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Gastroesophageal Reflux Disease (GERD)


The Manual's Editorial Staff

Reviewed/Revised Jul 2023
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What is gastroesophageal reflux disease (GERD)?

GERD (acid reflux) is a disease caused by your stomach contents and stomach acid flowing back up your esophagus. Your esophagus is the tube that connects your throat to your stomach. Acid reflux is a problem because stomach acid can damage your esophagus.

  • GERD is a common disorder

  • The most common symptom is heartburn, a burning pain in your chest

  • GERD can permanently damage the inside lining of your esophagus

  • GERD can also affect your voice box, windpipe, and lungs

  • Treatment relieves symptoms in most people

Gastroesophageal Reflux Disease

What causes GERD?

A ring of muscle keeps the end of your esophagus closed. GERD happens when that muscle doesn't work properly. When the muscle is weak or relaxes at the wrong time, or if there is too much pressure in your stomach, your stomach contents can flow back up into your esophagus.

GERD is not usually caused by having too much acid in your stomach. The problem is the acid backing up into the esophagus. The esophagus doesn't have a lining like the stomach to protect it from the acid.

What are the risk factors for GERD?

You’re more likely to have GERD if you:

  • Gain a lot of weight

  • Drink alcohol, carbonated drinks, or caffeine

  • Smoke

  • Take certain medicines

  • Are pregnant

Whatever risk factors you have, you're more likely to have GERD symptoms when you lie down.

What are the symptoms of GERD?

  • Burning pain or discomfort in the middle of your chest (called heartburn), usually after a meal

  • Bitter taste in your mouth

  • Sore throat, hoarse voice, cough, or a feeling that there’s a lump in your throat

Your symptoms may feel worse if you lie down too soon after eating.

What are the complications of GERD?

Over time, acid reflux can hurt your esophagus and cause:

GERD can also affect your voice box, windpipe, and lungs.

How can doctors tell if I have GERD?

  • Usually, doctors can tell based on your symptoms, and you won't need any tests

  • They may need to look down your esophagus with a flexible tube (endoscopy)

  • Rarely, doctors will need to measure the amount of acid in your esophagus using a thin, flexible tube with a sensor at the end (esophageal pH test)

  • Sometimes, doctors may test the muscle at the end of your esophagus to see if it's working (esophageal manometry)

How do doctors treat GERD?

Doctors may recommend the following steps:

  • Don't eat foods that make GERD worse, such as chocolate, tomato sauce, fatty or deep-fried foods, and salad dressings made with vinegar

  • Don't drink alcohol, coffee, and acidic drinks, such as colas and orange juice

  • Avoid eating for 2 to 3 hours before going to bed

  • Don't smoke

  • Raise the head of your bed about 6 inches

  • Lose weight if you're overweight

If these steps don't help, you may need medicines that decrease the acid in your stomach.

  • Medicines that decrease stomach acid are proton pump inhibitors and H2-receptor blockers

  • You will take the medicine for 4 to 12 weeks or longer so your esophagus has time to heal

Doctors may recommend surgery if medicines aren’t helping. The surgery is called fundoplication. The surgeon wraps part of your stomach around the bottom of your esophagus, which stops stomach contents from flowing back up.

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