Gastroesophageal Reflux Disease (GERD) - Causes, Treatment


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GERD or Gastroesophageal Reflux Disease is a common, chronic condition that affects the muscle ring between the oesophagus and the stomach. It is a condition in which stomach acid repeatedly flows back into the mouth through the oesophagus. Patients with GERD may experience acid indigestion, heartburn, trouble swallowing, etc. If left untreated, it may sometimes cause serious complications. 

While GERD can cause some uncomfortable symptoms, there are several effective treatment options to manage the condition. Continue reading to learn GERD’s full form, meaning, symptoms, causes, diagnosis, treatment, and other important details. 

Disease Name GERD
Alernative Name Gastroesophageal reflux disease
Symptoms Vomiting, Breathing difficulties, Chest pain, Nausea, Bad breath etc
Causes Acid reflux, Hiatal Hernia, Frequently eating large meals, Lying down soon after large meals
Diagnosis Upper endoscopy, Ambulatory 24-hour pH probe, Bravo wireless oesophageal pH monitoring

Treated by

Treatment options

Medications, Fundoplication, Transoral Incisionless Fundoplication etc

What is GERD?

Many people experience acid reflux, a condition in which the contents of their stomach move back into their oesophagus. This action of stomach contents returning to the oesophagus is known as acid regurgitation or gastroesophageal reflux. When the symptoms of acid reflux are experienced more than twice a week, the condition is known as Gastroesophageal Reflux Disease (GERD). In short, GERD is a chronic condition more severe than acid reflux.

Stages of GERD

Gastroesophageal Reflux Disease occurs in stages. The stage of GERD is determined by the symptoms a person experiences. The four stages of GERD are as follows:

  1. Stage 1: Mild GERD: The patient experiences mild symptoms like infrequent heartburn and regurgitation once or twice a month. 
  2. Stage 2: Moderate GERD: The patient experiences heartburn or regurgitation a few times a week. Untreated GERD symptoms in this stage can affect the patient’s daily activities. 
  3. Stage 3: Severe GERD: The patient experiences regular heartburn, regurgitation, a chronic cough, a hoarse voice, and oesophageal inflammation. The quality of life is substantially lower in this stage. 
  4. Stage 4: Oesophageal Cancer or Precancerous Lesions: Stage 4 results from several years of untreated severe GERD. Patients in this stage experience similar symptoms as stage 3, in addition to food getting stuck in the back of their throats while eating.
    1. About 10% of patients with unmanaged reflux advance to this stage and develop a precancerous condition called Barrett’s oesophagus. It may lead to cancer if left untreated.   

GERD Symptoms

The primary symptoms of GERD are acid regurgitation and persistent heartburn. Heartburn feels like an uncomfortable burning in the chest, which can move up into the neck and throat. Other GERD symptoms may include:

  1. A bitter or sour taste at the back of the mouth
  2. Nausea
  3. Chest pain
  4. Hoarseness in the morning
  5. Trouble swallowing
  6. Pain when swallowing
  7. Feels like a lump in the throat
  8. Bad breath

People who have acid reflux at night may experience the following symptoms:

  1. Chronic cough
  2. Laryngitis (inflammation of the vocal cords)
  3. New or worsening asthma
  4. Sleep problems

Infants and children may experience similar GERD symptoms. In addition, they may experience the following:

  1. Recurring small vomiting episodes
  2. Excessive crying and refusal to eat
  3. Breathing difficulties
  4. A feeling of choking may wake up the child
  5. Wet burps or hiccups
  6. Weight loss or poor growth
  7. Difficulty sleeping after eating

GERD Causes and Risk Factors

GERD is caused by frequent acid reflux that results from the relaxation or weakness of the lower oesophageal sphincter (a circular band of muscle around the bottom of the oesophagus). Normally, this valve closes tightly after food and liquid flow into the stomach.

