Acid Reflux & GERD: Symptoms, Causes, Treatment

This guide explains acid reflux and GERD in plain language, including their symptoms, causes, treatment, and when to see a doctor.

Occasional acid reflux is common and often temporary ^5,7. GERD causes repeated reflux that leads to troubling symptoms or health problems.

Many people manage reflux through lifestyle changes and medicine ^6,7. However, ongoing symptoms or warning signs need medical review.

Acid reflux occurs when stomach contents flow backward into the esophagus ^5,7. The esophagus is the tube connecting the mouth and stomach.

Refluxed contents may reach the throat or mouth ^2,5. This backwash can irritate tissue that lacks the stomach’s protective lining ^7,8.

A muscle called the lower esophageal sphincter sits between the esophagus and stomach. It normally relaxes during swallowing and then closes again.

Reflux can happen when this muscle weakens or relaxes at the wrong time ^5,7. Stomach contents can then move upward through the opening ^7,8.

Many adults experience reflux from time to time ^5,7. Occasional reflux does not always mean that GERD is present.

GERD develops when reflux keeps happening and causes troubling symptoms or complications. The full name is gastroesophageal reflux disease.

GERD is often a long-term problem without treatment ⁹. Symptoms may return after they improve.

Ongoing acid exposure can inflame the lining of the esophagus ^7,9. Doctors call this inflammation esophagitis.

Possible long-term complications include:

Treatment can ease symptoms and help limit continued irritation ⁶.

Heartburn and regurgitation are the most common GERD symptoms ^2,5. Heartburn is a burning feeling behind the breastbone ⁵.

The burning may start low in the chest and move toward the throat ^2,5. It often begins after eating.

Regurgitation means food or stomach liquid rises into the throat or mouth ⁵. It may leave a sour or bitter taste ^5,9.

Symptoms may worsen in these situations:

Not every adult with GERD develops heartburn or regurgitation ⁵. Some people notice throat, breathing, or swallowing problems instead ⁵.

Reflux may cause nausea or a feeling of food returning upward ^5,8. Some people experience a lump-like feeling in the throat.

Other possible symptoms include:

These symptoms can have causes other than GERD. This is especially important when heartburn and regurgitation are absent.

For more on another cough condition, read our acute bronchitis guide.

Reflux-related discomfort may feel like burning behind the breastbone ^2,5. Some noncardiac discomfort may feel like pressure or tightness ⁸.

Heart problems can cause similar symptoms ^2,9. A person should not assume that chest discomfort comes from reflux.

GERD often begins when the lower esophageal sphincter becomes weak ^5,7. It may also relax when it should stay closed ⁵.

A hiatal hernia can raise the chance of GERD or worsen symptoms ⁵. This problem occurs when part of the stomach moves through the diaphragm ⁵.

The diaphragm is the muscle separating the chest from the abdomen. A hiatal hernia can disrupt support around the lower esophageal sphincter ⁸.

Several conditions and habits can increase the chance of reflux. These include:

These factors do not confirm that GERD is present. A doctor can consider them with symptoms and medical history ¹.

Foods do not cause reflux by themselves, but some can contribute ⁸. Heavy meals also take longer to digest ⁸.

Common aggravating factors include:

Some medicines can also contribute to reflux ^2,5. Calcium channel blockers may cause GERD or make its symptoms worse ⁵.

Nitrates may lower pressure in the lower esophageal sphincter. Doctors may review current medicines while assessing reflux symptoms ⁹.

Lifestyle changes may reduce reflux symptoms ⁶. They often form part of a treatment plan with medicine ⁶.

These habits may help reduce reflux symptoms over time:

Nighttime symptoms may improve when the head and upper body are raised during sleep ⁶. Raise them by 6 to 8 inches using a foam wedge ⁶.

The wedge should support both the head and upper back ⁶. Elevating the head of the bed by at least six inches may also help ⁹.

Several medicines reduce or control reflux symptoms ⁶. The right choice depends on symptom severity and a clinician’s assessment.

Common medicine options include:

Adults with typical symptoms may receive a clinician-directed PPI trial. Alarm symptoms require assessment rather than treatment based only on symptoms.

A response to a PPI trial can support a GERD diagnosis. Symptoms that continue despite treatment may require further testing ^1,2.

Over-the-counter access does not make a medicine suitable for daily use. Discuss ongoing or frequent use with a doctor ⁶.

Doctors may consider a procedure when lifestyle changes and medicines do not control GERD ⁶. Testing may first confirm reflux or look for another cause ^1,2.

Possible procedures include:

Endoscopic procedures are used in a small number of GERD cases ⁶. A specialist can explain whether testing or a procedure is appropriate.

Use emergency care for these chest-pain situations without delay:

Certain symptoms may point to GERD complications or another serious condition ⁵. They need medical assessment rather than repeated self-treatment.

Arrange medical care promptly if any of these signs occur:

Schedule a visit if reflux symptoms are severe or frequent. A visit is also needed when lifestyle changes or nonprescription medicines do not help ⁵.

Using nonprescription heartburn medicine more than twice weekly also warrants an appointment. Repeated symptoms should not be managed indefinitely without medical review.

Doctors often diagnose GERD by reviewing symptoms and medical history ¹. Typical heartburn and regurgitation may support a diagnosis without immediate testing ⁹.

A doctor may first recommend lifestyle changes and medicine ¹. Tests may become necessary when symptoms suggest a complication or another condition ¹.

Testing may also help when treatment does not improve symptoms ¹. A gastroenterologist is a doctor who diagnoses and treats digestive disorders ¹.

Upper endoscopy lets a doctor examine the lining of the upper digestive tract ¹. The test uses a flexible tube with a camera ¹.

The tube passes through the mouth into the esophagus and stomach ⁹. It may also reach the first section of the small intestine ⁹.

During endoscopy, a doctor may remove tiny tissue samples called biopsies ¹. A specialist then examines those samples under a microscope ¹.

Endoscopy may identify GERD complications or other causes of symptoms ¹. It may be appropriate for swallowing trouble, bleeding, weight loss, or poor treatment response ^1,2.

Esophageal pH monitoring measures acid within the esophagus ¹. A thin catheter may pass through the nose for monitoring ¹.

Another method places a small wireless capsule on the esophageal lining ¹. A monitor records information about reflux, meals, sleep, and symptoms ¹.

Doctors may use pH monitoring to confirm GERD ¹. They may also use it to assess whether GERD treatment is working ¹.

Many people control acid reflux and GERD with lifestyle changes and suitable medicines ^6,7. Helpful steps may include weight loss, smoking cessation, meal changes, and nighttime elevation ⁶.

Persistent or frequent symptoms need medical review. Trouble swallowing, persistent vomiting, bleeding, appetite loss, or unexplained weight loss also need assessment.