What are the common symptoms of gastroesophageal reflux disease (GERD). How does GERD differ from occasional heartburn. When should you seek medical attention for acid reflux symptoms. What lifestyle changes can help manage GERD.

What is Gastroesophageal Reflux Disease (GERD)?

Gastroesophageal reflux disease, commonly known as GERD, is a chronic condition affecting millions of people worldwide. It occurs when stomach acid frequently flows back into the esophagus, the tube connecting your mouth and stomach. This backwash (acid reflux) can irritate the lining of your esophagus, causing discomfort and various symptoms.

GERD is more than just occasional heartburn. It’s a persistent condition that affects your daily life and can lead to complications if left untreated. Understanding GERD is crucial for proper management and treatment.

How Common is GERD?

GERD is surprisingly prevalent, especially in Western countries. In the United States alone, more than 60 million Americans experience acid reflux at least once a month. This high prevalence underscores the importance of recognizing GERD symptoms and seeking appropriate treatment.

Common Symptoms of GERD

GERD can produce a variety of symptoms, some more common than others. Recognizing these symptoms is the first step towards proper diagnosis and treatment. Here are the most frequently reported symptoms of GERD:

• Heartburn
• Regurgitation
• Dyspepsia
• Difficulty swallowing (dysphagia)
• Chest pain
• Chronic cough
• Hoarseness, especially in the morning

Heartburn: The Hallmark Symptom of GERD

Heartburn is the most common symptom of GERD. Despite its name, it has nothing to do with the heart. Heartburn is a burning sensation that typically starts behind the breastbone and may travel up towards the throat. It often worsens after eating, when lying down, or bending over.

Why does heartburn occur? When the lower esophageal sphincter (LES) weakens or relaxes inappropriately, stomach acid can flow back into the esophagus. The esophagus, unlike the stomach, isn’t protected against acid, leading to the characteristic burning sensation.

Regurgitation: Another Key GERD Symptom

Regurgitation is another common symptom of GERD. It involves the sensation of acid backing up into your throat or mouth, often leaving a sour or bitter taste. Some people may experience what’s known as “wet burps,” where small amounts of liquid come up with the burp.

Dyspepsia: The Umbrella Term for Digestive Discomfort

Many people with GERD also experience dyspepsia, a general term for stomach discomfort. Symptoms of dyspepsia can include:

• Frequent burping
• Nausea, particularly after eating
• Feeling of fullness or bloating in the stomach
• Upper abdominal pain or discomfort

When Do GERD Symptoms Typically Occur?

Understanding when GERD symptoms are most likely to occur can help in managing the condition effectively. Acid reflux symptoms most often appear:

1. After consuming a heavy meal
2. When bending over or lifting objects
3. When lying down, especially on your back

Many people with frequent acid reflux symptoms experience them predominantly at night. Nighttime GERD often produces the most intense pain. However, it’s important to note that the level of pain doesn’t always correlate with the degree of damage to your esophagus.

GERD During Pregnancy

Pregnancy can exacerbate GERD symptoms. More than half of all pregnant women experience heartburn during pregnancy. This is due to increased hormones and pressure from the growing fetus. Fortunately, in most cases, heartburn improves or completely resolves after delivery.

Factors That Can Worsen GERD Symptoms

Certain factors can exacerbate GERD symptoms. Being aware of these can help in managing the condition more effectively. Here are some common triggers:

Dietary Triggers

Certain foods are known to trigger or worsen GERD symptoms in many people. These include:

• Citrus fruits
• Chocolate
• Caffeinated drinks
• Alcoholic beverages
• Spicy, fatty, or fried foods
• Garlic and onions
• Peppermint
• Tomatoes

It’s important to note that dietary triggers can vary from person to person. Keeping a food diary can help identify your personal triggers.

Lifestyle Factors

Certain lifestyle habits can also contribute to GERD symptoms:

• Eating large meals
• Eating close to bedtime
• Being overweight or obese
• Smoking
• Wearing tight-fitting clothes

Potential Complications of Untreated GERD

While GERD symptoms are usually manageable and rarely serious, ignoring them can lead to complications over time. Persistent acid reflux can damage the lining of your esophagus and cause various issues:

Esophagitis and Esophageal Strictures

Continued esophageal damage can lead to inflammation (esophagitis) and scarring. This scarring may cause the esophagus to narrow, creating strictures. Strictures can make swallowing difficult, a condition known as dysphagia.

