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Gastroesophageal reflux disease (GERD)

Medically reviewed by Drugs.com. Last updated on Jan 4, 2023.

Overview

Gastroesophageal reflux disease (GERD) occurs when stomach acid repeatedly flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.

Many people experience acid reflux from time to time. However, when acid reflux happens repeatedly over time, it can cause GERD.

Most people are able to manage the discomfort of GERD with lifestyle changes and medications. And though it's uncommon, some may need surgery to ease symptoms.

How heartburn and GERD occur

Acid reflux occurs when the sphincter muscle at the lower end of your esophagus relaxes at the wrong time, allowing stomach acid to back up into your esophagus. This can cause heartburn and other signs and symptoms. Frequent or constant reflux can lead to GERD.

Symptoms

Common signs and symptoms of GERD include:

If you have nighttime acid reflux, you might also experience:

When to see a doctor

Seek immediate medical care if you have chest pain, especially if you also have shortness of breath, or jaw or arm pain. These may be signs and symptoms of a heart attack.

Make an appointment with your doctor if you:

Causes

GERD is caused by frequent acid reflux or reflux of nonacidic content from the stomach.

When you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again.

If the sphincter does not relax as it should or it weakens, stomach acid can flow back into your esophagus. This constant backwash of acid irritates the lining of your esophagus, often causing it to become inflamed.

Risk factors

Conditions that can increase your risk of GERD include:

Factors that can aggravate acid reflux include:

Hiatal hernia

A hiatal hernia occurs when the upper part of your stomach bulges through your diaphragm into your chest cavity.

Complications

Over time, chronic inflammation in your esophagus can cause:

Diagnosis

Your health care provider might be able to diagnose GERD based on a history of your signs and symptoms and a physical examination.

To confirm a diagnosis of GERD, or to check for complications, your doctor might recommend:

Upper endoscopy

An upper endoscopy procedure involves inserting a long, flexible tube called an endoscope down your throat and into your esophagus. A tiny camera on the end of the endoscope allows views of your esophagus, stomach and the beginning of your small intestine, called the duodenum.

Treatment

Your doctor is likely to recommend that you first try lifestyle changes and nonprescription medications. If you don't experience relief within a few weeks, your doctor might recommend prescription medication and additional testing.

Nonprescription medications

Options include:

If you start taking a nonprescription medication for GERD, be sure to inform your doctor.

Prescription medications

Prescription-strength treatments for GERD include:

Surgery and other procedures

GERD can usually be controlled with medication. But if medications don't help or you wish to avoid long-term medication use, your doctor might recommend:

Because obesity can be a risk factor for GERD, your health care provider could suggest weight-loss surgery as an option for treatment. Talk with your provider to find out if you're a candidate for this type of surgery.

GERD surgery

Surgery for GERD may involve a procedure to reinforce the lower esophageal sphincter. The procedure is called Nissen fundoplication. In this procedure, the surgeon wraps the top of the stomach around the lower esophagus. This reinforces the lower esophageal sphincter, making it less likely that acid will back up in the esophagus.

Substitute for esophageal sphincter

The LINX device is an expandable ring of magnetic beads that keeps stomach acid from backing up into the esophagus, but allows food to pass into the stomach.

Lifestyle and home remedies

Lifestyle changes may help reduce the frequency of acid reflux. Try to:

Alternative medicine

Some complementary and alternative therapies, such as ginger, chamomile and slippery elm, may be recommended to treat GERD. However, none have been proved to treat GERD or reverse damage to the esophagus. Talk to your health care provider if you're considering taking alternative therapies to treat GERD.

Preparing for an appointment

You may be referred to a doctor who specializes in the digestive system (gastroenterologist).

What you can do

Questions to ask your doctor

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment anytime you don't understand something.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may leave time to go over points you want to spend more time on. You may be asked:

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