What is GERD?
There is no cure for GERD — it’s an ongoing digestive disorder — but it is treatable. Some people can manage symptoms with diet and lifestyle changes; others need more treatment.
GERD is a common disorder, but the symptoms are sometimes mistaken for other conditions. So what are the symptoms of GERD in adults? Let’s discover.
GERD stands for gastroesophageal reflux disease. It happens when stomach acid, fluids, or food flow back up into your food pipe, also called the esophagus. The acid irritates the lining of your esophagus, causing inflammation and symptoms, usually heartburn. Over time, the stomach acid breaks down the lining of the esophagus. This can cause damage like sores, scarring, and other problems.
Some people have a type of GERD called non-erosive esophageal reflux disease, or NERD, where you have a normal esophagus lining despite the acid reflux. The acid doesn’t damage your lining, though it can still cause symptoms. Some experts think NERD is an early stage of GERD that will eventually advance to an erosive type. Others think it’s one type of GERD on a spectrum of many variations.
GERD vs. acid reflux
GERD is sometimes called acid reflux, but GERD is a more severe form. Everyone has acid reflux or heartburn at some point, like when you burp and taste acid in your mouth. When you have GERD, it interferes with your daily life.
Stages of GERD
There are different stages of GERD, and symptoms vary depending on the stage. The severity and frequency of your symptoms determine the stage of your GERD. They include:
- Stage 1: mild GERD with symptoms less than once a week
- Stage 2: moderate GERD with symptoms a few times a week
- Stage 3: severe GERD with daily symptoms
- Stage 4: GERD with complications
If you leave GERD untreated or it worsens over time, complications can develop. In that situation, GERD can advance to more severe diseases. These include:
- Erosive esophagitis, in which the acid causes ulcers or open sores in your esophagus lining
- Esophageal strictures, where scarring makes your esophagus more narrow, restricting the room in the pipe
- Barret’s esophagus, a condition in which the damage causes pre-cancerous changes to your esophageal lining
- Esophageal cancer
What are the symptoms of GERD in adults?
The most common symptom of GERD is heartburn, a burning sensation in your chest after meals or when you lie down. There are lots of other symptoms of GERD in adults, including:
- Regurgitation, or bringing back up swallowed food or liquids
- Sour or bitter taste in your mouth
- Chest pain
- Trouble swallowing
- Throat clearing
- Coughing or wheezing
- Sore throat
- Cavities or tooth enamel break down
- Bad breath
- Feeling a lump in your throat
Sometimes acid stays in your throat, and you breathe it into your lungs. The acid irritates your lung tissues and can cause symptoms of lung diseases. Complications can include times when food gets stuck in your food pipe, which can also lead to food impaction.
What causes GERD?
The cause of GERD is a weak or irregular lower esophageal sphincter. This is a muscle at the bottom of your esophagus that acts as a valve to your stomach.
Usually, you chew your meal and swallow. Your sphincter then opens up to allow the food into your stomach. For some people, the muscle relaxes too often or for too long. This lets fluid flow back in the wrong direction.
Some factors can affect your esophageal muscle and lead to weakness, including:
- Obesity or being overweight, in which the extra weight puts pressure on your esophagus
- Pregnancy, where higher levels of progesterone hormone cause the muscle to relax
- Caffeine and alcohol intake
Sometimes a hiatal hernia can also interfere with the muscle. In a hiatal hernia, your stomach pushes through a small opening in your diaphragm called a hiatus. Normally your esophagus passes through the hiatus to connect to your stomach. If your stomach pushes up through this opening, this can cause problems with your esophagus muscle.
What are the GERD treatment options?
GERD treatment involves lifestyle changes and diet first, and then medication and surgical procedures as needed.
The first step to managing GERD is to change your lifestyle. Sometimes changing how and when you eat and other habits are enough to relieve symptoms. You should:
- Stop smoking
- Limit alcohol
- Eat smaller meals
- Avoid eating within 3 hours of bedtime
- Stay upright after eating, which means no bending over, lifting, or laying down
- Lose weight
- Cut back on caffeine
- Prop yourself up in bed
Exercise can help you lose weight, but wait a few hours after eating before you workout. Bending over and jumping around can aggravate your symptoms.
