Gastroesophageal reflux disease (GERD) is when the contents of your stomach persistently move back up into your esophagus. These contents sometimes contain excessive acid and may cause irritation and pain.

Many people may experience acid reflux, indigestion, or heartburn from time to time. However, if you experience acid reflux symptoms more than twice per week, you may have gastroesophageal reflux disease (GERD).

GERD affects about 20% of people in the United States. If left untreated, it may lead to serious complications.

Read on to learn more about the symptoms, causes, and treatments for GERD.

The most common symptom of GERD is persistent heartburn, which may involve:

  • a burning feeling in your stomach that may rise to your chest, neck, and throat
  • a sour or bitter taste at the back of your mouth
  • regurgitation of food or liquid from your stomach into your mouth

Other possible symptoms of GERD include:

  • a feeling of fullness or of a lump in the back of your throat (globus sensation)
  • chronic cough
  • a hoarse voice
  • bad breath

In some cases, people may experience alarm symptoms associated with GERD. These are typically persistent and could progressively worsen despite medical treatment. Alarm symptoms may also indicate an underlying condition.

Alarm symptoms may include:

If you’re experiencing any of these, get medical attention.

Heartburn or heart attack?

Heartburn and heart attacks are two common causes of chest pain. However, their causes and sensations are typically different:

  • Heartburn may occur when acidic contents of your stomach move back up into your esophagus. This may cause a burning sensation that rises from your stomach and radiates into your chest.
  • Heart attack is when your heart doesn’t get enough blood and oxygen due to a reduced flow of blood in one or more major arteries. This may cause sudden, uncomfortable, or sharp pain in the center or left side of your chest that feels like pressure or squeezing. It could spread to your neck, jaw, and shoulder too.

If you’re feeling any heart attack symptoms, such as shortness of breath or faintness, get medical assistance immediately.

Symptoms in infants

It’s normal for babies to sometimes spit up food or vomit. But if your baby is frequently spitting or vomiting, they may have GERD.

Other signs and symptoms of GERD in infants might include:

  • refusal to eat
  • trouble swallowing
  • gagging or choking
  • wet burps or hiccups
  • irritability or arching of the back during or after feeding
  • weight loss or poor growth
  • recurring cough or pneumonia
  • difficulty sleeping

If you suspect that your baby might have GERD or another health condition, speak with a doctor.

GERD commonly causes acid reflux, which may result from improper functioning of the lower esophageal sphincter (LES).

The LES is a circular band of muscle at the end of your esophagus. When you swallow, it relaxes and opens up to allow food and liquid to travel from your mouth to your stomach. Then, it tightens and closes again.

Acid reflux happens when your LES doesn’t tighten or close properly. This allows digestive juices and other contents of your stomach to rise up into your esophagus.

Your LES may not function properly if you:

  • Have a hiatal hernia: This occurs when part of your stomach moves above your diaphragm toward your chest. If your diaphragm is compromised, it may prevent your LES from functioning properly.
  • Frequently eat large meals: This may cause distension of the upper part of your stomach. This distension sometimes means there isn’t enough pressure on the LES, and it doesn’t close properly.
  • Lie down too soon after meals: This might not create enough pressure for the LES to function properly.

Other factors, including those listed below, may also contribute to having heartburn more than twice a week.

Lifestyle factors

Lifestyle factors that may contribute to persistent reflux with esophageal inflammation include:

Health factors

Health factors such as the following may contribute to GERD:

Other conditions

Other health conditions that can worsen the symptoms of GERD include:

Alcohol

Studies suggest that drinking alcohol may increase the risk of GERD. The greater the quantity of alcohol and frequency of consumption, the greater the correlation.

If you’ve received a diagnosis of GERD, limiting or stopping alcohol intake may provide symptom relief.

Dietary triggers

Some foods may trigger GERD symptoms more than others, including:

  • high fat foods such as fried and fast foods
  • spicy foods
  • certain fruits and vegetables, such as pineapple, tomato, and citrus
  • certain liquids, such as coffee, tea, and carbonated drinks

A doctor will typically take your medical history and perform a physical examination to assess your symptoms.

