Acid Reflux / GERD

Overview

Gastro-oesophageal reflux disease (GERD) is a condition in which stomach acid repeatedly flows back into the food pipe, causing heartburn, regurgitation and other symptoms, and sometimes inflaming the lining of the food pipe. Unlike occasional acidity, GERD is a recurring condition that often needs regular treatment and lifestyle change. This is the condition-focused page; the symptom of burning itself is covered on the Acidity and Heartburn page, which links here.

Symptoms

• Heartburn — burning behind the chest bone, often after meals or when lying down.
• Regurgitation — acid or food coming back into the mouth or throat.
• A sour or bitter taste, especially in the morning.
• A sensation of a lump in the throat or frequent throat clearing.
• Chronic cough or worsening of asthma, which reflux can trigger.
• Disturbed sleep due to night-time reflux.

Causes and risk factors

• A weakened lower oesophageal sphincter — the valve that should stop acid flowing back.
• Being overweight or obese, which increases pressure on the stomach.
• Hiatus hernia, where part of the stomach pushes up through the diaphragm.
• Smoking, alcohol, and excess tea or coffee.
• Large, fatty or late meals, and lying down soon after eating.
• Pregnancy.

Possible complications

When untreated over years, GERD can inflame the food pipe (oesophagitis), cause narrowing that makes swallowing difficult, or lead to changes in the lining called Barrett’s oesophagus, which carries a small increased risk of oesophageal cancer. Recognising and treating GERD properly reduces these risks.

Diagnosis

Diagnosis is often made from the history and the response to a trial of acid-suppressing medicine. An upper gastrointestinal endoscopy is arranged when symptoms are persistent, severe, or accompanied by warning features such as difficulty swallowing, weight loss or bleeding — to check for inflammation, ulcers, hiatus hernia or Barrett’s changes. In selected cases, pH monitoring or manometry may be used.

Treatment and management

Treatment combines lifestyle measures and medicines. Lifestyle measures include weight loss, avoiding trigger foods, smaller meals, not lying down for two to three hours after eating, and raising the head of the bed. Medicines include acid-suppressing drugs (proton-pump inhibitors and H2 blockers) and, where appropriate, prokinetics. Most people respond well; long-term treatment is tailored to symptom control and reviewed regularly. Surgery is rarely needed and reserved for carefully selected cases.

Diet and lifestyle

• Eat smaller, regular meals; avoid overeating.
• Limit spicy, fried and fatty food, chocolate, mint, tea, coffee, colas and alcohol.
• Avoid lying down for two to three hours after meals; raise the head of the bed.
• Maintain a healthy weight; avoid smoking.
• Identify and avoid your personal trigger foods.

Warning signs — seek prompt care

• Difficulty or pain on swallowing, or food getting stuck.
• Vomiting blood or coffee-ground material.
• Black, tarry stools.
• Unintended weight loss.
• Chest pain that may be cardiac rather than acid-related — emergency.

How we help

Dr. Nayak confirms GERD, arranges endoscopy when indicated, and builds a combined lifestyle-and-medicine plan with regular review. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Acidity and Heartburn
• Indigestion / Dyspepsia
• Gastritis
• Peptic Ulcer Disease
• Obesity & Weight Management
• Abnormal Test Results