Acid Reflux & GERD : What to know
Written on August 10, 2021
What it is | Symptoms | Causes | Prevalence | Treatment | Concerns | Bottom Line
What is acid reflux and GERD?
Acid reflux occurs when gastric acid and bile moves from the stomach to the esophagus. It is often perceived as a discomfort in the chest and/or a sour taste in the throat.
The lower esophageal sphincter (LES) muscle connects the stomach and esophagus. If the LES is impaired, the acid from your stomach can move back to your esophagus.
Gastroesophageal reflux disease or GERD differs from acid reflux. GERD is a chronic form of reflux. In the long-term, the damage to your esophagus caused by reflux can lead to esophageal cancer. In some cases, GERD can be caused by reflux that is not acid reflux.
If you suffer from intermittent heartburn – less than twice per week, you aren’t classified as a GERD case. If you suffer from frequent heartburn – more than twice per week, and are experiencing inflammation in your esophagus, you may be suffering from GERD arising from reflux.
The symptoms of acid reflux are:
- feeling of discomfort behind the breastbone that moves upward from the stomach
- bad breath
- damage to tooth enamel
- bitter taste in the back of your throat
- chest pain
- persistent dry cough
- trouble swallowing
A primary reason for GERD is muscle weakness in your lower esophageal sphincter valve.
Other factors contribute:
- Being overweight or pregnant.
- Certain medications
- Certain foods
- Hiatal hernia
GERD is a common gastrointestinal disease in the Western world with up to 20% of the US population suffering from GERD, although this has been projected to rise.
Heartburn is especially common and affects over 50 million Americans in any given month. Women may be more prone to GERD, however their symptoms are generally less than men.
In cases of infrequent heartburn and acid reflux, lifestyle modifications and over-the-counter medicines can provide relief.
- Avoid trigger foods including alcoholic beverages, chocolate, tomato products, coffee, peppermint, greasy foods. These foods relax the LES, and can irritate esophageal lining leading to GERD.
- If you smoke, stop. Tobacco is a causative factor for acid reflux and cancer.
- Weight loss if overweight. Excess abdominal fat is one of the main risks for heartburn. This can be achieved by eating smaller servings. Slowly chewing your food thoroughly will help satiate you, minimising the perception of hunger.
- Stop eating in the 3 hours before you go to sleep.
- Avoid tight clothing, especially near your core.
The two prescription medications used to treat GERD are H2 blockers and proton pump inhibitors.
H2 blockers reduce the symptoms of heartburn and reflux.
Proton pump inhibitors are more expensive, and are often the second line of treatment for severe cases.
Antacids may provide relief for heartburn however should not be indicated until patients do not respond to lifestyle modifications.
These medications have side effects ranging from gas, flatulence and stomach cramps.
Other concerns – From the American College of Gastroenterology
- Heartburn is a common, but serious condition.
Left untreated, longstanding, severe and chronic heartburn has been linked with esophageal cancer. Don’t ignore frequent heartburn — instead consult with your physician regarding an endoscopy and treatment to achieve early symptom resolution.
- If you suffer infrequent heartburn, antacids, or H2 blockers (now available without a prescription) or proton pump inhibitors (pending release at reduced strength over-the-counter dosages) may provide the relief you need.
- If you are experiencing heartburn two or more times a week, you may have acid reflux disease, also known as GERD, which, if left untreated, is potentially serious.
- If you are self-medicating for heartburn two or more times a week, or if you still have symptoms on your over-the-counter or prescription medication, you need to see a doctor and perhaps be referred to a gastroenterologist.
- GERD has a physical cause that’s not your fault and can only be treated by a physician.
- GERD has a significant role in asthma, chronic cough and ear, nose and throat problems — all referred to as extra-esophageal manifestations (EEM) although this connection may often go unrecognized.
- With effective treatment, using the range of prescription medications and other treatments available today, you can become symptom free, avoid potential complications and restore the quality of life you deserve.
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Antunes, C., Aleem, A., & Curtis, S. A. (2021). Gastroesophageal Reflux Disease. In StatPearls. StatPearls Publishing. Also available link
Acid reflux. American College of Gastroenterology. (2021, April 28). https://gi.org/topics/acid-reflux/.
El-Serag, H. B., Sweet, S., Winchester, C. C., & Dent, J. (2014). Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut, 63(6), 871-880.
Gastroesophageal reflux disease (GERD). American Gastroenterological Association. (2020, November 20). https://gastro.org/practice-guidance/gi-patient-center/topic/gastroesophageal-reflux-disease-gerd/.
Kang, A., Khokale, R., Awolumate, O. J., Fayyaz, H., & Cancarevic, I. (2020). Is Estrogen a Curse or a Blessing in Disguise? Role of Estrogen in Gastroesophageal Reflux Disease. Cureus, 12(10), e11180. https://doi.org/10.7759/cureus.11180
U.S. Department of Health and Human Services. (n.d.). Acid reflux (GER & GERD) in adults. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults.