What is Gastroesophageal Reflux Disease (GERD)?

A man holds the tips of his fingers to the area under his breastbone. He is likely suffering from heartburn or GERD.
  • Gastroesophageal reflux disease — commonly called GERD — is a chronic digestive disorder characterized by the reflux of stomach acid and/or bile into the esophagus, causing symptoms such as heartburn, chest pain, and regurgitation.
  • Lifestyle factors and dietary changes may be enough for some people to manage GERD, while others will require OTC medications or prescription drugs like AcipHex®.
  • Doctors generally recommend medications for GERD as temporary solutions until underlying causes can be resolved. Surgery is seldom required and is regarded as a last-line treatment for GERD.

What is GERD?

GERD — which is short for gastroesophageal reflux disease — is a digestive disorder characterized by frequent burning sensations in the chest and throat.

This kind of burning pain emerges when stomach acid rises into the esophagus (your "food pipe" or gullet). Known as acid reflux or heartburn, it happens periodically based on your diet, but it becomes a more diagnosable problem when it’s a regular occurrence.

GERD is a form of severe and regular acid reflux. If your acid reflux occurs two or more times a week and symptoms persist even after you’ve tried common over-the-counter treatments, you may have GERD.

Is GERD serious?

Uncontrolled GERD can cause multiple problems. People who experience symptoms of GERD frequently are at an increased risk of developing more severe complications that can significantly impact their quality of life. For example:

  • GERD can cause sleep disturbances for those dealing with burning pain through the night

  • GERD can reduce your ability to stay physically active, as physical activity can trigger acid reflux

  • It can limit your social interactions, food and drink choices, and even impact productivity

  • It can affect you psychologically by increasing anxiety and even depression

  • Consistent acid reflux increases the risk of developing a condition called Barrett's esophagus and esophagitis

  • It can lead to upper GI (gastrointestinal) bleeding

  • It increases the risk of developing esophageal cancer — especially if you already have Barret’s esophagus

Understanding what causes GERD and being able to recognize the symptoms can help you limit the triggers of acute acid reflux, find the right treatment, and improve your quality of life.

If you’re prone to coughing or clearing your throat after eating spicy or greasy foods, don’t wait until acid reflux turns into GERD before you take action.

What Causes GERD?

A specific cause of GERD can be difficult to identify as this digestive disorder often results from a combination of factors.

Factors that can contribute to, or worsen, GERD include:

  • Being overweight or pregnant: Increased pressure in the abdomen can contribute to acid rising into the esophagus

  • Eating late at night, especially fried and fatty foods

  • Lying down shortly after a meal

  • Eating large meals, especially spicy or greasy dishes

  • Having a hiatal hernia, a bulging of the stomach above the diaphragm

  • Drinking alcohol or coffee

  • Taking vitamins, supplements, or medications that irritate the esophageal lining. For some people, this can include iron supplements, ibuprofen, and aspirin

Can GERD Be Genetic?

Although GERD is mainly a result of dietary and lifestyle factors, a rare condition called Zollinger-Ellison Syndrome (ZES) can lead to GERD symptoms.

Data from the National Institutes of Health (NIH) shows that only 0.5 to 3 people out of every 1 million are diagnosed with ZES each year. This disorder is characterized by gastrinomas (tumors) that produce excess stomach acid, causing — among other symptoms — acid reflux.

Surgical removal of these tumors is the only way to cure ZES. Proton pump inhibitors can be used to help manage symptoms and reduce acid build-up in the stomach and esophagus.

Knowing if You Have GERD

Heartburn is one of the primary symptoms of GERD and can cause considerable discomfort and pain. Heartburn is characterized by a burning sensation in the chest and a sour smell or taste in the mouth.

While periodic heartburn is normal for individuals who occasionally eat greasy, heavy, or spicy meals, frequent heartburn –– twice a week or more –– can be a sign of broader issues. If you’re constantly reaching for antacids or over-the-counter proton pump inhibitors like omeprazole (Prilosec®), it’s worth talking to a doctor to determine if there’s more going on, like GERD.

