Gastroesophageal reflux disease (GERD) causes heartburn and regurgitation when stomach acid irritates the esophagus due to LES dysfunction or anatomical factors. Risk factors include obesity, smoking, pregnancy, and certain foods. Diagnosis often relies on symptoms and response to therapy; endoscopy or pH testing is used when needed. Management emphasizes lifestyle changes, antacids for occasional heartburn, H2 blockers or PPIs for frequent symptoms, and surgical or device options for refractory cases.

What is GERD?

Gastroesophageal reflux disease (GERD) happens when stomach contents, including acid, flow back into the esophagus because the lower esophageal sphincter (LES) does not close effectively. The stomach makes hydrochloric acid and digestive enzymes like pepsin; when acid reaches the esophagus it irritates the lining and produces the familiar burning sensation called heartburn.

Common causes and risk factors

  • Transient LES relaxations and anatomic problems such as a hiatal hernia.
  • Obesity and pregnancy, which increase abdominal pressure.
  • Tobacco use and alcohol, which can weaken the LES.
  • Certain foods and drinks: citrus, tomato-based products, chocolate, peppermint, coffee/caffeine, fatty or spicy foods, and carbonated beverages.
  • Some medications can worsen reflux (talk with your clinician about any prescriptions).

Symptoms to watch for

Typical symptoms include heartburn (a burning feeling behind the breastbone), regurgitation of sour or bitter fluid into the mouth, and a bad taste. Less typical symptoms include chronic cough, hoarseness, throat clearing, or dental erosion. Seek prompt care for alarm symptoms: trouble swallowing, persistent chest pain, vomiting blood, or unexplained weight loss.

How GERD is diagnosed

Many people are diagnosed by a typical symptom pattern and response to treatment. Clinicians may use a trial of acid suppression (H2 blockers or proton pump inhibitors) for diagnosis. When symptoms are severe, persistent, or there are alarm features, tests can include upper endoscopy, ambulatory pH monitoring, or manometry.

Treatment and daily strategies

  • Lifestyle measures: lose excess weight, avoid late or large meals, eat smaller portions, and remain upright for 2-3 hours after eating. Raise the head of the bed (6-8 inches) if nighttime reflux disturbs sleep.
  • Avoid or limit tobacco, alcohol, and foods that trigger symptoms.
  • Over-the-counter antacids can relieve occasional heartburn. H2 receptor blockers (e.g., famotidine) and proton pump inhibitors (PPIs, e.g., omeprazole) treat frequent or more severe reflux; use them under medical guidance for ongoing symptoms.
  • When medications and lifestyle changes fail, procedures such as surgical fundoplication or device-based therapies (e.g., magnetic sphincter augmentation) are options for selected patients.

Long-term considerations

Untreated chronic reflux can lead to esophagitis, strictures, or Barrett's esophagus, which requires surveillance. Work with your healthcare provider to choose the right combination of lifestyle changes, medication, and, when appropriate, testing or procedures.

FAQs about Acid Reflux Symptoms

What triggers heartburn in GERD?
Triggers include large meals, lying down soon after eating, alcohol, tobacco, and specific foods such as citrus, tomato products, chocolate, peppermint, caffeine, fatty or spicy items, and carbonated drinks.
When should I see a doctor for reflux?
See a doctor for frequent or worsening symptoms, or immediately for alarm signs like difficulty swallowing, persistent chest pain, vomiting blood, or unexplained weight loss.
Are over-the-counter remedies enough?
OTC antacids can relieve occasional heartburn. Frequent or severe reflux often requires H2 blockers or proton pump inhibitors prescribed or recommended by a clinician.
Can lifestyle changes help GERD?
Yes. Losing excess weight, avoiding trigger foods, not lying down for 2-3 hours after eating, and elevating the head of the bed at night can reduce reflux symptoms.
What are treatment options if medications don't work?
For persistent symptoms despite medical therapy, surgical fundoplication or device-based procedures such as magnetic sphincter augmentation are options for selected patients after evaluation.

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