Gastroesophageal Reflux Disease – Your Ultimate Guide to GERD

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As per NCBI, the Gastroesophageal reflux disease prevalence rate in the United States ranges from 18.1% to 27.8%.

What is gastroesophageal reflux disease?

Gastroesophageal reflux occurs when acid and food in the stomach back up into the esophagus. Gastroesophageal reflux disease (GERD) is reflux that occurs more than twice a week for a few weeks. It usually causes heartburn and other symptoms. GERD can cause other health problems over time if it is not treated.

The esophagus is the tube that carries food from your mouth to your stomach. GERD happens when a muscle at the end of your esophagus does not close properly. This allows stomach contents to leak back, or reflux, into the esophagus and irritate it.

Gastroesophageal Reflux Disease Symptoms

Some people with gastroesophageal reflux disease (GERD) may experience symptoms that are primarily gastrointestinal. This type of GERD is called non-erosive reflux disease (NERD), and it’s characterized by symptoms other than damage to the esophagus.

The most common symptom of NERD is heartburn, which is a pain or burning sensation felt in the chest, behind the breastbone, and/or in the middle of the abdomen. Heartburn usually occurs after eating a large meal or while lying down.

Other symptoms of NERD include:


Some people with GERD may occasionally experience regurgitation, which is when undigested food and gastric acid from the stomach move up into the esophagus and mouth. Regurgitation also causes a sour or bitter taste in the mouth.

Chest pain or discomfort

Chest pain is another common feature of NERD. However, chest pain caused by GERD can be difficult to distinguish from cardiac chest pain because both cause similar sensations in the chest area. For example, an episode of chest pain may be mistaken for a heart attack if there’s a blockage in one of the coronary arteries that supply oxygen-rich blood


Heartburn, also called acid indigestion, is the most common symptom of GERD and usually feels like a burning chest pain beginning behind the breastbone and moving upward to the neck and throat. Many people say it feels like food is coming back into the mouth, leaving an acid or bitter taste.

Heartburn usually is worse after eating or made worse by lying down or bending over. Occasional heartburn is common but does not necessarily mean one has GERD. Heartburn that occurs more than twice a week may be considered GERD, and it can eventually lead to more serious health problems.

Many people experience heartburn or acid indigestion due to gastroesophageal reflux disease (GERD). But recurrent vomiting, coughing, and other symptoms may be a sign of childhood GERD.

Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning, or trouble swallowing. You may feel like you have food stuck in your throat, or like you are choking, or your throat is tight. GERD can also cause a dry cough and bad breath.

Difficulty swallowing

Dysphagia is the medical term for difficulty swallowing. If you have GERD, you may feel as if food is sticking in your throat


This may be accompanied by bloating, belching, and a feeling of fullness that occurs soon after eating.

Coughing and wheezing

Chronic cough and/or wheezing can be symptoms of GERD, especially if you have trouble breathing that gets worse when you lay down at night

Asthma attack

When refluxed stomach acid touches the lining of the esophagus, it causes a reaction similar to squirting lemon juice in your eye.

Dry mouth

Acid from your stomach can get into the back of your throat, leaving an icky, bitter taste in your mouth.

Bad breath

It’s caused by acid from the stomach getting into the back of the throat and respiratory system.

GERD Symptoms in Kids

“Symptoms that are specific to children include nausea, vomiting, abdominal pain, cough or hoarseness,” says Dr. Carol J. Baker, professor of pediatrics and chief of the section of pediatric infectious diseases at Baylor College of Medicine in Houston. “If parents notice any of these symptoms in their children, they should talk with their doctor.”

You may also have:

  • a cough or hiccups that keep coming back
  • a hoarse voice
  • bad breath
  • bloating and feeling sick


Gastroesophageal reflux disease (GERD) is a digestive disorder that affects the lower esophageal sphincter (LES) – the muscle connecting the esophagus with the stomach.

