GERD: Meaning, Symptoms, and Causes

What is GERD?

Gastroesophageal Reflux Disease (GERD) is a chronic condition where stomach acid flows back into the esophagus, causing irritation and inflammation. GERD is a common condition affecting millions worldwide.

Causes of GERD

The main cause is a weakened lower esophageal sphincter (LES), a crucial muscle ring that acts as a barrier between the esophagus and stomach.

Normally, the LES opens when you swallow to allow food into the stomach and contracts to prevent stomach acid from refluxing.

In GERD, the LES relaxes inappropriately or is weak, allowing stomach acid to flow back into the esophagus, causing related symptoms.

GERD vs Acid Reflux

GERD and acid reflux are related but not identical. GERD is a chronic, more severe form of acid reflux with persistent symptoms.

GERD vs Heartburn

Heartburn is an uncomfortable burning sensation in the chest behind the breastbone, which may extend to the throat, caused by stomach acid reflux.

GERD encompasses broader symptoms and potential complications beyond persistent acid reflux and heartburn.

Risk Factors for GERD

Factors affecting the LES and increasing GERD risk include:

• Obesity: Excess abdominal pressure can push stomach acid into the esophagus.
• Hiatal hernia: Part of the stomach protrudes through the diaphragm, weakening the LES and allowing easier acid reflux.
• Dietary choices: Spicy, fatty foods, chocolate, caffeine, alcohol, and acidic foods can trigger GERD symptoms in some people.
• Pregnancy: Hormonal changes and pressure from a growing uterus may contribute to GERD symptoms.

Symptoms of GERD

Symptoms vary but commonly include:

• Heartburn
• Acid regurgitation: sour or bitter taste rising into the throat or mouth, especially after meals or when lying down
• Chest pain
• Difficulty swallowing
• Chronic cough
• Hoarseness
• Feeling of a lump in the throat
• Bad breath

How is GERD Diagnosed?

Diagnosis involves medical history, physical examination, and investigations:

• Upper GI endoscopy: A flexible tube with a camera examines the esophagus and stomach lining; biopsies may check for damage or infection.
• Prolonged esophageal pH study: Measures the severity of acid reflux using a sensor tube through the nose or a wireless sensor during endoscopy for 24 hours.

GERD Treatment

Lifestyle Modifications

• Diet changes: Avoid trigger foods and drinks (spicy, fatty, citrus, tomato, chocolate, caffeine, alcohol, carbonated beverages).
• Eating habits: Eat smaller, frequent meals; avoid lying down or bending immediately after meals; elevate the head of the bed.
• Weight loss: Reducing excess weight helps relieve stomach pressure and reflux.
• Quit smoking: Improves symptoms and reduces complication risk.

Medications

Mild symptoms:

• Antacids (e.g., Gaviscon) neutralize stomach acid for short-term relief.
• Histamine receptor antagonists (e.g., cimetidine, famotidine) reduce acid production with longer-lasting effects.

Moderate to severe symptoms:

• Proton pump inhibitors (PPIs, e.g., omeprazole, pantoprazole) effectively reduce stomach acid. Some PPIs are OTC; higher doses require a prescription.

Surgery

Severe GERD not responding to lifestyle changes or medications, or with complications (hiatal hernia, esophageal stricture, Barrett’s esophagus), may require surgical intervention such as fundoplication.

Is GERD Serious?

Untreated GERD can lead to serious complications. Chronic acid exposure may cause esophagitis, Barrett’s esophagus, and increase esophageal cancer risk. Persistent symptoms require prompt medical attention.

Some cases are temporary and managed with lifestyle changes or medication, while others require long-term treatment. Even with daily medication, symptoms may persist for many.

Preventing GERD

Prevent acid reflux through lifestyle and dietary adjustments.

Foods to Avoid

• Spicy foods
• Citrus fruits and juices
• Tomatoes and tomato products
• Chocolate
• Mint
• Fried and fatty foods
• Carbonated beverages
• Caffeine
• Alcohol

Lifestyle Changes

• Maintain a healthy weight to reduce stomach pressure.
• Eat smaller, more frequent, balanced meals to avoid overeating.
• Avoid late meals; allow at least three hours between the last meal and bedtime.
• Sleep on your left side to help move stomach contents away from the esophagus.
• Quit smoking to strengthen the LES and reduce reflux episodes.
• Manage stress through meditation, yoga, or deep breathing exercises.

Schedule an Appointment at Pantai Hospital

GERD is a chronic condition that can significantly affect your quality of life. If you suspect GERD, contact us to schedule a consultation or visit our Gastroenterology team at the nearest Pantai Hospital.

Pantai Hospital is accredited by the Malaysian Society for Quality in Health (MSQH) for commitment to patient safety and service quality.