GERD is the repeated reflux of stomach acid into the esophagus causing heartburn, regurgitation, and sometimes cough or hoarseness. Start with lifestyle changes (smaller meals, trigger avoidance, weight loss, head-of-bed elevation) and OTC remedies for mild symptoms. H2 blockers and proton pump inhibitors are mainstays for more frequent or severe reflux; long-term PPI use should be overseen by a clinician. For refractory disease or complications, surgical fundoplication or magnetic sphincter augmentation may be considered.
What GERD (acid reflux) is
Gastroesophageal reflux disease (GERD) occurs when stomach acid repeatedly flows back into the esophagus, irritating its lining. Typical symptoms include heartburn (a burning chest sensation), regurgitation of sour fluid, chronic cough, hoarseness or a sensation of a lump in the throat. Because chest pain can also signal heart problems, new or severe chest pain should be evaluated urgently.First-line self-care and lifestyle steps
Many people reduce symptoms with nonprescription measures. Key changes include:- Eat smaller, more frequent meals and avoid heavy meals close to bedtime.
- Avoid trigger foods and drinks (for many people: high-fat meals, chocolate, caffeine, spicy foods, citrus, tomato-based products, and alcohol). Individual triggers vary.
- Stop smoking and cut back on alcohol.
- Lose weight if overweight; modest weight loss often helps.
- Avoid lying down for two to three hours after eating and raise the head of the bed by 6-8 inches to use gravity while sleeping.
- Avoid tight belts and garments that compress the abdomen.
Over-the-counter and prescription medicines
Antacids (calcium carbonate or magnesium/aluminum combinations) provide quick, short-term symptom relief. H2 receptor blockers (like famotidine) reduce acid production and can help episodic reflux. Proton pump inhibitors (PPIs, such as omeprazole and esomeprazole) are the most effective medicines for frequent or erosive reflux and are commonly used for short courses or as longer maintenance therapy when needed.Long-term PPI use should be supervised by a clinician; they are effective but require periodic review to confirm ongoing need and to monitor for potential side effects.
When to see a doctor
See a clinician if you have:- New, severe, or persistent symptoms despite lifestyle measures and OTC medicines
- Difficulty swallowing, unintended weight loss, persistent vomiting, blood in vomit or stool, or anemia
Advanced treatments: procedures and surgery
For people whose symptoms do not respond to medical therapy or who have complications (like esophageal injury), procedural options exist. Surgical fundoplication (commonly laparoscopic Nissen fundoplication) restores the barrier between stomach and esophagus. Magnetic sphincter augmentation (LINX) is a less-invasive, laparoscopic option available in many centers.Endoscopic approaches (for example, transoral incisionless fundoplication) are also used selectively; their benefits vary by patient and procedure.
Surgery or devices are considered when medical management and lifestyle changes fail or when complications arise. Your gastroenterologist and surgeon will weigh risks and benefits for your situation.