However, if the valve weakens or does not relax as it should, the stomach contents can flow back into the oesophagus. The regular backwash of acid can irritate the oesophagus lining, causing it to become inflamed. 

Other possible causes of GERD include:

  1. Hiatal Hernia: It is a condition in which a part of the stomach bulges above the diaphragm towards the chest area, getting in the way of normal food intake.
  2. Frequently eating large meals: Large meals can cause distension of the upper stomach, decreasing pressure on the sphincter. As a result, it does not close properly. 
  3. Lying down soon after large meals: This also decreases the pressure on the sphincter. 

Certain health factors and lifestyle choices can increase the risk of GERD. These factors include:

  1. Obesity
  2. Pregnancy
  3. Delayed stomach emptying
  4. Connective tissue disorders, like scleroderma
  5. Smoking 
  6. Eating large meals or late at night
  7. Eating certain types of foods, like deep-fried or fatty foods
  8. Certain beverages, like soda, coffee or alcohol
  9. Certain non-steroidal anti-inflammatory drugs, like aspirin or ibuprofen

Prevention of GERD

Occasional or mild cases of GERD can usually be prevented or treated by adopting a few lifestyle changes. Some tips for GERD treatment at home or to prevent the onset of GERD include:

  1. Maintain a healthy weight.
  2. Quit smoking.
  3. Eat smaller, frequent servings rather than large meals a few times a day.
  4. Eat food slowly and chew properly.
  5. Stay upright for 45 to 60 minutes after eating.
  6. Eat at least three hours before lying down or going to bed.
  7. Reduce fat by decreasing the intake of butter, oil, fatty meats, salad dressings, and full-fat dairy products like cheese and sour cream.
  8. Avoid wearing tight-fitting clothes that put pressure on your abdomen.
  9. Elevate the head of the bed by 6 to 9 inches with the help of wood or cement blocks under the bedpost.
  10. Avoid possible trigger foods and drinks, such as chocolates, caffeine, alcohol, etc. 

How is GERD diagnosed?

The healthcare provider diagnoses GERD based on the patient’s signs and symptoms and a physical examination. They may recommend some other tests to confirm GERD diagnosis or look for complications. These tests include:

  1. Upper endoscopy: The doctor inserts an endoscope (a long tube with a light and camera) down the patient’s throat to look inside the oesophagus and stomach.
    1. An endoscopy can help detect inflammation of the oesophagus. It can also be used to collect a tissue sample (biopsy) to look for other complications. 
  2. Ambulatory 24-hour pH probe: It is generally considered the gold standard for diagnosing GERD. In this test, a small catheter is threaded through the patient’s nose into the oesophagus for 24 hours.
    1. A pH sensor at the tube’s tip measures how long stomach acid regurgitates in the oesophagus. The sensor sends this data to a portable computer the patient wears around their waist or shoulder. 
  3. Bravo wireless oesophageal pH monitoring: The test is similar to an ambulatory pH probe test. Instead of 24 hours, the patient wears the monitoring system for 48 hours. 
  4. Esophogram: X-ray imaging is used to look for problems in the upper digestive tract after drinking a barium solution. 
  5. Oesophageal manometry: During the test, the doctor passes a flexible tube through the patient’s nose into the oesophagus to measure the strength of the oesophageal muscles. The test is used for people who experience difficulty swallowing. 
  6. Transnasal esophagoscopy: The test is used to look for any damage in the oesophagus or stomach with the help of a thin tube and video camera. 

How to Prepare for Doctor Consultation?

For GERD, the patient may be referred to a gastroenterologist (a doctor specialising in the digestive system). While preparing for the consultation, the patient can do the following:

  1. Take a prior appointment.
  2. Be aware of any pre-appointment restrictions.
  3. Write down their signs and symptoms.
  4. Write down their personal and medical information.
  5. Make a list of their medicines, supplements, herbs, and vitamins.

