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Gastroesophageal Reflux Disease (GERD): Causes, Symptoms, Diagnosis, and Treatment

August 22nd, 2023 | 4 min. read

By Michael P Underbrink, MD

GERD Symptoms diagnosis and treatment

GERD is a common condition, impacting as many as 20% of the world's western culture, especially Canada, Europe, New Zealand, Australia, and the United States. GERD can be chronic, leading to damage to the esophagus. That's why diagnosis and treatment for GERD is essential. 

What is GERD?

GERD stands for Gastroesophageal Reflux Disease. It's a digestive disorder where stomach acid moves back into the esophagus, causing heartburn.

Even though it is common for many people to experience acid reflux from time to time, when it occurs repeatedly, it may cause GERD.

Most people can manage GERD symptoms by changing their lifestyle, using home remedies and over-the-counter medications. Although rare, extreme cases of GERD may require surgery to ease the symptoms.

Schedule an appointment for your GERD evaluation at our Memorial City location today!




What causes GERD?

Usually, when you eat, a muscle at the end of the esophagus, also known as the lower esophageal sphincter (LES), prevents swallowed food from moving back up. GERD happens when the muscles do not close properly.

The stomach acids then move back up to the esophagus causing GERD symptoms.

The following can worsen the symptoms of GERD in people.

  • Obesity

  • Alcohol use

  • Smoking or tobacco use

  • Pregnancy

  • Scleroderma

  • Lying down within three hours of eating

  • Hiatal hernia, a condition where a part of the stomach moves above the diaphragm

The use of certain medications can also cause heartburn and other symptoms of GERD:

  • Beta-blockers for high blood pressure and heart disease

  • Bronchodilators for asthma and other lung disease

  • Dopamine active medicine for Parkinson's disease

  • Sedatives used for insomnia or anxiety

What are the symptoms of GERD?

Common symptoms include persistent heartburn that involves:

  • A sour or bitter taste at the back of your mouth

  • A burning feeling in the stomach that may spread to the chest, throat, and neck

  • Regurgitation of liquid and food from the stomach to the mouth

Other common symptoms of GERD include:

  • Chronic cough

  • A sensation of a lump in the throat

  • Worsening asthma symptoms

  • Difficulty swallowing

  • Chest pain

  • Bad breath

  • Sore throat with a feeling of irritation in the esophagus

  • Nausea and vomiting

You need to make a doctor’s appointment if:

  • You experience severe symptoms of GERD

  • You take over-the-counter medications for GERD more than twice a week

How is GERD diagnosed?

Your doctor will consider your symptoms and medical history to determine if you have simple acid reflux or chronic GERD. Depending on your symptoms, your doctor may recommend certain diagnostic tests.

Upper gastrointestinal endoscopy and biopsy: Your doctor uses an endoscope, a long tube with lights attached, to look into the esophagus. They can cut tissues from the esophagus (biopsy) to examine for GERD.

Barium esophragm:  Barium esophragm or barium contrast radiography is a standard procedure to diagnose GERD. It involves taking an X-ray of the esophagus after swallowing a barium solution. The barium coats the gastrointestinal tract and esophagus, helping the doctor detect abnormalities.

Ambulatory acid probe tests: The tests measure the pH levels in the esophagus. Your provider inserts a thin tube (catheter) or pH probe into your esophagus. The probe then monitors the pH level in the esophagus for 24 to 48 hours as you follow the normal pattern of eating and resting.

Esophageal manometry: Manometry tests determine how efficiently the esophageal muscles move food from the esophagus to the stomach. Your doctor will insert a small tube with sensors into your nose. The sensor will measure the strength of the esophageal sphincter and muscles as you swallow.

How is GERD different from occasional heartburn?

One of the primary symptoms of GERD is heartburn or acid indigestion. It appears as a burning chest pain that begins behind the chest bone and spreads toward the neck and throat. It can accompany the regurgitation of food from the stomach, leaving an acidic or bitter taste in the mouth.

