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GERD

GERD Explained

GERD happens when the valve between your esophagus and stomach (the lower esophageal sphincter) does not close properly or relaxes at the wrong time, allowing acid and stomach contents to wash back up into the esophagus. This ongoing reflux can irritate and inflame the esophageal lining and sometimes the throat or lungs.

Over time, untreated GERD can lead to complications such as esophagitis, strictures, Barrett’s esophagus, or chronic cough and asthma-like symptoms. Many people improve with lifestyle changes and medicines, but some may need endoscopic or surgical options.

Symptoms

GERD most often causes classic heartburn and regurgitation, but it can also show up as chest discomfort, trouble swallowing, chronic cough, or throat symptoms.

Symptoms include:
Burning pain in the chest (“heartburn”), often after meals or when lying down
Sour or bitter taste in the mouth; food or liquid coming back up (regurgitation)
Chest discomfort or pressure not related to the heart
Trouble swallowing (food “sticking”)
Chronic cough, hoarseness, or throat clearing, especially at night
Asthma-like symptoms or worsening of known asthma

When to call

Call the office if you have heartburn or reflux symptoms more than twice a week, symptoms that persist despite medication, difficulty swallowing, chronic cough, or unexplained weight loss. These may signal the need for further evaluation or a change in your treatment plan.

Seek emergency care for severe chest pain (especially if it may be heart-related), vomiting blood, black or tarry stools, sudden trouble swallowing or inability to swallow liquids, or severe shortness of breath. These symptoms can be signs of a more serious problem that needs immediate attention.

Evaluation & Tests
Management & Treatment

Diagnosis is often based on symptoms and how you respond to a trial of acid-suppressing medication. If symptoms are atypical, severe, or don’t improve, your provider may recommend testing such as upper endoscopy, esophageal pH monitoring, or manometry.

Careful history of symptom pattern, frequency, triggers, and response to medications
Review of medications, weight changes, alcohol and tobacco use, and diet
Upper endoscopy to look for esophagitis, Barrett’s esophagus, strictures, or other causes of symptoms
Esophageal pH or pH-impedance monitoring to confirm abnormal acid or non-acid reflux when needed
Esophageal manometry if there is concern for motility disorders or prior to surgery

Most patients are managed with lifestyle changes and acid-suppressing medications such as proton pump inhibitors (PPIs) or H2 blockers. When symptoms persist or complications are present, further evaluation and options like endoscopic or surgical anti-reflux procedures may be considered.

Lifestyle changes: weight loss if needed, elevating the head of the bed, avoiding late meals, and limiting trigger foods (e.g., fatty foods, caffeine, alcohol, chocolate, peppermint)
Medication therapy, typically with PPIs or H2 blockers, taken as directed
Avoiding tobacco and moderating alcohol intake
Periodic review of long-term PPI use and dose adjustment when appropriate
Referral for endoscopic or surgical options (such as fundoplication or LINX) when symptoms are refractory or complications are present
This information is for general educational purposes only and is not a diagnosis or personalized medical advice. It does not replace a visit with your own healthcare provider. Always follow the specific recommendations given by your medical team. If you have urgent or worsening symptoms, contact your provider or seek emergency care right away.

At-a-glance

Bloating / gasHeartburnTrouble swallowing

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Information on this website is for education only and not a substitute for medical advice.

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