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Understanding gastroesophageal reflux disease (GERD)
Audience: patients-public, students-learners ยท Review state: published
What it is
Gastroesophageal reflux disease, or GERD, is a condition in which stomach contents flow back up into the esophagus, the tube that carries food from the mouth to the stomach. Occasional reflux is normal; it becomes GERD when it happens often or causes troublesome symptoms or complications.
The usual cause is a weakened or relaxed lower esophageal sphincter, the ring of muscle at the bottom of the esophagus that normally keeps stomach contents down.
Symptoms
The most common symptom is heartburn, a burning feeling behind the breastbone, often after eating or when lying down. Regurgitation of sour or bitter fluid into the throat or mouth is also common.
Other possible symptoms include chest pain, trouble swallowing, a chronic cough, hoarseness, and a feeling of a lump in the throat. In some people, especially older adults, symptoms can be unusual or silent.
Causes and risk factors
Anything that increases pressure on the stomach or relaxes the sphincter can contribute: obesity, pregnancy, smoking, and a hiatal hernia, where part of the stomach pushes up through the diaphragm. Certain foods and drinks, such as fatty meals, coffee, chocolate, and alcohol, can make symptoms worse in some people.
Some medicines, including certain pain relievers and blood pressure drugs, can also promote reflux.
Treatment and when to seek help
Mild GERD is often managed with lifestyle changes: losing excess weight, avoiding late meals, raising the head of the bed, and cutting down on personal trigger foods. Antacids, H2 blockers, and proton pump inhibitors reduce stomach acid and relieve symptoms.
A doctor should evaluate symptoms that are frequent, severe, or not helped by over-the-counter treatment. Difficulty swallowing, unintentional weight loss, vomiting blood, or black stools need prompt attention, and long-standing GERD can lead to complications such as esophageal inflammation or Barrett's esophagus.
Limitations
General educational overview, not medical advice and not a diagnosis. Persistent reflux symptoms and any alarm features need evaluation by a clinician.