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GERD
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Digestive System

GERD

Gastroesophageal reflux disease (GERD) is a chronic condition where stomach acid flows back into the esophagus, causing discomfort and potential long-term health issues.

What is GERD?

Sometimes, after eating a large meal or lying down too soon after eating, you might feel acid coming up into your throat. This is called gastroesophageal reflux (GER). It happens when the muscle at the end of your esophagus (the tube that carries food from your mouth to your stomach) doesn't close properly, allowing stomach contents to move back up and irritate the esophagus.

Having reflux occasionally is common. But if you have symptoms two or more times a week or if they cause damage to the lining of your esophagus, you may have gastroesophageal reflux disease (GERD). GERD is a chronic condition that can cause discomfort and, over time, lead to other health problems. Anyone can have GERD, including infants and children.

What causes GERD?

GERD can happen when the muscle at the bottom of your esophagus becomes weak or relaxes at the wrong time. You are more likely to have GERD if you:

  • Are overweight or have obesity
  • Are pregnant
  • Smoke or are around secondhand smoke
  • Have a hiatal hernia (when part of the stomach pushes up into the chest)

Certain foods, drinks, or medicines can also make GERD worse.

What are common symptoms of GERD?

The most common symptom of GERD is heartburn, a burning feeling in your chest or throat. You can also have GERD without having heartburn. Other symptoms may include:

  • Tasting acid or food in the back of your mouth
  • A dry cough or hoarse voice
  • Asthma-like symptoms
  • Trouble swallowing

Get medical help right away if you have chest pain with shortness of breath, or pain in your jaw or arm. These can be signs of a heart problem.

How is GERD diagnosed?

Your health care provider will ask about your symptoms and medical history. They may recommend tests such as:

  • Upper GI endoscopy to look at the esophagus and stomach lining with a tiny camera
  • Biopsy to check a small tissue sample
  • X-Ray to take pictures of the upper digestive system
  • Esophageal pH test to measure how often acid backs up the esophagus and how long the acid stays there
  • Esophageal manometry to check how well your esophagus moves food when you swallow
  • Transnasal esophagoscopy to look for damage to the esophagus by using a small tube with a camera

How is GERD treated?

Most people can manage GERD with lifestyle changes and medicine. In rare cases, surgery is needed.

Lifestyle changes can include:

  • Eating smaller meals and avoiding lying down for at least 2-3 hours after eating
  • Avoiding foods that trigger symptoms, such as spicy foods, chocolate, caffeine, or fatty foods
  • Losing weight if needed
  • Raising the head of your bed
  • Quitting smoking

Medicines can include:

  • Over-the-counter medicines, such as antacids
  • Prescription medicines

If not treated, GERD can cause problems like inflammation of the esophagus, scarring, or changes in the tissue lining (Barrett's esophagus). It can also worsen asthma or cause chronic cough or hoarseness.

Can GERD be prevented?

You may be able to improve symptoms of GERD by:

  • Avoiding alcohol and trigger foods
  • Eating smaller meals
  • Not eating close to bedtime
  • Wearing loose-fitting clothes
  • Sleeping on your left side or raising the head of your bed
  • Maintaining a healthy weight

Frequently Asked Questions

GERD chest pain typically feels like a burning sensation behind the breastbone that often occurs after eating or while lying down, and it frequently improves with antacids. Heart attack pain tends to feel like crushing pressure, squeezing, or fullness in the center of the chest that may radiate to the left shoulder, arm, neck, jaw, or back, often accompanied by shortness of breath, cold sweats, nausea, or lightheadedness. Because the symptoms can overlap significantly and esophageal spasms can mimic cardiac angina, any new, severe, or unexplained chest pain should be treated as a medical emergency. What bedtime routine adjustments help reduce nighttime acid reflux?::Stop eating at least three hours before going to bed to allow sufficient time for your stomach to empty. Elevating the head of your bed by 6 to 8 inches using bed risers or a specialized wedge pillow keeps stomach acid physically lower than your esophagus while you sleep. Avoid stacking standard sleeping pillows under your head, which bends the neck and compresses the abdomen, increasing reflux risk. Additionally, sleeping on your left side positions the junction between your stomach and esophagus above gastric acid levels, reducing nighttime flare-ups. What are the risks associated with long-term use of proton pump inhibitors (PPIs) for GERD?::While PPIs are effective for managing severe reflux and healing esophagitis, prolonged daily use over multiple years can lower stomach acid enough to impair the absorption of certain nutrients, including calcium, magnesium, and vitamin B12. This may slightly increase the risk of bone fractures and nutritional deficiencies. Long-term use is also linked to an increased risk of intestinal infections, such as Clostridioides difficile. Patients should have regular medication reviews with their doctor to ensure they are maintained on the lowest effective dose needed to control symptoms. What red-flag symptoms in GERD require an immediate upper endoscopy?::Warning signs that warrant urgent endoscopic evaluation include trouble swallowing (dysphagia), painful swallowing (odynophagia), unexplained weight loss, continuous vomiting, iron-deficiency anemia, and signs of gastrointestinal bleeding such as vomiting blood or passing dark, tarry stools. These symptoms can indicate serious complications, such as an esophageal stricture, an active ulcer, or esophageal adenocarcinoma, and require prompt diagnostic imaging rather than simple medication adjustments.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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