Gastroesophageal Reflux Disease (GERD) - Symptoms

Gastroesophageal Reflux Disease Treatment

Gastroesophageal Reflux Disease (GERD) is a chronic disease in which stomach acid regularly flows back into the esophagus, leading to symptoms such as heartburn, regurgitation, and occasionally difficulty swallowing.

GERD Treatment Options

Lifestyle and Dietary Changes

These are the initial treatment options:

Avoid trigger foods:

• Spicy food, citrus, chocolate, coffee, alcohol, mint, carbonated beverages, fatty or fried foods
• Eat smaller, more frequent meals – don't overeat
• Do not lie down for 2–3 hours after eating
• Raise the head of the bed 6–8 inches
• Lose weight if obese
• Stop smoking and reduce alcohol

Medications

Prescription or over-the-counter depending on severity:

• Antacids: Counteract stomach acid
• H2-receptor blockers: Decrease acid production
• Proton Pump Inhibitors (PPIs): More potent acid decrease
• Prokinetics (less often): Facilitate faster emptying of the stomach

Surgical or Procedural Treatment

Resorted to when medication and dietary changes are ineffective:

• Nissen fundoplication – surgical support of the lower esophageal sphincter
• LINX device – a ring of magnets around the esophagus that blocks reflux
• Stretta procedure – radiofrequency therapy to tighten the sphincter

Alternative and Complementary Therapies

• Herbal teas: Deglycyrrhizinated licorice (DGL), slippery elm (ask your doctor first)
• Mind-body strategies: Stress reduction using yoga, meditation

GERD Symptoms

Stomach acid frequently flows back into the esophagus, causing irritation and this condition is called GERD. The usual symptoms are:

Primary Symptoms:

Heartburn

• Symptoms include a burning sensation in the chest which frequently occurs after consumption of food or when lying down.

Regurgitation

• The backup of sour or bitter-tasting acid into the throat or mouth

Chest pain

• It can be heart related pain, but it is due to acid pain

Dysphagia 

• Feeling food stuck in the throat

Sensation of a lump in the throat

• It is often referred to as a relentless tightness or blockage.

Secondary Symptoms:

Chronic cough

• Especially worse at night.

Sore throat

• Acid irritating the vocal cords (released).

Symptoms of asthma or worsening of asthma

• Especially in people with no previous history

Halitosis (bad breath)

• Of regurgitated stomach contents

Dental erosion

• This was caused by frequent acid exposure.

Gastroesophageal Reflux Disease (GERD) Diet

A proper GERD diet can help reduce GERD symptoms by avoiding food and drinks that trigger reflux. See here for a detailed guide:

GERD-Friendly Diet Plan

Safe Foods (Low-Acid, Low-Fat, Easy to Digest)

Vegetables

• Leafy greens, carrots, cucumbers, zucchini, green beans, potatoes (boiled/baked)

Fruits (non-citrus)

• Bananas, apples (not sour), melons, pears, papaya

Grains

• Oatmeal, brown rice, whole wheat bread, couscous

Protein

• Skinless chicken/turkey, fish (grilled or baked), egg whites, tofu, lentils (if tolerated)

Dairy substitutes

• Almond milk, oat milk, coconut milk (avoid full-fat versions)

Healthy fats

• Avocados (in moderation), olive oil

Herbal teas

• Chamomile, ginger, licorice root (consult doctor first)

Foods to Avoid (Common Triggers)

Spicy foods

• Chili, hot sauce, black pepper in excess

Citrus fruits

• Oranges, lemons, limes, grapefruits

Tomato-based products

• Sauce, ketchup, soup, pizza

Fatty/fried foods

• Bacon, sausage, deep-fried snacks, creamy gravies

Caffeinated drinks

• Coffee, black tea, energy drinks, cola

Chocolate

• Contains caffeine and relaxes the LES (lower esophageal sphincter)

Mint

• Peppermint and spearmint relax the LES

Carbonated drinks

• Soda, sparkling water, beer

Alcohol

• All types can worsen reflux

Eating Habits Matter

Eat small, frequent meals

• Reduces pressure on the stomach

Don’t eat within 2–3 hours of bedtime

• Prevents reflux during sleep

Chew food slowly and thoroughly

• Aids digestion

Stay upright for at least 30–60 minutes after meals

• Gravity helps keep acid down

GERD vs Acid Reflux

GERD

• GERD (Gastroesophageal Reflux Disease) is a more frequent and more serious type of acid reflux. 
• GERD is diagnosed when reflux of acid happens often—usually more than twice a week—or when it causes inflammation or damage to the esophagus. 
• GERD can include more constant symptoms, including frequent heartburn, chest pain, difficulty swallowing, chronic cough, hoarseness, or feeling of having something stuck in the throat. 
• Left untreated, GERD over the course of time can cause complications like esophagitis, Barrett's esophagus, and even a higher risk of esophageal cancer.