Enlist questions for the doctor. Here’s what the patient can ask the doctor about GERD:

  1. What is the cause of my symptoms?
  2. What tests do I need for diagnosis?
  3. Is my condition chronic?
  4. Can it get worse if left untreated?
  5. How can I prevent progression?
  6. What complications should I look out for?
  7. What treatment options are available?
  8. Is surgery required?
  9. Can it be managed without surgery?
  10. What is the recovery time? 
  11. Do I need to follow any restrictions?

Here’s what the patient can expect from the doctor during the consultation appointment:

  1. When did you begin experiencing these symptoms?
  2. How severe are your symptoms?
  3. Are the symptoms persistent or occasional?
  4. Does anything improve or worsen your symptoms?
  5. Are the symptoms worse after eating or lying down?
  6. Do these symptoms wake you up at night?
  7. Do you experience difficulty swallowing?
  8. Does food ever come up in the back of your throat?
  9. Have you experienced any weight gain or loss?

GERD Treatment

For GERD treatment, the doctor usually recommends trying lifestyle changes and nonprescription medicines first. The doctor may recommend prescription medicines and other treatments if the patient does not get relief within a few weeks. 

GERD Treatment without surgery


Over-the-counter and prescription medicines for GERD include:

  1. Antacids: Antacids can offer quick relief by neutralising stomach acids. 
  2. H-2 Blockers: Histamine (H-2) blockers may reduce acid production from the stomach for up to 12 hours. 
  3. Proton Pump Inhibitors: Stronger than H-2 blockers, these medications block acid production and heal the damaged oesophagus.   


Homoeopathy can be used as a treatment for early-detected cases of GERD with mild to moderate symptoms. It can also be a supportive treatment for patients with chronic GERD who are undergoing other treatments. Some commonly prescribed homoeopathic medicines for GERD include:

  1. Natrum Phosphorica
  2. Robinia
  3. Iris versicolour
  4. Nux Vomica
  5. Lycopodium
  6. Carbo Vegetabilis


Ayurveda defines GERD as “Amlapitta”, i.e., the Pitta dosha (which regulates digestion) develops a sour taste from being burnt. Some common GERD treatments in Ayurveda include:

  1. Pippali: stimulates digestion and balances the Pitta dosha:
  2. Tulsi: relieves flatulence, gas, and hyperacidity.
  3. Elaichi: facilitates digestion, reduces nausea, bloating, and bitter taste in the mouth.
  4. Ash Gourd: decreases acid level in the gut and averts nausea, vomiting, and constipation.
  5. Aloe Vera: neutralises stomach acids, heals peptic ulcers, and eases heartburn.

Please Note: The treatment approach and procedure selection are based on the patient’s health and the doctor’s opinion. 

Yoga and GERD

  1. According to a study, 45.6% of people identify stress as a factor that impacts their GERD symptoms. Another study says that increased stress can cause an increase in acid secretion by the stomach. For years, yoga has proved effective for most people in reducing the body’s stress response.

While yoga for GERD cannot be used as a standalone treatment, it can be a part of the treatment plan. Yoga poses that can help reduce acidity include:

  1. Supta Baddha Konasana (reclining bound angle)
  2. Parsvottanasana (side stretch with upright modification)
  3. Supported Supta Sukhasana (reclined easy cross-legged)
  4. Trikonasana (triangle)
  5. Parivrtta Trikonasana (revolved triangle)
  6. Virabhadrasana 1 (Warrior 1)

GERD Treatment with surgery

GERD is generally managed with medications and lifestyle changes. However, if they don’t work or the patient cannot take medicines for a long period, the doctor may recommend surgery. The surgical options for GERD treatment include:

  1. Fundoplication (or Laparoscopic antireflux surgery): It is a minimally invasive, standard surgical treatment used to treat acid reflux by creating a new sphincter at the bottom of the oesophagus. During the procedure, the surgeon wraps the upper part of the stomach around the lower oesophageal sphincter. This tightens the sphincter to prevent food from refluxing back into the oesophagus. 
  2. Transoral Incisionless Fundoplication (TIF): It is a newer form of surgery that uses an endoscope to wrap the stomach around the lower oesophageal sphincter with polypropylene fasteners. It is less invasive than standard fundoplication and thus offers benefits like no scars and quick recovery. 
  3. LINX device implantation: A LINX device is a ring of magnetic beads wrapped around the junction between the stomach and oesophagus during minimally invasive surgery. These magnets are strong enough to stop reflux but loose enough to let food pass into the stomach. 
  4. Stretta procedure: In this procedure, the doctor puts a small tube down the oesophagus. The tube sends mild radiofrequency heat to the tissue, where the oesophagus joins the stomach to reshape the lower oesophageal sphincter. 

Risks and complication of GERD

GERD is not a dangerous or life-threatening condition. However, long-term GERD or chronic oesophageal inflammation can lead to serious complications, such as:

  1. Oesophagitis (Inflammation of the oesophagus): Stomach acid can cause irritation and inflammation in the lining of the oesophagus. Oesophagitis can cause bleeding, ulcers in the oesophagus, heartburn, chest pain, and trouble swallowing. 
  2. Oesophageal stricture (Narrowing of the oesophagus): Damage to the lining of the oesophagus can sometimes form scar tissues, causing the narrowing of the oesophagus. These strictures can lead to problems with eating, drinking, and swallowing. 
  3. Barrett’s oesophagus (Precancerous changes to the oesophagus): The condition develops in about 10% of people with long-term GERD. Damage from stomach acid can cause changes in the cells in the lining of the lower oesophagus, increasing the risk of oesophageal cancer. 
  4. Oesophageal cancer: It can be divided into two types:
    1. Adenocarcinoma (develops in the lower part of the oesophagus and progresses from Barrett’s oesophagus)
    2. Squamous Cell Carcinoma (begins in the cells that line the upper and middle part of the oesophagus). 

When to See a Doctor?

The patient should call their healthcare professional in the following situations:

  1. Experience severe or frequent GERD symptoms.
  2. The condition is not improving with at-home remedies.
  3. Trouble swallowing or persistent nausea or vomiting.
  4. Over-the-counter medications are not effective.
  5. You have a family history of Barrett's oesophagus or oesophagal cancer.

Diet for GERD

The diet and eating habits of the patient play a key role in managing GERD symptoms. Patients should avoid trigger foods that keep giving them heartburn. Certain food items that may trigger symptoms of GERD include:

  1. Fried foods
  2. Spicy foods
  3. Fatty foods (including dairy products)
  4. Chocolate
  5. Peppermint
  6. Foods with tomato products
  7. Citrus fruits
  8. Garlic and onion
  9. Coffee, alcohol, and carbonated drinks

If a person avoids these foods and still experiences the symptoms of GERD, they must consult a doctor for some other underlying condition that may be causing the symptoms. 


If you experience occasional heartburn due to GERD, you are not alone! While GERD may cause several uncomfortable symptoms, there are effective management strategies to counter the condition. Over-the-counter medications and lifestyle changes can usually cause relief. However, the doctor may recommend prescription medicines or surgery if the condition worsens. 

Consult a professional at HexaHealth if you experience persistent GERD symptoms. Our team of experts can help you diagnose your condition and recommend management strategies like lifestyle and dietary changes. If you google “GERD doctor near me”, you may end up confused with the plethora of online options. But fret not! At HexaHealth, we will help you connect with the best doctors and surgeons as per your needs and requirements. 


What are the myths versus facts about GERD?