Many people, including pregnant women, suffer from heartburn or acid indigestion caused by GERD. Doctors believe that some people suffer from GERD due to a condition called hiatal hernia. In most cases, heartburn can be relieved through diet and lifestyle changes; however, some people may require medication or surgery.

There are several risk factors for GERD, such as obesity, smoking, pregnancy, and certain medications.

Here are common causes of gastroesophageal reflux disease:

  1. Obesity

Obesity is one of the main risk factors for GERD. In fact, overweight and obese people are two to three times more likely to suffer from reflux symptoms. People with extra weight can develop a condition called hiatal hernia, which contributes even more to acid reflux.

  1. Certain foods

Certain foods are known to cause GERD symptoms like heartburn, including coffee (especially decaf), caffeinated beverages and tea, chocolate, citrus fruits like oranges and grapefruit, tomato products, peppermint and spearmint, spicy foods, fructose (in large quantities), fruits with high acidity levels, fatty or fried foods and processed meats.

  1. Not eating enough fiber

A diet that is low in fiber can contribute to constipation and lead to the development of GERD because constipation can block the digestive tract. Some studies have suggested that a high fiber diet can reduce the symptoms of GERD by reducing pressure on the abdomen.

  1. Asthma

Studies have shown that people with asthma have a higher incidence of GERD than people without asthma. It has been suggested that airway remodeling in asthma may be similar to changes in esophageal tissue due to acid reflux disease — a condition known

  1. Hiatal hernia

Normally, the diaphragm helps keep acid in our stomach. A hiatal hernia occurs when the upper part of the stomach protrudes into the chest through an opening of the diaphragm called the esophageal hiatus. This opening usually is only large enough to accommodate the esophagus. With a hiatal hernia, however, the stomach bulges up into the chest, sometimes squeezing the lower esophagus so tightly that it can’t even empty into the stomach. This leads to reflux symptoms.

  1. Delayed gastric emptying

Normally, after our body digests food, it pushes any remaining liquid and solids out of our stomach and into our small intestine. However, if there is a problem with this “pump” mechanism and too much remains in our stomach, it can back up into our esophagus. Some medications can contribute to this problem.

  1. Pregnancy

Hormonal changes during pregnancy can cause the lower esophageal sphincter to relax, allowing stomach acid to back up into the esophagus. These changes are also responsible for many other symptoms of pregnancy, like morning sickness and heartburn.

  1. Smoking

Smoking cigarettes increases your risk of GERD symptoms by weakening the lower esophageal sphincter muscle.

  1. Eating large meals

Overeating causes your stomach to stretch more than normal, increasing pressure on your lower esophageal sphincter muscle and triggering reflux.

  1. Lying down after eating

Large meals may put extra pressure on your stomach, increasing reflux symptoms. Lying down with a full stomach is likely to make these worsening symptoms even worse.


It’s normal to experience gastroesophageal reflux (“acid reflux”) once in a while after eating. For most people, this acid reflux is a mild form of heartburn that can be controlled with over-the-counter medications, changes in food choices, or changes in the quantity of food eaten.

For an unlucky few, however, persistent acid reflux can lead to a deadly cancer of the esophagus. Mindy Mintz Mordecai’s husband, Monte Mordecai, was one of the unlucky ones. Mintz Mordecai herself has battled Barrett’s esophagus, a precursor to esophageal cancer.

Now more than ever before, there is a reason for hope. A new approach to treatment has recently been developed at Johns Hopkins Medicine through the pioneering work of Drs. John Lipham and Richard Sampliner are members of our Gastroesophageal Surgery Program.

If you have gastroesophageal reflux disease (GERD), your doctor will probably recommend lifestyle changes and medication to treat your condition.

Lifestyle changes

Lifestyle changes can sometimes help with mild GERD. For example, weight loss (if appropriate), avoiding tight-fitting clothes, avoiding lying down after eating a meal; elevating the head of the bed by 6 to 8 inches with wood blocks under the head of the bed if night-time regurgitation is an issue; quitting smoking; and avoiding alcohol.