Still, some individuals with GERD may not experience heartburn. Those who do not experience heartburn with GERD might still have some of the following symptoms:

  • Chest pain

  • Hoarseness upon waking up

  • A sensation of choking or food being stuck in the throat

  • Throat tightness

  • A dry cough that won’t disappear

  • Foul breath or a bad taste in the mouth

  • Tooth sensitivity

  • Pain when swallowing

  • Inflamed gums

  • Wheezing (or worsening asthmatic symptoms)

  • Regular sore throat symptoms

How Do I Treat GERD?

Treatment approaches for chronic acid reflux diagnosed as GERD will vary depending on the individual and the severity of the symptoms.

Research has shown that lifestyle changes — which may include losing weight and making dietary adjustments — can drastically reduce the symptoms of GERD. But lifestyle changes may be impractical or impossible for some. For example, most of us don’t want to permanently give up coffee or the rich, spicy foods — even if they can trigger acid reflux.

In addition, lifestyle adjustments alone may not be enough to treat gastroesophageal reflux disease.

A healthcare professional may recommend a combination of lifestyle and dietary changes, as well as medications, to comprehensively address GERD.

Home remedies/home care for GERD

Some of the best ways to help improve the symptoms of GERD, particularly in those with less severe cases, include:

Avoiding trigger foods

Limiting the foods and beverages that trigger your acid reflux is often recommendation number one when it comes to treating GERD.

Everyone’s body and GERD symptoms are a little different, so you may not need to cut all acidic or fatty foods from your diet. See how your body responds to certain foods, and limit those that give you symptoms.

To decrease the symptoms of GERD, steer clear or limit the following:

  • Fatty or fried foods, such as cheese, greasy food like pizza, fried foods, and processed meats

  • Caffeinated and acidic drinks like coffee and most sodas

  • Alcoholic beverages

  • Acidic foods such as citrus fruits and tomato-based foods

  • Spicy foods

  • Mint

Eat slower, and consume smaller portions

When you eat more slowly, you naturally consume less food than when you eat quickly — less food means less stomach acid that can lead to acid reflux.

It can take 10 to 20 minutes for your body to recognize that your stomach is actually full and satiated. Eating fast can lead to overeating. When your stomach is full, there’s a greater chance that the lower esophageal sphincter will open and release the surplus of stomach acid into the esophagus, causing that painful burning sensation.

Take your time — and ease the work that your stomach has to do — by chewing more and putting your fork down between bites.

Consider your weight

Just like being pregnant may cause acid reflux due to increased abdominal pressure, so does being overweight.

If you know you’re overweight, you may find lasting relief from the symptoms of GERD by shedding extra pounds with a healthier diet and regular exercise. A medical professional can help guide this process.

Break bad habits and build good ones

Limit caffeine, quit smoking, and reduce your alcohol consumption.

Reduce stress and get a good night’s rest as often as you can.

Smoking and alcohol can both contribute to the symptoms of GERD, and kicking these bad habits can be the fastest path to not only improving your acid reflux symptoms, but your overall health as well.

Wear loose clothing

Tight or restrictive clothing can aggravate acid reflux by exerting force on the lower esophageal sphincter. Opt for comfortable clothing that doesn’t put pressure on your stomach, chest, or neck regions.

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OTC medications for GERD

Over-the-counter medications can help relieve the symptoms of GERD. But be sure to read the label carefully and take the medicine as instructed.

It’s important to only use these medications for their recommended duration — typically a maximum of a few weeks. Reach out to your healthcare provider if you don’t see a change in your GERD symptoms after you’ve started using OTC medications.

Common OTC medications for treating GERD include:

  • Antacids like Mylanta® and TUMS®

  • H2 blockers like cimetidine, famotidine, and nizatidine

  • Proton pump inhibitors (PPIs) like lansoprazole (Prevacid®), esomeprazole (Nexium®), and omeprazole (Prilosec®)

Prescription treatments for GERD

Like OTC options, prescription medications for GERD are generally not a long-term solution. But if home remedies or lifestyle changes and OTC options don’t bring relief, a medical professional can help you get more effective treatment with more powerful prescription medications.

Effective prescription treatments for GERD include:

  • Prescription-strength PPIs like rabeprazole (AcipHex®), dexlansoprazole (Dexilant®), and pantoprazole (Protonix®)

  • H2 blockers like cimetidine (Tagamet®), ranitidine (Zantac®), and famotidine (Pepcid®)

Surgery for GERD

If nonsurgical interventions aren’t effective enough for managing your GERD, it may be time to speak to your physician about surgical treatments.