Barrett’s Esophagus

In some cases, repeated exposure to stomach acid can cause the cells lining the lower esophagus to change. This condition, called Barrett’s esophagus, is a risk factor for esophageal cancer. While the risk is small, it’s important to monitor this condition closely.

When to Seek Medical Attention for GERD Symptoms

While occasional heartburn is common and usually not a cause for concern, certain symptoms warrant immediate medical attention. You should call your doctor if:

• You don’t get lasting relief from over-the-counter medications
• You experience difficulty or pain when swallowing
• You have unexplained weight loss
• You notice blood in your vomit or have black, tarry stools
• You develop persistent asthma-like symptoms, such as wheezing or a dry cough
• You have chronic hoarseness or sore throat
• You experience persistent nausea or hiccups

If you experience chest pain, it’s crucial to determine whether it’s due to GERD or a heart problem. When in doubt, always seek immediate medical attention.

Diagnosing GERD: Tests and Procedures

Diagnosing GERD typically involves a combination of patient history, physical examination, and sometimes, diagnostic tests. Here are some common procedures used to diagnose GERD:

Upper Endoscopy

An upper endoscopy allows your doctor to visually examine your upper digestive system. During this procedure, a thin, flexible tube with a camera is inserted down your throat to examine the esophagus, stomach, and beginning of the small intestine.

Esophageal pH Monitoring

This test measures the amount of acid in your esophagus over a 24-hour period. It can help determine the frequency and duration of acid reflux episodes.

Esophageal Manometry

This test measures the strength and coordination of your esophageal muscles when you swallow. It can help identify problems with the lower esophageal sphincter.

Treatment Options for GERD

Treatment for GERD typically follows a step-up approach, starting with lifestyle modifications and progressing to medications and, in some cases, surgery.

Lifestyle Changes

Often, the first line of treatment for GERD involves lifestyle modifications. These can include:

• Maintaining a healthy weight
• Avoiding trigger foods
• Eating smaller meals
• Not lying down immediately after eating
• Elevating the head of your bed
• Quitting smoking

Medications

If lifestyle changes alone don’t provide sufficient relief, medications may be recommended. These can include:

• Antacids for quick relief of occasional symptoms
• H2 blockers to reduce acid production
• Proton pump inhibitors (PPIs) for more severe cases

Surgical Options

In cases where medications and lifestyle changes don’t effectively manage GERD symptoms, surgery might be considered. The most common surgical procedure for GERD is called fundoplication, which involves wrapping the upper part of the stomach around the lower esophageal sphincter to strengthen it.

Living with GERD: Long-term Management Strategies

Managing GERD is often a long-term process. Here are some strategies for living comfortably with GERD:

Dietary Management

Identifying and avoiding your personal trigger foods can significantly reduce GERD symptoms. Some general dietary tips include:

• Eating smaller, more frequent meals
• Avoiding eating close to bedtime
• Limiting fatty foods, which can relax the lower esophageal sphincter
• Reducing alcohol and caffeine intake

Stress Management

While stress doesn’t cause GERD, it can exacerbate symptoms in some people. Incorporating stress-reduction techniques like meditation, yoga, or regular exercise can be beneficial.

Regular Check-ups

Regular follow-ups with your healthcare provider are important, especially if you’re taking medications long-term. Your doctor can monitor your symptoms, adjust your treatment plan if necessary, and check for any potential complications.

Living with GERD requires patience and often some lifestyle adjustments. However, with proper management, most people with GERD can lead comfortable, symptom-free lives. Remember, everyone’s experience with GERD is unique, so what works for one person may not work for another. It’s important to work closely with your healthcare provider to find the best management strategy for you.

