, vomiting blood, or black stools

• If GERD symptoms wake you up at night or interfere with daily life

Last Updated: June 28, 2025