Gastroesophageal reflux disease (GERD) is when the contents of your stomach persistently move back up into your esophagus. These contents sometimes contain excessive acid and may cause irritation and pain. Many people may experience acid reflux, indigestion, or heartburn from time to time. However, if you experience acid reflux symptoms more than twice per week, you may have gastroesophageal reflux disease (GERD).
The most common symptom of GERD is persistent heartburn, which may involve:
- a burning feeling in your stomach that may rise to your chest, neck, and throat
- a sour or bitter taste at the back of your mouth
- regurgitation of food or liquid from your stomach into your mouth
Other possible symptoms of GERD include:
- a feeling of fullness or a lump in the back of your throat (Globus sensation)
- chronic cough
- a hoarse voice
- bad breath
In some cases, people may experience alarm symptoms associated with GERD. These are typically persistent and could progressively worsen despite medical treatment. Alarm symptoms may also indicate an underlying condition.
- difficulty swallowing (dysphagia)
- pain when swallowing (odynophagia)
- nausea or vomiting
- weight loss
- anemia
- bleeding
If you’re experiencing any of these, get medical attention.
Heartburn or heart attack?
Heartburn and heart attacks are two common causes of chest pain. However, their causes and sensations are typically different:
- Heartburn may occur when acidic contents of your stomach move back up into your esophagus. This may cause a burning sensation that rises from your stomach and radiates into your chest.
- Heart attack is when your heart doesn’t get enough blood and oxygen due to a reduced flow of blood in one or more major arteries. This may cause sudden, uncomfortable, or sharp pain in the center or left side of your chest that feels like pressure or squeezing. It could spread to your neck, jaw, and shoulder too.
If you’re feeling any heart attack symptoms, such as shortness of breath or faintness, get medical assistance immediately.
Symptoms in infants
It’s normal for babies to sometimes spit up food or vomit. But if your baby is frequently spitting or vomiting, they may have GERD.
- refusal to eat
- trouble swallowing
- gagging or choking
- wet burps or hiccups
- irritability or arching of the back during or after feeding
- weight loss or poor growth
- recurring cough or pneumonia
- difficulty sleeping
If you suspect that your baby might have GERD or another health condition, speak with a doctor.
Causes of GERD
GERD commonly causes acid reflux, which may result from improper functioning of the lower esophageal sphincter (LES). The LES is a circular band of muscle at the end of your esophagus. When you swallow, it relaxes and opens up to allow food and liquid to travel from your mouth to your stomach. Then, it tightens and closes again. Acid reflux happens when your LES doesn’t tighten or close properly. This allows digestive juices and other contents of your stomach to rise up into your esophagus.
Your LES may not function properly if you:
- Have a hiatal hernia: This occurs when part of your stomach moves above your diaphragm toward your chest. If your diaphragm is compromised, it may prevent your LES from functioning properly.
- Frequently eat large meals: This may cause distension of the upper part of your stomach. This distension sometimes means there isn’t enough pressure on the LES, and it doesn’t close properly.
- Lie down too soon after meals: This might not create enough pressure for the LES to function properly.
Other factors, including those listed below, may also contribute to having heartburn more than twice a week.
- smoking or being exposed to secondhand smoke
- eating large meals before lying down
- using an abundance of nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen
- Health factors such as the following may contribute to GERD:
- obesity
- pregnancy
- connective tissue disorders
- older age
- Other conditions
- Other health conditions that can worsen the symptoms of GERD include:
- anxiety
- pregnancy
- asthma
- irritable bowel syndrome
Alcohol
Studies suggest that drinking alcohol may increase the risk of GERD. The greater the quantity of alcohol and frequency of consumption, the greater the correlation. If you’ve received a diagnosis of GERD, limiting or stopping alcohol intake may provide symptom relief.
Diagnosis
A doctor will typically take your medical history and perform a physical examination to assess your symptoms. If you’re experiencing alarm symptoms, such as chest pain or trouble swallowing, they may refer you to a gastroenterologist or request certain tests, including:
- Ambulatory 24-hour pH probe: A small tube is inserted through your nose into your esophagus. A pH sensor at the tip of the tube measures how much acid exposure your esophagus is getting and sends the data to a portable computer. You wear this tube for about 24 hours.
- Esophagram: After you drink a barium solution, healthcare professionals use X-ray imaging to examine your upper digestive tract.
- Upper endoscopy: A flexible tube with a tiny camera is threaded into your esophagus to examine it and collect a tissue sample (biopsy) if needed.
- Esophageal manometry: A flexible tube is passed through your nose into your esophagus to measure the strength of your esophageal muscles.
- Esophageal pH monitoring: A monitor is inserted into your esophagus to help healthcare professionals find out how acid is regulated in your body over a few days.
After arriving at a diagnosis, your doctor will speak with you to decide what treatment plan will work best for you. To manage and relieve symptoms of GERD, certain home remedies and lifestyle habits may help, including:
- breathing exercises
- consuming foods and liquids that may help with your acid reflux
- making efforts to maintain a moderate weight
- quitting smoking, if you smoke
- avoiding eating big, heavy meals in the evening
- waiting 2–3 hours after eating to lie down
- elevating your head during sleep
Medication
If lifestyle strategies alone don’t help treat GERD, a doctor might prescribe medications to decrease your stomach acid secretion, since acid reflux is a common manifestation of GERD.
Surgery
In most cases, lifestyle strategies and medications are enough to prevent and relieve symptoms of GERD. However, a doctor might recommend surgery if these approaches haven’t stopped your symptoms or if you’ve developed complications.
To lower your chances of complications, it’s important to take the steps to prevent, manage, and treat symptoms of GERD.