Heartburn, Regurgitation, Dyspepsia, and More

Written by Annie Stuart

Medically Reviewed by Poonam Sachdev on April 24, 2023

• What Are the Common Acid Reflux Symptoms?
• When Do Acid Reflux Symptoms Occur?
• What Makes Acid Reflux Symptoms Worse?
• Are There Potential Complications With Acid Reflux Symptoms?
• When Should I Call the Doctor With Acid Reflux Symptoms?
• Acid Reflux vs. GERD
• More

Lots of people are intimately familiar with acid reflux symptoms. More than 60 million Americans experience acid reflux at least once a month. Acid reflux disease, also known as gastroesophageal reflux disease (GERD), can produce a variety of symptoms.

Heartburn, regurgitation, and dyspepsia are a few of the most common acid reflux symptoms.

Heartburn. Also called acid indigestion, heartburn is a burning pain or discomfort that can move up from your stomach to the middle of your abdomen and chest. The pain can also move into your throat. Despite its name, heartburn doesn’t affect your heart.

Regurgitation. Another common symptom of acid reflux is regurgitation — or the sensation of acid backing up into your throat or mouth. Regurgitation can produce a sour or bitter taste, and you may experience “wet burps.” 

Dyspepsia. Many people with acid reflux disease also have a syndrome called dyspepsia. Dyspepsia is a general term for stomach discomfort. Symptoms of dyspepsia include:

• Burping
• Nausea after eating
• Stomach fullness or bloating
• Upper abdominal pain and discomfort

Symptoms of acid reflux may be a sign that stomach acid has inflamed your esophagus. When that happens, stomach acid can damage the lining of your esophagus and cause bleeding. Over time, it can also change the cells of esophagus and cause a condition called Barrett’s esophagus.

Although acid reflux is extremely common and rarely serious, don’t ignore your acid reflux symptoms. Making a few lifestyle changes and using over-the-counter antacids are often all you need to control acid reflux symptoms.

Acid reflux symptoms most often occur:

• After eating a heavy meal
• When bending over or lifting an object
• When lying down, especially on your back

People who have frequent acid reflux symptoms most often experience them at night. Nighttime GERD also produces the most pain. However, the level of pain does not always indicate the degree of damage to your esophagus.

More than half of all pregnant women experience heartburn during pregnancy. Increased hormones and pressure from a growing fetus can combine to produce this acid reflux symptom. In most cases, heartburn improves or completely goes away after delivery.

Acid reflux disease is also known as gastroesophageal reflux disease (GERD).

Certain foods can make the symptoms of acid reflux worse for some people. To lessen your symptoms, try avoiding:

• Citrus fruits
• Chocolate
• Caffeinated drinks or alcohol
• Spicy, fatty, or fried foods
• Garlic and onions
• Peppermint
• Tomatoes

Usually, acid reflux symptoms cause no complications. In a few cases, continued esophageal damage can lead to scarring, which may cause the esophagus to narrow. The narrowing creates strictures and makes it difficult to swallow. You may have dysphagia, a sensation that food is stuck in your esophagus. In some cases, normal cells in the lining of the esophagus may be replaced by a different type of cell. This is called Barrett’s esophagus, which can sometimes develop into cancer.

Be sure to call your doctor if you don’t get lasting relief from medications. Also call the doctor right away if you have any “alarm” acid reflux symptoms, such as these:

• Unexpected weight loss
• Blood in vomit
• Black, tarry, or maroon-colored stools
• Difficulty or pain with swallowing

Other acid reflux symptoms that should prompt a call to your doctor include:

• Asthma-like symptoms, such as wheezing or dry cough
• Hoarseness, especially in the morning
• Chronic sore throat
• Hiccups that don’t let up
• Nausea that lasts for more than a day or two

Sometimes, people confuse the symptoms of heart attack with symptoms of acid reflux disease. That’s because pain in the chest can feel like heartburn. When in doubt, call your doctor.

Call 911 if you have any of these symptoms of heart attack:

• Chest pain, pressure, or fullness lasting more than a few minutes or that goes away and comes back
• Pain or discomfort in your neck, shoulder, upper back, or jaw
• Shortness of breath, with or without chest pain
• Dizziness, lightheadedness, or nausea
• Sweating along with chest pain

GERD stands for gastroesophageal reflux disease. It’s heartburn (or reflux) that happens two or more times per week. It’s more serious than regular heartburn.