Avoid foods and drinks that trigger heartburn

Avoid common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.

Eat smaller meals

Large meals may increase stomach pressure and, therefore, reflux.

Don’t lie down after a meal

Wait at least three hours before you lie down after a meal. Gravity normally helps keep acid reflux from developing. When you eat a meal and then stretch out for a nap, you’re taking gravity out of the equation.

Wear loose-fitting clothing

Tight belts or waistbands can put pressure on your stomach, causing acid to rise up into your esophagus. Lose weight if necessary.

Dietary changes

It is eliminating foods that cause symptoms (spicy foods, citrus fruits, juices, tomato products, chocolate, fatty foods), eating smaller meals more frequently during the day rather than large meals at dinner time, reducing caffeine intake, and eliminating carbonated beverages.


Several types of medicines can help relieve heartburn symptoms or reduce the risk of heartburn.

Over-the-counter antacids neutralize existing stomach acid and can provide fast pain relief. They typically come in the form of calcium carbonate (Tums) or sodium bicarbonate.

Medicines called proton pump inhibitors (PPIs) reduce the amount of acid in your stomach. PPIs include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), dexlansoprazole (Dexilant), and esomeprazole (Nexium). They come in capsule, tablet, or liquid form. The prescription versions are stronger than the over-the-counter ones.

You can try over-the-counter PPIs for a short time to see how well they relieve your symptoms. But if you do, be sure to take them according to directions and don’t take them longer than two weeks without talking to your doctor first.

Antacids reduce the amount of acid in your stomach and help you digest food. Take them an hour after meals or whenever you have heartburn. They’re available over the counter or in prescription strength. Antacids include Tums, Rolaids, Maalox, Mylanta, Gaviscon, and many others.

H2 blockers reduce stomach acid by blocking histamine, a chemical that stimulates acid cells in the stomach to produce acid. However, make sure you consult your doctor first before taking any sort of medicine. It is highly recommended to seek expert advice.


What is the main reason behind gastroesophageal reflux disease?

The main cause of gastroesophageal reflux disease (GERD) is a problem with the lower esophageal sphincter (LES). The LES is a muscle at the bottom of the food pipe (esophagus). The LES opens to let food into the stomach. It closes to keep food in the stomach. In people with GERD, the LES relaxes too often or for too long. This allows stomach contents to flow back or reflux into the esophagus.

What is the sign of gastroesophageal reflux disease?

Acid reflux can cause an uncomfortable burning feeling in your chest, which can radiate up toward your neck. This feeling is often known as heartburn. If you have acid reflux, you might develop a sour or bitter taste in the back of your mouth. It might also cause you to regurgitate food or liquid from your stomach into your mouth.

Is GERD (gastroesophageal reflux disease) a lifelong disease?

GERD is a chronic disease. Once it begins, it usually is lifelong. If there is an injury to the esophagus lining (esophagitis), this is also a chronic condition. Moreover, after the esophagus has healed with treatment and treatment is stopped, the injury will return to most patients within a few months.

A couple of Interesting facts

GERD is a very common disorder that affects 20% of people at least once per week. It is caused by the failure of the sphincter muscle at the top of the stomach to close properly. As a result, acid produced in the stomach can reflux up into the esophagus, causing symptoms like heartburn, regurgitation, and difficulty swallowing.

Many interesting facts about GERD make it a very interesting disease to talk about.

1) GERD occurs more often than you might think. It affects 20% of people at least once per week! That is a lot of people. This is because many people have GERD without knowing they have it. Symptoms like hoarseness and throat clearing are common, but many do not know that they are related to acid reflux or GERD.

2) Most people who have GERD do not have heartburn. That’s right. Most people with GERD have symptoms like hoarseness, chronic cough, throat clearing, and difficulty swallowing rather than classic heartburn pain. This makes it difficult for both patients and doctors to identify those with GERD because it does not follow typical patterns we expect from acid reflux disease like heartburn or pain when eating acidic foods.

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