- Gastroesophageal reflux disease (GERD) is a chronic digestive disorder that occurs when stomach contents, including acid and sometimes bile, flow backward into the esophagus. This backward movement, known as reflux, happens when the lower esophageal sphincter (LES)—a muscular ring at the junction of the esophagus and stomach—becomes weakened or relaxes inappropriately. The recurring exposure of the esophageal lining to acidic gastric contents leads to irritation, inflammation, and characteristic symptoms such as heartburn (a burning sensation behind the breastbone), acid regurgitation, chest discomfort, and a sour taste in the mouth.
- The causes of GERD are multifactorial and often involve both mechanical and physiological factors. Obesity, pregnancy, hiatal hernia, and delayed gastric emptying can all increase abdominal pressure, promoting reflux. Certain foods and habits, such as consuming fatty or spicy meals, drinking caffeine or alcohol, smoking, and lying down soon after eating, can also contribute to LES dysfunction. In some individuals, genetic predisposition or anatomical abnormalities of the esophagus may play a role in GERD development.
- While occasional reflux is common and usually harmless, GERD is diagnosed when reflux becomes frequent (typically occurring two or more times per week) and begins to interfere with daily life or cause complications. In addition to heartburn and regurgitation, GERD may present with symptoms such as chronic cough, hoarseness, sore throat, difficulty swallowing (dysphagia), or the sensation of a lump in the throat (globus sensation). In severe or untreated cases, repeated acid exposure can lead to esophagitis (inflammation of the esophageal lining), strictures (narrowing of the esophagus due to scar tissue), Barrett’s esophagus (a precancerous condition involving changes in the esophageal lining), or esophageal adenocarcinoma.
- Diagnosis of GERD is often based on clinical symptoms and response to acid-suppressing medications. When further evaluation is needed, tests such as upper endoscopy, esophageal pH monitoring, or manometry may be used to assess the extent of esophageal damage, acid exposure, and LES function.
- Treatment for GERD focuses on relieving symptoms, healing esophagitis, and preventing complications. Lifestyle modifications are the first line of management and include weight loss, elevating the head of the bed, eating smaller meals, avoiding trigger foods and late-night eating, and quitting smoking. Medications, such as proton pump inhibitors (PPIs), H2-receptor antagonists, and antacids, are commonly used to reduce stomach acid production and relieve symptoms. In cases where medical therapy is ineffective or complications arise, surgical options such as Nissen fundoplication (a procedure to reinforce the LES) may be considered.
- GERD is a manageable condition, but it requires long-term attention to lifestyle and, in many cases, sustained medical therapy. Early diagnosis and treatment are important to prevent progressive esophageal damage and maintain a good quality of life.