The problem lies at the place where your esophagus (the tube that connects your mouth to your stomach) connects to your stomach. You have a muscular valve there called the lower esophageal sphincter. Its job is to keep stomach acid in your stomach. But if that valve doesn’t work well, the acid can go back up into your esophagus. That’s reflux. 

If stomach acid goes into your esophagus, you may have heartburn and belching. If it goes higher into your throat, you may have hoarseness and sore throat. And if it gets into your mouth, you’ll notice a bitter taste and you may cough. If it happens a lot, it may wear down your tooth enamel or worsen the symptoms of asthma.

Symptoms

The most common one is chronic heartburn. Others include:

• Burping
• Chronic sore throat
• Trouble or pain when swallowing
• Suddenly having too much saliva
• Hoarseness
• Sour or bitter taste in the mouth  
• Bad breath
• Inflammation of the gums
• Erosion of tooth enamel (the surface of the teeth)
• Nausea  
• Chest pain

Sometimes, there are no symptoms and you only find out that you have GERD if it causes other problems. But just like with acid reflux, you should call 911 or go to the nearest emergency room if you have chest pain.

Complications

Over time, untreated GERD may cause:

Esophagitis. This is an irritation and inflammation of the lining of the esophagus caused by stomach acid.

Trouble swallowing. Your doctor may call this dysphagia. It can happen if scarring narrows your esophagus.

Barrett’s esophagus. This means that there are changes in the cells of the esophagus that may be precancerous.

Esophageal cancer. Years of exposure to stomach acid may cause cancer of the esophagus.

Top Picks

Heartburn, Regurgitation, Dyspepsia, and More

Written by Annie Stuart

Medically Reviewed by Poonam Sachdev on April 24, 2023

• What Are the Common Acid Reflux Symptoms?
• When Do Acid Reflux Symptoms Occur?
• What Makes Acid Reflux Symptoms Worse?
• Are There Potential Complications With Acid Reflux Symptoms?
• When Should I Call the Doctor With Acid Reflux Symptoms?
• Acid Reflux vs. GERD
• More

Lots of people are intimately familiar with acid reflux symptoms. More than 60 million Americans experience acid reflux at least once a month. Acid reflux disease, also known as gastroesophageal reflux disease (GERD), can produce a variety of symptoms.

Heartburn, regurgitation, and dyspepsia are a few of the most common acid reflux symptoms.

Heartburn. Also called acid indigestion, heartburn is a burning pain or discomfort that can move up from your stomach to the middle of your abdomen and chest. The pain can also move into your throat. Despite its name, heartburn doesn’t affect your heart.

Regurgitation. Another common symptom of acid reflux is regurgitation — or the sensation of acid backing up into your throat or mouth. Regurgitation can produce a sour or bitter taste, and you may experience “wet burps.” 

Dyspepsia. Many people with acid reflux disease also have a syndrome called dyspepsia. Dyspepsia is a general term for stomach discomfort. Symptoms of dyspepsia include:

• Burping
• Nausea after eating
• Stomach fullness or bloating
• Upper abdominal pain and discomfort

Symptoms of acid reflux may be a sign that stomach acid has inflamed your esophagus. When that happens, stomach acid can damage the lining of your esophagus and cause bleeding. Over time, it can also change the cells of esophagus and cause a condition called Barrett’s esophagus.

Although acid reflux is extremely common and rarely serious, don’t ignore your acid reflux symptoms. Making a few lifestyle changes and using over-the-counter antacids are often all you need to control acid reflux symptoms.

Acid reflux symptoms most often occur:

• After eating a heavy meal
• When bending over or lifting an object
• When lying down, especially on your back

People who have frequent acid reflux symptoms most often experience them at night. Nighttime GERD also produces the most pain. However, the level of pain does not always indicate the degree of damage to your esophagus.

More than half of all pregnant women experience heartburn during pregnancy. Increased hormones and pressure from a growing fetus can combine to produce this acid reflux symptom. In most cases, heartburn improves or completely goes away after delivery.

Acid reflux disease is also known as gastroesophageal reflux disease (GERD).