If you’re experiencing alarm symptoms, such as chest pain or trouble swallowing, they may refer you to a gastroenterologist or request certain tests, including:

  • Ambulatory 24-hour pH probe: A small tube is inserted through your nose into your esophagus. A pH sensor at the tip of the tube measures how much acid exposure your esophagus is getting and sends the data to a portable computer. You wear this tube for about 24 hours.
  • Esophagram: After you drink a barium solution, healthcare professionals use X-ray imaging to examine your upper digestive tract.
  • Upper endoscopy: A flexible tube with a tiny camera is threaded into your esophagus to examine it and collect a tissue sample (biopsy) if needed.
  • Esophageal manometry: A flexible tube is passed through your nose into your esophagus to measure the strength of your esophageal muscles.
  • Esophageal pH monitoring: A monitor is inserted into your esophagus to help healthcare professionals find out how acid is regulated in your body over a few days.

After arriving at a diagnosis, your doctor will speak with you to decide what treatment plan will work best for you.

Lifestyle strategies

To manage and relieve symptoms of GERD, certain home remedies and lifestyle habits may help, including:

  • breathing exercises
  • consuming foods and liquids that may help with your acid reflux
  • making efforts to maintain a moderate weight
  • quitting smoking, if you smoke
  • avoiding eating big, heavy meals in the evening
  • waiting 2–3 hours after eating to lie down
  • elevating your head during sleep

Medication

If lifestyle strategies alone don’t help treat GERD, a doctor might prescribe medications to decrease your stomach acid secretion, since acid reflux is a common manifestation of GERD.

These may include:

Consult a doctor before taking medications because they may have negative side effects.

Surgery

In most cases, lifestyle strategies and medications are enough to prevent and relieve symptoms of GERD.

However, a doctor might recommend surgery if these approaches haven’t stopped your symptoms or if you’ve developed complications.

Possible surgery options include:

For most people, GERD doesn’t cause serious complications.

However, in rare cases, it may lead to serious or life threatening health problems such as:

  • esophagitis, which is inflammation of your esophagus
  • esophageal stricture, which happens when your esophagus narrows or tightens
  • Barrett’s esophagus, which involves permanent changes to the lining of your esophagus
  • esophageal cancer, which affects a small portion of people with Barrett’s esophagus
  • tooth enamel erosion, gum disease, or other dental problems

To lower your chances of complications, it’s important to take the steps to prevent, manage, and treat symptoms of GERD.

How do you know if you have GERD?

Only a healthcare professional may provide an accurate GERD diagnosis. If you’re experiencing acid reflux symptoms or indigestion more than twice per week, you may have GERD. A healthcare professional may want to assess your symptoms, perform a physical exam, and consider your medical history to rule out other possible causes.

What are the 8 symptoms of GERD?

Not everyone experiences the same symptoms of GERD or with the same intensity. Also, there’s not a specific number of symptoms of the condition. The most common GERD symptom is persistent acid reflux, which may involve a burning feeling in your upper stomach, chest, or throat, a sour or bitter taste in your mouth, and regurgitation of food or liquid back into your mouth. Chronic cough, a hoarse voice, nausea, pain swallowing, and weight loss may also be symptoms of GERD.

What can be mistaken as GERD?

Other conditions may cause symptoms similar to those of GERD. For example, peptic ulcers, esophagitis (inflammation of the food pipe), gallstones, anxiety, hiatal hernias, and esophageal cancer. A healthcare professional can help you explore possible causes of acid reflux and related symptoms.

What are the four stages of GERD?

GERD may start as mild and infrequent symptoms (stage 1) and progress to moderate symptoms that present at least twice per week (stage 2). Unmanaged GERD could advance to habitual and severe acid reflux symptoms with a persistent cough and changes to your voice (stage 3). Although rare, some people may enter a fourth stage with severe symptoms that turn into precancerous lesions in the esophagus (food pipe) and throat.

What is the fastest way to cure GERD?

Following the advice of a healthcare professional may help you heal GERD permanently or manage symptoms. Strategies may include dietary changes, medications, and lifestyle modifications. For example, avoiding trigger foods and liquids, managing your weight, not using tobacco, limiting alcohol intake, and waiting 2–3 hours after eating to lie down. If these don’t help, you may need surgery.

If you experience heartburn every so often, you’re not alone. Lifestyle changes and over-the-counter medications are usually enough to address these occasional instances.

But if you’re experiencing heartburn more than twice per week and small lifestyle changes are not helping, you may be dealing with GERD.

If you’ve received a diagnosis of GERD, your doctor will help you find a treatment plan that works for you.

Don’t let persistent heartburn get in the way of living your life. Talk with a doctor if you believe you may have symptoms of GERD.