If you have GERD, you might experience symptoms like bloating, belching, and burping every time you eat. Some foods can relax your esophagus muscle and trigger acid reflux, worsening your symptoms. But food can affect GERD in different ways:
- High-fat foods lower the pressure in your lower esophagus, which eventually causes it to open
- Acidic foods raise your stomach acid levels, adding more acid to the mix
- Certain chemicals in foods or drinks affect the muscle movements in your esophagus
- High-fat foods take longer to digest and slow down stomach emptying
Sometimes changing what you eat can help your symptoms. Avoid:
- Fast food
- Fried foods
- Tomatoes and tomato-based products
- Citrus fruits
- Carbonated drinks
If lifestyle and diet changes don’t help, you might need medication. These can help lower the amount of stomach acid you make, neutralize your stomach acid, block stomach acid production totally, or strengthen your sphincter muscle. Medications can include:
- Over-the-counter or prescription H-2 receptor blockers
- Over-the-counter or prescription proton pump inhibitors
- Prescription baclofen
In most cases, you can control GERD with medication. If nothing helps or you don’t want to take medication long-term, surgery to tighten the esophageal muscle might be an option.
GERD is a chronic disease. There is no cure, but you can manage the condition with medication and changes to your eating and lifestyle habits. You’ll need ongoing treatment, but serious complications are rare.
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American Academy of Allergy, Asthma & Immunology: "Gastroesophageal Reflux Disease."
Antunes, C., Aleem, A., Curtis, S., StatPearls, "Gastroesophageal Reflux Disease."
Canadian Society of Intestinal Research: "Gastroesophageal reflux disease (GERD)."
Cedars Sinai: "Gastroesophageal Reflux Disease (GERD)/Heartburn."
Cleveland Clinic Health Essentials: "What's the Difference Between Heartburn, Acid Reflux, and GERD?"
Cooper University Health Care: "The Stages of GERD."
Harvard Medical School Harvard Health Publishing: "What is GERD or Gastroesophageal reflux disease."
JOHNS HOPKINS MEDICINE: "Gastroesophageal Reflux Disease (GERD) Treatment," "GERD Diet: Foods That Help with Acid Reflux (Heartburn)."
Mayo Clinic: "Gastroesophageal reflux disease (GERD)," "Hiatal hernia."
Scientific Reports: "Treatment of non-erosive reflux disease and dynamics of the esophageal microbiome: a prospective multicenter study."
University of Texas Southwestern Medical Center: "Feeling the burn? Tips to manage heartburn, GERD in pregnancy."
Top Is GERD Curable Related Articles
aluminum hydroxideAluminum hydroxide is an antacid available over the counter and is used to relieve heartburn from gastritis, peptic ulcers, ulcerative colitis, and gastroesophageal reflux disease (GERD). Use with caution in patients with heart failure, cirrhosis, kidney disease, or edema. Common side effects of aluminum hydroxide include constipation, hemorrhoids, fecal discoloration (white speckles), fecal impaction, gastrointestinal obstruction, chalky taste, nausea, vomiting, stomach cramps, loss of appetite (anorexia), weakness, feeling unwell (malaise), rebound hyperacidity, low phosphate levels in the blood (hypophosphatemia), low magnesium in blood (hypomagnesemia), softening of bones (osteomalacia), brittle bones (osteoporosis), and others. Aluminum hydroxide overdose can cause severe constipation, confusion, mood changes, and reduced urination.
aluminum hydroxide/magnesium trisilicateAluminum hydroxide/magnesium trisilicate is a combination medication used to relieve symptoms of acid indigestion and heartburn due to acid reflux. Common side effects of aluminum hydroxide include stomach cramps, constipation, fecal impaction, hemorrhoids, nausea, vomiting, chalky taste, rebound hyperacidity, softening of bones (osteomalacia), and others. Common side effects of magnesium trisilicate include nausea, vomiting, diarrhea, headache, dizziness, lethargy, drowsiness, lightheadedness, and high magnesium levels in blood (hypermagnesemia).