While occasional heartburn is common and can happen to anyone, GERD is a chronic condition. If you experience heartburn more than twice a week, it could be GERD.

What foods and drinks should be avoided if you have GERD?

Common triggers include spicy foods, citrus fruits, tomatoes, chocolate, mint, garlic, onions, fatty foods, caffeine, and carbonated drinks. Alcohol, in general, can also exacerbate GERD symptoms.

How is GERD treated?

The primary goal of GERD treatments is to prevent or reduce acid reflux and lessen the damage the acid causes to the esophagus lining. Your doctor may prescribe over-the-counter antacids or other prescription medicines to treat GERD.

  • Antacids: The medicine can neutralize the acids in the esophagus, relieving heartburn and acid reflux symptoms. Over-the-counter antacids may provide temporary or permanent relief. For best results, antacids are often combined with a foaming agent, the compounds forming a foam barrier stopping acid reflux.
  • H2 blockers: In chronic acid reflux, H2 blockers help block acid secretion in the stomach.

  • Proton pump inhibitors: Also known as acid pumps, the drugs block proteins that make stomach acid.

  • Prokinetics: The medicines help empty the stomach faster so that you don’t have much acid left behind.

In severe cases, surgery might be recommended.

Can GERD lead to more serious conditions?

If left untreated, chronic inflammation can lead to:

  • Esophageal ulcers or esophagitis: Stomach acid can cause the breakdown of the esophageal tissues causing inflammation, bleeding, and sometimes an open sore or ulcer. Esophagitis can cause pain and difficulty in swallowing.
  • Esophageal strictures: The reflux of stomach acid can damage the lower esophagus causing the formation of scar tissues. The scar tissues narrow the esophagus causing difficulty in swallowing.
  • Barrett's esophagus:  Damage from stomach acid can alter the tissues lining the lower esophagus, increasing the esophageal cancer risk in people.

How can I manage GERD symptoms at home?

Your doctor may suggest certain dietary and lifestyle changes to manage GERD symptoms. This includes:

  • Eating smaller meals-People with GERD must eat smaller meals. 

  • Avoid lying down immediately after eating: eating at least two to three hours before bedtime allows the stomach acid to settle before sleeping, reducing acid reflux.

  • Elevating your head while sleeping: Elevating the head of the bed at least six inches can allow gravity to prevent the reflux of stomach acids into the esophagus, managing GERD.

  • Avoiding food and beverages that can trigger GERD symptoms: Foods like chocolates, fatty food, caffeine, peppermint, and alcoholic beverages can relax the lower esophageal sphincter causing acid reflux. Food like citrus fruits, tomato products, and pepper can irritate a damaged esophageal lining aggravating GERD.

  • Maintaining a healthy weight: Being overweight can worsen GERD symptoms. Maintaining a stable weight can help control acid reflux. 

  • Wearing loose, breathable clothes: Tight-fitted clothes can squeeze the belly, putting pressure on the lower abdomen.

  • Acupuncture: Treatments using acupuncture can lower acid reflux symptoms and help manage GERD for a prolonged period.

Is GERD a lifelong condition?

For many people, GERD is a chronic condition. However, symptoms can often be managed with medication and lifestyle changes. Some people might find relief from surgical treatments.

Schedule an appointment to evaluate and treat GERD with Houston ENT & Allergy.

Although it is normal for people to experience acid reflux symptoms like heartburn from time to time, severe GERD symptoms can have serious complications if left untreated.

If you are experiencing consistent heartburn and other GERD symptoms, request an appointment with one of our doctors at Houston ENT immediately.

Our ENT specialists are committed to understanding your specific concerns and offering tailor-made treatments for a complete recovery.

Schedule an appointment here or call us at (281) 649-7000.  We have 9 convenient locations in the Houston area. 


Michael P Underbrink, MD