Overview
GERD happens when the muscle between the esophagus and stomach does not keep stomach contents from moving upward. This backflow can irritate the esophagus over time. Many people have occasional reflux, but GERD usually means symptoms happen repeatedly or lead to complications.
Key Symptoms
Common symptoms include burning pain in the chest after eating, a sour or bitter taste in the mouth, and food or liquid coming back up into the throat. Some people have trouble swallowing, a chronic cough, hoarseness, sore throat, or a feeling of a lump in the throat. Symptoms often get worse after large meals, when bending over, or when lying flat.
Causes and Risk Factors
GERD is linked to weakness or relaxation of the lower esophageal sphincter, the muscle that normally helps keep stomach contents down. Risk factors include obesity, pregnancy, smoking, hiatal hernia, and delayed stomach emptying. Some foods, drinks, and medicines can trigger or worsen reflux in some people, though triggers vary from person to person.
Who Is Affected
GERD can affect adults and children. It is common worldwide and may be more likely in people with excess body weight, pregnant people, and those who smoke. Some people have typical heartburn, while others mainly notice throat, voice, or cough symptoms.
Prevention
Not all cases can be prevented, but reducing personal triggers may help lower symptoms. Maintaining a healthy weight, avoiding tobacco, and limiting alcohol can help many people. Eating smaller meals and avoiding lying down soon after eating may also reduce reflux.
Diagnosis and Tests
A healthcare professional often starts with questions about symptoms and when they occur. In some cases, further testing may be needed, such as an upper endoscopy, esophageal pH monitoring, or tests of swallowing and esophageal movement. Testing is especially important when symptoms are severe, unusual, or linked to trouble swallowing, bleeding, or weight loss.
Treatment Categories
Treatment may include lifestyle changes, nonprescription or prescription medicines, and in some cases procedures or surgery. The goal is to reduce reflux, ease symptoms, and prevent damage to the esophagus. A clinician can help decide which approach fits the pattern and severity of symptoms.
Diet and Lifestyle
Keeping a symptom diary can help identify foods or habits that make reflux worse, such as large meals, late eating, fatty foods, caffeine, chocolate, mint, spicy foods, or alcohol. Some people benefit from avoiding meals close to bedtime and raising the head of the bed rather than using extra pillows. Weight management and stopping smoking can also make a meaningful difference.
When to Seek Medical Care
Seek medical care if reflux symptoms happen often, interfere with sleep or daily life, or keep returning. Also seek care for pain with swallowing, food getting stuck, ongoing nausea or vomiting, unexplained weight loss, or symptoms that continue despite treatment. Children and older adults may show symptoms differently and should also be assessed when symptoms persist.
When It May Be an Emergency
Get urgent medical help for chest pain that could be related to the heart, especially if it comes with shortness of breath, sweating, fainting, or pain spreading to the arm, back, neck, or jaw. Emergency care is also needed for vomiting blood, black stools, severe trouble swallowing, choking, or signs of dehydration from ongoing vomiting.