chamomileChamomile is a medicinal herb commonly used for many ailments including gastrointestinal disorders, inflammation, hay fever, menstrual disorders, mouth ulcers, wounds and muscle spasms. Common side effects of chamomile include hypersensitivity reactions, contact dermatitis, severe allergic reaction (anaphylaxis), exacerbation of eye inflammation with eye washing, and vomiting if taken in large doses. Do not take chamomile if you have allergic conditions such as asthma. Chamomile may increase anticoagulant properties of other medications. Avoid chamomile use in pregnant or breastfeeding women.
cimetidine, Tagamet HBCimetidine (Tagamet) is a drug prescribed for the treatment of GERD, duodenal ulcers, active gastric ulcers, Zollinger Ellison syndrome, heartburn, indigestion; and the prevention of gastrointestinal bleeding. Minor side effects include constipation, diarrhea, fatigue, headache, insomnia, muscle pain, nausea, and vomiting. Consult your doctor before taking if pregnant or breastfeeding.
citric acid/sodium citrateCitric acid/sodium bicarbonate is a combination antacid medication used for the temporary relief of upset stomach, including sour stomach, heartburn, and acid indigestion. Use with caution if you are on a sodium-restricted diet. Side effects of citric acid/sodium bicarbonate include gas (flatulence), abdominal bloating, nausea, vomiting, diarrhea, fluid retention, and excessive alkalinity of body fluids (alkalosis). Consult your doctor if pregnant or breastfeeding.
DiarrheaDiarrhea is a change in the frequency and looseness of bowel movements. Symptoms associated with diarrhea are cramping, abdominal pain, and the sensation of rectal urgency. Causes of diarrhea include viral, bacterial, or parasite infection, gastroenteritis, food poisoning, and drugs. Absorbents and anti-motility medications are used to treat diarrhea.
Diverticulitis (Diverticulosis)Most people with diverticulosis have few if any symptoms at all. When people do experience signs and symptoms of diverticulosis (diverticular disease) they may include abdominal pain, abdominal cramps, diarrhea, constipation, and bloating. Diverticulitis is a condition in which diverticula in the colon rupture. The rupture results in infection in the tissues that surround the colon. Treatment methods for diverticulitis include prescription medications, and in some cases, diverticulitis surgery.
famotidineFamotidine is a drug prescribed for the treatment of stomach and duodenal ulcers, heartburn, esophagitis, GERD, and Zollinger-Ellison syndrome. The most commonly reported minor side effects of famotidine are constipation, diarrhea, fatigue, headache, insomnia, muscle pain, nausea, and vomiting. Other important side effects include anemia, confusion, easy bruising or bleeding, hair loss, and rash. Consult with your doctor if pregnant or breastfeeding.
Intestinal Gas and Gas PainIntestinal gas and painful bloating are common. Learn about what causes gas pain and how eliminating certain foods from your diet can help relieve symptoms.
magaldrateMagaldrate is an over-the-counter medication commonly used to treat gastrointestinal (GI) issues from acidity including heartburn, acid indigestion, gastroesophageal reflux, gastric and duodenal ulcers. Common side effects of magaldrate include chalky taste, stomach cramps, fecal discoloration, constipation, fecal impaction, nausea, vomiting, osteomalacia, aluminum intoxication (hyperaluminemia), hypophosphatemia, hypermagnesemia, and diarrhea.
omeprazoleOmeprazole, omeprazole/sodium bicarbonate is a proton pump inhibitor drug (PPI) prescribed for the treatment of ulcers, gastroesophageal reflux disease (GERD), Zollinger-Ellison syndrome, duodenitis, erosive esophagitis, heartburn, and H. pylori infection. Side effects, drug interactions, warnings and precautions, and patient information should always be reviewed prior to taking any medication.
Proton Pump Inhibitors (PPIs)Proton pump inhibitors (PPIs) reduce the production of acid in the wall of the stomach (that produces acid) thereby preventing ulcers and assists in the healing of ulcers that exist on the esophagus, stomach, or duodenum. PPIs are prescribed for the prevention and treatment for acid-related conditions such as GERD (gastroesophageal reflux disease), ulcers, and Zollinger-Ellison syndrome. PPIs may also be used in combination with antibiotics for the treatment of Helicobacter pylori.