GERD (Acid Reflux)
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Gastroesophageal reflux disease occurs when stomach acid frequently flows back into the esophagus, causing heartburn, regurgitation, and chest discomfort. It's often related to diet, obesity, or a weakened valve between the stomach and esophagus, and is typically managed with lifestyle changes and acid-reducing medication.
This information is for general awareness only and does not replace professional medical advice. Consult a doctor for diagnosis and treatment.
Quick answer
Gastro-oesophageal reflux disease (GERD) is when stomach acid repeatedly flows back into the food pipe (oesophagus), irritating its lining. Occasional reflux is common; GERD is when it happens often or causes problems.
The typical symptoms are heartburn — a burning feeling behind the breastbone — and regurgitation of sour fluid, especially after meals or when lying down.
Lifestyle changes and acid-reducing medicines control symptoms in most people. See a doctor if symptoms are frequent, don't respond to treatment, or come with trouble swallowing, weight loss, vomiting or black stools.
Symptoms
Heartburn
A burning feeling in the chest, often after eating or lying down.
Regurgitation
A sour or bitter taste as stomach contents come up into the throat.
Difficulty or pain when swallowing
Chronic cough or hoarse voice
Especially at night or in the morning.
Sore throat and a feeling of a lump in the throat
Bloating, belching and nausea
Disturbed sleep from night-time symptoms
Symptom guides
Causes and risk factors
Causes
- Weak or relaxing lower oesophageal sphincter — The muscle valve between the food pipe and stomach lets acid escape upward.
- Hiatus hernia — Part of the stomach pushes up through the diaphragm.
- Pressure on the stomach — From excess weight or pregnancy.
- Slow stomach emptying
Risk factors
- Overweight or obesity
- Pregnancy
- Smoking and alcohol
- Large or late meals, and lying down soon after eating
- Foods and drinks that trigger symptoms — For example fatty or spicy foods, coffee, chocolate.
- Certain medicines — Some can irritate the oesophagus or relax the sphincter.
How is it diagnosed?
Typical symptoms that respond to treatment are often enough for a diagnosis. Tests are used when symptoms are severe, persistent or accompanied by warning signs.
Clinical assessment
Symptom pattern, triggers and medicines are reviewed.
Upper endoscopy
A thin camera examines the food pipe and stomach for inflammation, narrowing, or other changes; biopsies may be taken.
Reflux monitoring and pressure tests
Measure acid exposure and oesophageal function in selected cases.
Treatment
Treatment starts with lifestyle changes and, if needed, acid-reducing medicines. The choice and duration depend on your symptoms and any complications, and are set by your doctor.
Lifestyle changes
Smaller meals, avoiding late meals, weight loss if overweight, stopping smoking, raising the head of the bed and identifying personal trigger foods.
Medicines
Antacids for occasional symptoms, and acid-reducing medicines for frequent symptoms, used as advised.
Reviewing other medicines
Some can worsen reflux.
Surgery or endoscopic procedures
Considered for severe cases that do not respond to medicines or when medicines are not wanted long-term.
Frequent use of over-the-counter antacids for weeks is a reason to see a doctor.
When should you see a doctor?
Arrange a medical assessment if
- Heartburn on most days, or symptoms lasting more than a few weeks
- Symptoms not controlled by treatment
- Frequent night-time symptoms or chronic cough
- Needing medicine long term
- Age over 55 with new symptoms
Seek urgent care if
- Difficulty swallowing or food sticking
- Unintentional weight loss
- Repeated vomiting, vomiting blood, or black or bloody stools
- Chest pain spreading to the arm, jaw or back, or with sweating or breathlessness — this can be a heart attack
Prevention
Eat smaller meals
And avoid eating within 2–3 hours of lying down.
Maintain a healthy weight
Avoid smoking and limit alcohol
Identify and limit personal triggers
Raise the head of your bed
If night-time symptoms are a problem.
Frequently asked questions
What is acid reflux?
It is when stomach acid flows back up into the food pipe, often causing heartburn. When frequent or troublesome it is called GERD.
What is the difference between heartburn and GERD?
Heartburn is a symptom. GERD is the condition in which reflux happens often enough to cause symptoms or damage.
What foods trigger reflux?
Triggers vary by person, but fatty or spicy foods, chocolate, coffee, alcohol and large meals are common.
Can GERD cause complications?
Long-standing reflux can cause inflammation, narrowing of the food pipe, and in some people changes in the lining (Barrett's oesophagus), which is why persistent symptoms should be assessed.
Can heartburn be confused with a heart problem?
Yes. Chest pain can come from the heart, and it should never be assumed to be reflux, especially if it comes with breathlessness, sweating or spreads to the arm or jaw.
Do I need an endoscopy?
Not always. It is recommended for warning symptoms, symptoms that don't respond to treatment, or in older adults with new symptoms.
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Medical sources
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