At some point or another, many people will experience what is often referred to as ‘heartburn’, which can be a symptom of gastroesophageal reflux disease. You begin to feel a burning sensation in the centre of your chest which can radiate up your throat, even leaving a bitter or sour taste in your mouth. It can last a few minutes to a few hours, and usually happens after eating (especially if you lay down right away). Heartburn is usually a symptom of acid reflux, which is a backflow of stomach acid up and into the esophagus (Kashyap, 2019).
Gastroesophageal reflux disease is frequent and severe acid reflux, occurring more than two times a week. The word ‘gastroesophageal’ means that the stomach and food pipe (the esophagus) are connected. The passage between the esophagus and the stomach is closed most of the time – it only opens when chewed food, saliva, and fluids arrive. Once the contents have passed into the stomach, ensuring that the contents of the stomach don’t flow back.
If the stomach is significantly stretched (which can occur after a large meal) the circular muscle at the entrance of the stomach (the lower esophageal sphincter) might loosen temporarily. This can allow gas and stomach contents to leak up into the esophagus. This leakage is even more likely to occur if the person is laying down horizontally, as the contents of the stomach need only move sideways to exit the stomach, instead of up. The digestive fluids from the stomach irritate the lining of the esophagus, causing heartburn. If the juices remain for some time, inflammation and further pain will occur along the esophagus (IQWiG, 2012).
For some, stomach contents regularly leak into their esophagus, or it may happen in large amounts. This is when a diagnosis of GERD is often made – frequent or severe heartburn or acid reflux that affects the quality of life or has caused inflammation of the esophagus. While heartburn is the main symptom of GERD, another common symptom is difficulty swallowing. Other signs and symptoms can include regurgitation of food or sour liquid, coughing, wheezing, a husky or hoarse voice, nausea, a feeling of being too full, and chest pain — especially while lying down at night (Kashyap, 2019).
Having heartburn occasionally after a large (or a heavily fried or spicy) meal is fairly normal and shouldn’t be cause for concern. This can usually be eased with a simple over-the-counter antacid. If the heartburn occurs more frequently, or isn’t relieved by over-the-counter medication, it’s time to see a doctor.
You should also see a doctor if you have symptoms that could be related to GERD complications or other serious health problems, such as
Your doctor will often diagnose GERD by reviewing both your symptoms and medical history. If the symptoms suggest GERD, they may recommend medicine or lifestyle changes. However, if your symptoms indicate you might have complications resulting from GERD, or symptoms don’t improve after treatment with medicine and lifestyle changes, they may recommend additional medical testing. They may also refer you to a gastroenterologist for further diagnosis and treatment (NIDDK, n.d.).
Your lower esophageal sphincter generally prevents the backflow of stomach contents into the esophagus, but most people experience acid reflux and heartburn occasionally. GERD may develop if the sphincter becomes weak or begins to relax when it shouldn’t. Some medications, such as benzodiazepines and sedatives that make you calm or sleepy, may cause GERD or make GERD symptoms worse. Certain asthma medications and tricyclic antidepressants may have the same effect.
A hiatal hernia can also increase the chance of getting GERD or make GERD symptoms worse. A hiatal hernia is a condition in which the opening in your diaphragm lets the upper part of the stomach move up into your chest (Weatherspoon, 2019).
Treatment options for GERD vary’s depending on the severity in each patient. Your doctor may recommend that you make lifestyle changes and take medicines to manage symptoms of gastroesophageal reflux disease if the symptoms are not severe. In some cases, doctors may also recommend surgery, especially if there may be indications of further complications (NIDDK, n.d.)
A change in lifestyle can often reduce symptoms or get rid of them completely. Your doctor may recommend:
Over-the-counter GERD medications can often help, but if symptoms persist, your doctor may prescribe further medications.
Your doctor may recommend surgery if your GERD symptoms don’t improve with lifestyle changes and medicines, or if you wish to stop taking long-term GERD medicines to manage symptoms. You’re more likely to develop complications from surgery than from medicines.