With GERD symptoms that do not resolve with first-line treatment approaches, surgical approaches may be able to help. This is particularly true if GERD is caused by a hiatal hernia, in which the upper portion of the stomach pushes through the dome-shaped muscle separating the abdominal and chest cavities.

The surgery used to treat GERD is called Nissen fundoplication. It’s an invasive GERD treatment that involves wrapping the top section of the stomach around the esophagus to create a secondary lower esophageal sphincter.

Fewer than 30,000 Nissen fundoplication surgeries are performed in the U.S. each year. This surgery can be an effective approach to resolving GERD for many people.

Can I Prevent GERD in the First Place?

Most doctors and dieticians will agree that it’s ideal to prevent gastroesophageal reflux disease rather than use medications to treat the symptoms afterward.

Ensuring that gastric acid stays where it belongs – in the stomach – is best.

Stomach acid can even damage your vocal cords, causing laryngeal pharyngeal reflux (LPR). This is most common in people who strain their voices – like singers and teachers, for example.

Preventing acid reflux and GERD largely comes down to lifestyle choice. The same changes to your habits that are used to treat mild symptoms can prevent acid reflux in the first place.

Whether you’ve been experiencing regular bouts of acid reflux, or you simply want to protect yourself against this digestive condition, here are some useful guidelines to follow:

Watch what you eat

Certain foods are well-known triggers of acid reflux. You may be able to prevent it by controlling what you eat.

Limiting those greasy and acidic foods listed above can not only benefit your symptoms, but you may very well lose weight— especially abdominal fat — and feel better in the process.

Keeping a food journal can be incredibly helpful when you’re trying to learn what’s triggering your acid reflux. Pay attention to what you’re eating and when you’re eating, and note how you feel after.

Additionally, monitor your portion sizes. Even if you’re reaching for strawberries instead of the potato chips, you can still end up with acid reflux due to the quantity you consume.

When you make a note of everything, you can more easily identify problem foods and eliminate them, or plan your meal times better.

Pay attention to your sleeping habits

A strong link exists between poor sleep quality and GERD, as many people with severe GERD symptoms also struggle with sleep disturbances. This is because acid reflux gets worse when you lie down — and most of us sleep lying flat.

To remedy this, eat dinner a few hours before bedtime and try a wedge pillow so you can sleep at a 15-45-degree angle — this can help keep acid from reaching your esophagus.

Break the habits that cause acid reflux

Smoking, drinking, and caffeine consumption are three factors known for causing acid reflux.

Smoking weakens the lower esophageal sphincter that’s responsible for keeping your stomach contents from rising into the esophagus, while alcohol and caffeine relax it.

When the lower esophageal sphincter isn’t functioning properly, acid reflux and GERD develop.

Managing stress, exercising regularly, and eating a balanced diet that limits greasy and spicy foods are positive changes you can make to prevent the development of acid reflux.

Watching your caloric intake can also prevent you from accumulating excess fat around your midsection, which puts pressure on your stomach and forces acid upward.

Can GERD Be Cured?

Depending on the severity of your GERD and what’s causing it, you can find a solution by exploring lifestyle changes, OTC medications, and prescription treatments.

Surgical interventions are seldom required with GERD. If OTC antacids or H2 blockers don’t work, a prescription solution often does the trick.

It’s important to note that both OTC medications and prescription treatments are usually considered temporary solutions to GERD. Long-term management plans should be discussed with your primary health care provider.

When Should I See a Doctor for GERD?

If your symptoms don’t improve with lifestyle changes or OTC treatments, it’s time to seek medical attention.

Symptoms like chest pain, bad breath, sore throat, and persistent cough can have a dramatic impact on your quality of life.

A LifeMD virtual visit can help you get answers to your pressing acid reflux questions, get prescription treatment when appropriate, and get the guidance and check-ins you might need to stay on track in reducing GERD symptoms. When appropriate, LifeMD can also refer you to a GI specialist in your area.

LifeMD makes it easy to stay on top of your health because talking to a doctor, filling your prescriptions, getting your labs done—and more—are all easy and cost-effective. Come discover a healthcare solution built around you and your life.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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