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Gastro-esophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a medical term for acid that moves into the “food swallowing tube” (esophagus) from the stomach. Sometimes acid moves up the swallowing tube, into the nose or mouth. The strong acid can burn and irritate the swallowing tube, throat, and vocal cords or cause a bad taste in your mouth.

GERD Symptoms

GERD symptoms are not the same for everyone. Common GERD symptoms may include:

  • Heartburn (a painful burning sensation in the chest)
  • Chest pain
  • Nausea
  • Difficult or painful swallowing
  • Feeling like there is food stuck in the throat
  • Other associated symptoms like cough or hoarse voice

GERD and Breathing Problems

Acid reflux into the upper portion of the swallowing tube can cause cough (especially when sleeping or during exercise), shortness of breath, wheezing, and vocal cord spasm.  Uncontrolled acid reflux can mimic asthma.

When to Call Your Provider:

Call your provider if you notice:

What Causes GERD?

Acid can move into the swallowing tube if the muscle at the top of the stomach opens or relaxes. Some causes and triggers of GERD include:

  • Excess weight or obesity
  • Certain foods like fried foods, dairy, or spicy foods
  • Alcohol and caffeine consumption
  • Certain medications such as blood pressure, allergy, and asthma medicines, pain medications, sedatives, aspirin, or antidepressants
  • Hiatal hernia (bulging of the top of the stomach above the diaphragm)
  • Smoking
  • Pregnancy
  • Heavy lifting
  • Bending over with a full stomach (tip: bend at the knees instead)
  • Lying down after eating
  • Wearing clothes that are too tight around the belly

How is GERD Diagnosed?

Often GERD is diagnosed by your symptoms and a physical examination. Your provider may give you a trial of medicine to see if your symptoms go away. Your doctor may also recommend tests, which may include:

    • Upper endoscopy: A thin tube with a camera is inserted down the throat, which lets your healthcare provider view your esophagus and stomach.
    • pH probe test: This test places a monitor in the esophagus to identify stomach acid.
  • X-ray of the upper digestive system
  • Esophageal manometry: This test looks at swallowing and is typically done in individuals with difficulty swallowing. 
  • Transnasal esophagoscopy: This test looks for esophageal damage. A thin tube with a camera is put through the nose, down the throat, and into the esophagus.

How is GERD Treated?

Natural GERD Treatment at Home

Here are some steps you can take that may help improve heartburn symptoms. 

  • Lose weight if you are overweight. Excess weight puts pressure on the abdomen, which can contribute to reflux.
  • Do not lie down for at least 3 hours after you eat.
  • Do not eat large meals.
  • Elevate the head of your bed by putting 6-inch blocks under the legs at the head of your bed.
  • Go to sleep on your left side. This helps reduce the chance of reflux symptoms. 
  • Do not wear tight clothes around your belly. Tight-fitting clothing puts pressure on the abdomen and lower esophageal sphincter.
  • Bend at your knees instead of bending over at the waist.
  • Do not smoke. Smoking interferes with the function of a part of the esophagus.
  • Take your time while eating. Chew food thoroughly before swallowing. Avoid food or drinks that make your symptoms worse. Common triggers include:
    • Caffeine
    • Peppermint
    • Spearmint
    • Alcohol
    • Citrus foods
    • Spicy foods
    • Fried foods
    • Onions
    • Tomatoes
    • Soda
    • Chocolate

GERD Medications

Treatment for GERD is based on symptoms. Many people start treatment on their own using over-the-counter (OTC) medicines. If you need medicine for indigestion or heartburn more than once or twice a week or your symptoms are getting worse, see your provider.

Based on your symptoms, your provider will guide treatment by “stepping” up the dose or frequency of medicine every few weeks until symptoms are gone. Once the symptoms are gone, the medicine should be continued at the same dose for at least 8 weeks. After 8 weeks, your provider may try to “step down” the dose or frequency or have you stop taking the medicine. The goal is to use the least amount of medicine to control symptoms. You should continue the lifestyle changes while you are taking the medicine.

There are several types of medicines available to relieve heartburn symptoms:

  1. Antacids are alkaline medicines that neutralize the acid in the stomach. They do not stop or reduce the production of stomach acid. The most common antacids are made of aluminum hydroxide, magnesium hydroxide (Phillips Milk of Magnesia®), calcium carbonate (Tums®, or a combination of ingredients such as Rolaids® (calcium carbonate/magnesium hydroxide). Some antacids also contain simethicone, to help relieve gas. They are taken as needed and sold over the counter. They provide quick but temporary relief.
  2. H2 blockers reduce the amount of acid made in the stomach, decreasing heartburn symptoms. The most common H2 blockers include Tagamet® (cimetidine); Axid® (nizatidine); or Pepcid® (famotidine). They are taken 1 or 2 times daily and are sold over the counter and by prescription.
  3. Proton pump inhibitors (PPIs) block acid from being made in the stomach and are the strongest of all the acid medicines. PPIs include: AcipHex® (rabeprazole); Nexium® (esomeprazole); Prevacid® (lansoprazole); Prilosec® (omeprazole); Protonix® (pantoprazole); and Dexilant (dexlansoprazole). They are taken 1 or 2 times a day. Some are sold over the counter, but others require a prescription.

If you do not get better on treatment or you develop worrisome symptoms such as weight loss, problems swallowing, blood in your vomit or stools, or painful swallowing, your provider will likely send you to a stomach specialist (gastroenterologist).

For more information:

Go to the Gastroesophageal Reflux Disease (GERD) health topic.