In infants, GERD is a less common, more serious form of spitting up. Children and adolescents may be diagnosed with GERD if they show symptoms and experience other complications. The potential complications of GERD include respiratory problems, difficulty gaining weight, and inflammation of the esophagus, or esophagitis.
The symptoms of childhood GERD are more serious than the occasional stomachache or infrequent act of spitting up. GERD may be present in infants and preschool children if they are:
GERD may be present in older children and adolescents if they have symptoms similar to what an adult with GERD may experience, as described above.
Researchers aren’t always exactly sure what causes GERD in young people. Several factors may be involved, including:
Some children may also have weak valves that are particularly sensitive to certain foods and beverages or inflammation in the esophagus that’s causing the problem (Story, 2012).
Certain conditions can greatly increase your risk of developing GERD, such as obesity, pregnancy, hiatal hernia, and connective tissue disorders.
Lifestyle behaviours can also raise the risk of developing GERD, such as:
When left untreated, GERD can lead to serious complications, including:
There are several lifestyle changes and home remedies that may help relieve GERD symptoms. For example, it might help to:
In some people, certain types of foods and beverages trigger symptoms of GERD. Common dietary triggers include:
In some people with gastroesophageal reflux disease, certain foods and drinks can make the symptoms worse. Those dietary triggers can include alcoholic beverages. Depending on your specific triggers, you might be able to drink alcohol in moderation. But for some people, even small amounts of alcohol trigger symptoms of GERD. If you combine alcohol with fruit juices or other mixers, those mixers might also trigger symptoms.
Th best way to avoid alcohol-based complications is simply to avoid alcohol completely. Speak with your doctor is the idea of abstaining from alcohol seems challenging or worrisome (Nall, 2017).
Heartburn is a common symptom of acid reflux. Most people experience it from time to time, and in general, occasional heartburn isn’t a cause for concern. But if you get heartburn more than twice a week, you might have GERD. GERD is a chronic type of acid reflux that can cause complications if left untreated (Kinman, 2020).
Barrett’s esophagus is a condition in which the cells that make up your esophagus begin to look like the cells that make up your intestines. This often happens when cells are damaged by exposure to acid from the stomach. This condition often develops after years of experiencing GERD. In some cases, Barrett’s esophagus can develop into esophageal cancer.
The exact cause of Barrett’s esophagus is not yet known. However, the condition is most often seen in people with GERD. It’s believed that the cells in the esophagus can become abnormal with long-term exposure to stomach acid. Barrett’s esophagus can develop without GERD, but patients with GERD are 3 to 5 times more likely to develop Barrett’s esophagus.
Approximately 5 to 10 percent of people with GERD develop Barrett’s esophagus. It affects men almost twice as often as women and is usually diagnosed after the age of 55 (Wint, 2018).
Clarrett, D. 2019. Gastroesophageal Reflux Disease (GERD). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140167/
IQWiG. 2012. Heartburn and GERD: Overview. https://www.ncbi.nlm.nih.gov/books/NBK279254/
Kashyap, P. 2019. Is acid reflux the same as GERD? https://www.mayoclinic.org/diseases-conditions/heartburn/expert-answers/heartburn-gerd/faq-20057894
Kinman, T. 2020. What Are the Differences Between Heartburn, Acid Reflux, and GERD? https://www.healthline.com/health/gerd/heartburn-vs-acid-reflux
Nall, R. 2017. Best Alcoholic Beverages for People with GERD. https://www.healthline.com/health/gerd/alcohol
NIDDK, n.d. Diagnosis of GER & GERD. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/diagnosis
NIDDK, n.d. Symptoms & Causes of GER & GERD. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/symptoms-causes
NIDDK, n.d. Treatment for GER & GERD. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/treatment
Story, C. 2012. Gastroesophageal Reflux Disease (GERD) in Children. https://www.healthline.com/health/gerd/children
Weatherspoon, D. 2019. Everything You Need to Know About Acid Reflux and GERD. https://www.healthline.com/health/gerd
Wint, C. 2018. Barrett’s Esophagus. https://www.healthline.com/health/barretts-esophagus