Certain foods can make the symptoms of acid reflux worse for some people. To lessen your symptoms, try avoiding:

• Citrus fruits
• Chocolate
• Caffeinated drinks or alcohol
• Spicy, fatty, or fried foods
• Garlic and onions
• Peppermint
• Tomatoes

Usually, acid reflux symptoms cause no complications. In a few cases, continued esophageal damage can lead to scarring, which may cause the esophagus to narrow. The narrowing creates strictures and makes it difficult to swallow. You may have dysphagia, a sensation that food is stuck in your esophagus. In some cases, normal cells in the lining of the esophagus may be replaced by a different type of cell. This is called Barrett’s esophagus, which can sometimes develop into cancer.

Be sure to call your doctor if you don’t get lasting relief from medications. Also call the doctor right away if you have any “alarm” acid reflux symptoms, such as these:

• Unexpected weight loss
• Blood in vomit
• Black, tarry, or maroon-colored stools
• Difficulty or pain with swallowing

Other acid reflux symptoms that should prompt a call to your doctor include:

• Asthma-like symptoms, such as wheezing or dry cough
• Hoarseness, especially in the morning
• Chronic sore throat
• Hiccups that don’t let up
• Nausea that lasts for more than a day or two

Sometimes, people confuse the symptoms of heart attack with symptoms of acid reflux disease. That’s because pain in the chest can feel like heartburn. When in doubt, call your doctor.

Call 911 if you have any of these symptoms of heart attack:

• Chest pain, pressure, or fullness lasting more than a few minutes or that goes away and comes back
• Pain or discomfort in your neck, shoulder, upper back, or jaw
• Shortness of breath, with or without chest pain
• Dizziness, lightheadedness, or nausea
• Sweating along with chest pain

GERD stands for gastroesophageal reflux disease. It’s heartburn (or reflux) that happens two or more times per week. It’s more serious than regular heartburn.

The problem lies at the place where your esophagus (the tube that connects your mouth to your stomach) connects to your stomach. You have a muscular valve there called the lower esophageal sphincter. Its job is to keep stomach acid in your stomach. But if that valve doesn’t work well, the acid can go back up into your esophagus. That’s reflux. 

If stomach acid goes into your esophagus, you may have heartburn and belching. If it goes higher into your throat, you may have hoarseness and sore throat. And if it gets into your mouth, you’ll notice a bitter taste and you may cough. If it happens a lot, it may wear down your tooth enamel or worsen the symptoms of asthma.

Symptoms

The most common one is chronic heartburn. Others include:

• Burping
• Chronic sore throat
• Trouble or pain when swallowing
• Suddenly having too much saliva
• Hoarseness
• Sour or bitter taste in the mouth  
• Bad breath
• Inflammation of the gums
• Erosion of tooth enamel (the surface of the teeth)
• Nausea  
• Chest pain

Sometimes, there are no symptoms and you only find out that you have GERD if it causes other problems. But just like with acid reflux, you should call 911 or go to the nearest emergency room if you have chest pain.

Complications

Over time, untreated GERD may cause:

Esophagitis. This is an irritation and inflammation of the lining of the esophagus caused by stomach acid.

Trouble swallowing. Your doctor may call this dysphagia. It can happen if scarring narrows your esophagus.

Barrett’s esophagus. This means that there are changes in the cells of the esophagus that may be precancerous.

Esophageal cancer. Years of exposure to stomach acid may cause cancer of the esophagus.

Top Picks

symptoms and diagnosis, prices for the treatment of heartburn in Moscow at the Hadassah clinic

Enroll

Heartburn is an unpleasant sensation, up to a burning pain in the upper abdomen. Many people experience discomfort regularly or occasionally, especially after overeating or drinking alcohol. If it happens from time to time, it does no harm. With frequent episodes, we are talking about the development of reflux disease. Heartburn occurs

when the contents of the stomach back up into the esophagus – this backflow is also known as reflux. Thus, heartburn is not an independent disease, but is a consequence.

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Symptoms of heartburn

Heartburn is not a disease, but a manifestation of reflux. Discomfort in the chest and neck is aggravated by leaning forward, physical activity and eating. Patients complain of the presence of sour belching and an unpleasant aftertaste in the oral cavity. Additional symptoms depend on the severity of the reflux disease. Thus, the patient may experience a violation of food intake and a manifestation of indigestion. Sometimes there is no discomfort at all.

