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A complete guide to gastroesophageal reflux disease: what causes it, the symptoms, how it is diagnosed, treatments from lifestyle changes to surgery, and possible complications.
By Editorial Team · Updated · 3 min read
This article is awaiting review by a qualified medical professional.
Quick answer
GERD (gastroesophageal reflux disease) is a long-term condition in which stomach acid regularly flows back into the esophagus, causing heartburn and regurgitation, usually at least twice a week. It is treated with lifestyle changes, antacids, H2 blockers or proton pump inhibitors (PPIs), and occasionally with surgery such as Nissen fundoplication. See a doctor if you have trouble swallowing, weight loss, vomiting, black stools, or symptoms that keep returning.
Gastroesophageal reflux disease (GERD) is one of the most common digestive conditions in the world. It happens when the muscle at the bottom of the esophagus (the lower esophageal sphincter) does not close properly, allowing stomach acid and contents to flow back up.
Everyone has reflux from time to time, for example after a large meal. GERD is diagnosed when reflux is frequent, causes troublesome symptoms, or damages the esophagus. It affects a large share of adults, and it is common in people who are overweight and in pregnancy.
The main symptoms are:
Other symptoms include chest pain, difficulty or pain swallowing, a feeling of a lump in the throat, chronic cough, hoarseness, sore throat, bad breath, nausea, and disturbed sleep. See our detailed guide to GERD symptoms and how to tell heartburn from a heart attack.
Doctors often diagnose GERD from your symptoms and may suggest a trial of medicine. Tests are used when symptoms are unusual, severe or not improving:
Long-term PPI use is linked in observational studies with issues such as low vitamin B12 or magnesium and a higher risk of some infections and fractures. When they are needed, the benefits usually outweigh the risks, but they should be taken at the lowest effective dose and reviewed regularly.
If medicine does not work well or is not wanted long term, options include laparoscopic Nissen fundoplication, partial wraps, the LINX magnetic device, and endoscopic treatments.
Untreated or severe GERD can cause:
See a doctor if you have heartburn most days, need antacids regularly for more than 2 weeks, or symptoms that are getting worse. Get medical advice promptly if you have:
Call emergency services if you have chest pain that is crushing or spreads to the arm, jaw or back, or comes with sweating, breathlessness or dizziness.
Acid reflux is the backward flow of stomach contents, which most people experience occasionally. GERD is the term for reflux that is frequent (typically twice a week or more) or that causes symptoms or damage.
Mild GERD can improve with weight loss, smaller meals, avoiding late eating and treating triggers. Many people, however, have symptoms that return when treatment stops, and some need long-term medicine.
A typical first course is about 8 weeks. If symptoms settle, doctors usually try to reduce to the lowest effective dose or stop, and over-the-counter courses are generally 14 days. Long-term use should be reviewed by a doctor.
Long-standing GERD can lead to Barrett's esophagus in some people, which carries a small risk of developing esophageal cancer. Most people with GERD never develop cancer, but those with alarm symptoms or long-standing symptoms may need an endoscopy.
Yes, reflux can cause chest pain that feels like a heart problem. Never assume chest pain is heartburn if it is pressure-like, spreads to the arm or jaw, or comes with sweating or breathlessness. Seek emergency care.
This article is for educational purposes only and does not replace advice from a doctor or other qualified health professional. See our medical disclaimer.
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