Acid Reflux

• Acid reflux is a frequent and usually occasional condition that happens when stomach acid backflows into the esophagus, the pipe between your mouth and stomach. 
• Backflow may produce symptoms such as heartburn—a burning feeling in the chest—combined with food or sour liquid regurgitation and bitter taste in the mouth. 
• Some individuals have acid reflux from time to time, particularly following a big meal, sleeping too early after eating, or eating trigger foods like spicy or greasy meals.

Gastroesophageal Reflux Disease Causes

GERD happens when the lower esophageal sphincter (LES) — a circular band of muscle at the end of the esophagus — weakens or relaxes inappropriately, letting stomach acid flow back up into the esophagus. This reverse flow is known as acid reflux, and if it's chronic, it produces GERD.

These are the primary causes and contributing factors:

• Weak or Dysfunctional LES
• Obesity
• Pregnancy
• Diet and Eating Habits
• Medications
• Smoking
• Hiatal Hernia
• Genetic or Structural Factors

GERD in Children

Gastroesophageal Reflux Disease (GERD) can happen to children and even babies, but its causes and manifestation may vary slightly from those of adults. Infrequent reflux (spitting up) is normal in babies and typically resolves spontaneously. GERD, however, defines chronic, symptomatic acid reflux that can disrupt a child's growth, development, or comfort.

Causes of GERD in Children

• Mature digestive system (particularly in infants)
• Obesity (raises abdominal pressure)
• Hiatal hernia
• Neurologic conditions (e.g., cerebral palsy)
• Some medications
• Food intolerance or allergy (e.g., to cow's milk protein)

Factors Affecting GERD Surgery Cost

There are a variety of factors that determine the cost of GERD (Gastroesophageal Reflux Disease) surgery, i.e., Nissen fundoplication or LINX procedure. The following are the main factors that determine pricing:

• Type of Surgery
• Hospital or Clinic
• Country or Region
• Surgeon’s Experience and Reputation
• Duration of Hospital Stay
• Pre- and Post-operative Care

GERD Diagnosis

Diagnosis of GERD (Gastroesophageal Reflux Disease) encompasses a process of clinical evaluation, history of symptoms, and in some cases, specialized testing to establish the condition, exclude other illnesses, or check for complications.

Clinical History and Physical Exam

The initial step is typically symptom-based on:

• Regular heartburn
• Acid regurgitation
• Chest pain
• Chronic cough, sore throat, or hoarseness

When symptoms resolve with antacids or proton pump inhibitors (PPIs), physicians may diagnose GERD without additional testing.

Diagnostic Tests (if symptoms are ambiguous, severe, or not responding to treatment):

Upper Endoscopy (EGD)

• Flexible tube with camera (endoscope) views the esophagus and stomach.
• Discovers inflammation (esophagitis), ulcers, Barrett's esophagus, or narrowing (strictures).
• Biopsies can be obtained to eliminate cancer or infection.

Esophageal pH Monitoring

• Assesses how frequently and for how long stomach acid flows into the esophagus.
• Involves inserting a thin probe into the esophagus for 24–48 hours or a temporary capsule attached to the wall of the esophagus.
• Most precise test for diagnosing GERD.

Esophageal Manometry

• Tests pressure and movement of muscles of the esophagus.
• Evaluates functioning of the lower esophageal sphincter (LES) and esophageal motility.
• Typically performed prior to surgery, not generally used to diagnose GERD.

Barium Swallow (Upper GI Series)

• X-ray after consuming a contrast liquid (barium).
• Aids in detecting structural issues such as hiatal hernia, strictures, or ulcers but not as good at detecting GERD itself.

GERD Complications

Gastroesophageal Reflux Disease (GERD), in case it is not treated or inadequately controlled, can cause severe complications in the long run. These are due to chronic irritation of the esophagus with stomach acid.

Major Complications of GERD:

• Esophagitis
• Esophageal Strictures
• Barrett’s Esophagus
• Esophageal Ulcers
• Esophageal Cancer
• Respiratory and ENT Complications

Gastroesophageal Reflux Disease in Pregnancy

GERD is extremely prevalent in pregnancy as a result of both hormonal and physical modifications to the digestive tract.

Why Does Pregnancy Cause GERD?

Hormonal Changes

• Progesterone levels increase, which relax smooth muscles all over the body, including the lower esophageal sphincter (LES).
• A relaxed LES makes it easier for stomach acid to reflux back into the esophagus.

Physical Changes

• The expanding uterus compresses the stomach, forcing its contents up into the esophagus.
• This tension grows with advancing pregnancy, particularly during the third trimester.