Additional symptoms of heartburn that indicate the presence of reflux disease:

• increased salivation;
• nausea and bitterness in the mouth;
• discomfort when swallowing food;
• occurrence of bad breath;
• lump in throat and characteristic burning;
• chronic cough and hoarseness;
• sleep problems;
• poor appetite.

In the chronic form of the disease, there are violations of the respiratory system. Inflammation of the lungs may develop, which occurs due to the reflux of gastric juice into the respiratory tract. Bronchial asthma can be complicated by frequent attacks.

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Causes of heartburn

Heartburn can have several causes. In most cases, they remain unclear. Most often, heartburn develops against the background of an unhealthy lifestyle and diet, which overload the stomach. For example, stress can literally hit the stomach and cause heartburn because it stimulates stomach acid production, delays emptying, and promotes reflux.

Other factors that can cause heartburn include:

• excessive body weight;
• alcohol abuse;
• smoking;
• inclusion in the diet of fatty and fried foods;
• eating hot spices such as garlic, mustard or horseradish;
• meal before going to bed.

Medicines are also among the causes of heartburn. They can both cause heartburn and increase existing discomfort. For some medications, reflux is a possible side effect. Painkillers from the group of so-called non-steroidal anti-inflammatory drugs cause heartburn especially often. Therefore, those who are prone to heartburn should prophylactically take a gastric protector during drug therapy.

In addition, there are some diseases that sometimes cause heartburn, for example:

• functional dyspepsia;
• diaphragmatic hernia;
• gastritis and gastric ulcer;
• stenosis and achalasia of the esophagus.

Delayed gastric emptying can also lead to heartburn and reflux. Usually, solid food stays in the stomach for 1 to 5 hours. Liquids are absorbed much faster – with an empty stomach, they enter the small intestine in an average of 10-20 minutes.

Methods for diagnosing heartburn

If you experience a symptom such as heartburn, you should make an appointment with a gastroenterologist. The doctor will take a history of the disease and conduct an initial examination. Comprehensive diagnostics for heartburn allows you to obtain accurate information about the state of the gastrointestinal tract (gastrointestinal tract) of the patient. To determine the cause of heartburn, the specialist will prescribe the following tests:

Esophagogastroduodenoscopy

examination of the mucous membrane of the esophagus, duodenum and esophagus

X-ray of the esophagus

Diaphragmatic herniation and complications of reflux disease

Electromyography

Examination of the muscles of the esophagus

Treatments for heartburn

Medication is given to reduce stomach acid, relieve symptoms, and address the cause of heartburn. In addition to drugs, the gastroenterologist prescribes a diet that allows you to normalize the activity of the intestines and stomach.

Medicines used to treat heartburn:

• Antacids. Neutralize acid, relieve discomfort and pain from heartburn.
• Proton pump inhibitors and H2-histamine receptor blockers. They inhibit the production of hydrochloric acid and improve the condition.

Medication for heartburn can last from 2-3 weeks to 6 months. Each stage of therapy is additionally controlled by a doctor to adjust dosages and eliminate the likelihood of complications.

Surgical intervention for heartburn is necessary only when another pathology was identified during the diagnosis, leading to dysfunction of the digestive tract.

Heartburn prevention and treatment programs at the Hadassah Clinic

As a preventive measure for heartburn, standard medical recommendations are used to prevent the reflux of stomach contents into the esophagus:

• lose extra pounds;
• avoid spicy, salty and fatty foods;
• give up alcohol and cigarettes;
• do not eat 2-3 hours before bedtime.

The Hadassah clinic in Moscow performs two types of operations to eliminate the cause of heartburn:

• Radiofrequency ablation of the esophagus – normalization of the functions of the esophageal sphincter.
• Endoscopic application – prevents the backflow of acid into the esophagus.

Text reviewed by medical expert

Kanevskaya
Svetlana Sergeevna

Medical director, therapist, doctor of medical sciences, professor

Doctor of medical sciences

Work experience: 22 years

Published: 06/24/2022 90 003

Updated: 06/24/2022

The information provided on the site is for reference only and cannot serve as a basis for making a diagnosis or prescribing treatment. Internal consultation of the expert is necessary.

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