  1. Myth: GERD does not affect the quality of life. 
    Fact: GERD can cause several unpleasant symptoms, such as bloating, heartburn, or discomfort, which may be present throughout the day or appear at night while sleeping. Chronic and poorly treated GERD may cause complications like oesophagitis, oesophageal ulcer, and Barrett’s oesophagus. These complications can negatively impact the patient’s physical, emotional, and social functioning.
  2. Myth: GERD is caused by excess acid production. 
    Fact: False! The problem with GERD is not the amount of acid but the place where the acid is created. While the amount of stomach acid in a GERD patient is generally normal, the problem occurs when the stomach contents move backwards into the oesophagus. This can happen due to various reasons. 
  3. Myth: GERD does not cause serious complications. 
    Fact: Most people believe GERD to be a common disease like the flu, which is not true! While GERD usually does not cause any life-threatening complications, it can lead to serious health problems if left untreated. Serious complications of GERD include oesophagitis, oesophageal ulcer, Barrett’s oesophagus, etc.   
  4. Myth: There is no treatment for GERD. 
    Fact: Another misconception! Over-the-counter medications, along with dietary and lifestyle changes, can help manage GERD. If it does not work, the doctor may recommend prescription medicines or surgical procedures like fundoplication, LINX device implantation, etc. 
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What is the main cause of GERD?

The main cause of GERD is the frequent acid reflux or reflux of non-acidic content from the stomach. The relaxation or weakness of the lower oesophageal sphincter causes acid reflux. Generally, the sphincter closes tightly after the food enters the stomach. However, if it relaxes when it should not, the stomach contents rise back up in the oesophagus.

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Can GERD be fully cured?

Yes, GERD can be fully cured. The most common GERD treatment is medications and lifestyle changes. Medications can help reduce the amount of acid in the stomach. The doctor may recommend surgery if medications and lifestyle changes do not help. 

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What are the symptoms of GERD?

The most common GERD symptoms include regurgitation and persistent heartburn. Other symptoms may include a sour or bitter taste at the back of the mouth, nausea, chest pain, hoarseness in the morning, trouble swallowing, pain when swallowing, a sensation of a lump in the throat, bad breath, chronic cough, inflammation of the vocal cords, new or worsening asthma, and sleep problems. 

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How do you test for GERD?

GERD diagnosis begins with the evaluation of the patient’s signs and symptoms and a physical examination. The tests done to confirm GERD or look for complications include:

  1. Upper endoscopy: Help detect inflammation of the oesophagus.
  2. Ambulatory 24-hour pH probe: Measures when and for how long stomach acid regurgitates in the oesophagus during 24 hours.
  3. Bravo wireless oesophageal pH monitoring: Measures when and for how long stomach acid regurgitates in the oesophagus during 48 hours.
  4. Esophogram: X-ray imaging is used to look for problems in the upper digestive tract.
  5. Oesophageal manometry: Measures the strength of the oesophageal muscles.
  6. Transnasal esophagoscopy: Used to look for any damage in the oesophagus or stomach. 
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Is GERD caused by stress?

 Even though researchers do not completely understand the relationship between GERD and stress, it is known that stress can trigger or worsen GERD symptoms. Stress can increase stomach acid production, worsening GERD.
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What does GERD pain feel like?

One of the most common symptoms of GERD is heartburn, a burning pain in the chest that usually occurs after eating or while lying down. Chest pain associated with GERD is known as noncardiac chest pain.
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What is the difference between acid reflux and GERD?

Acid reflux and GERD are closely related but do not mean the same things. Acid reflux is the flow of stomach acid back into the oesophagus. GERD is a severe form of acid reflux that develops when acid reflux occurs twice a week or causes oesophageal inflammation.
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How long does it take GERD to heal?

Mild cases of GERD can heal in less than a month. Moderate GERD requires about 6-12 weeks of treatment. The doctor may recommend surgery if a patient does not report positive outcomes after 12 weeks of medications and lifestyle changes. 

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Does exercise help with GERD?

Exercise can both relieve and trigger GERD symptoms. Moderate and low-impact exercises like walking, swimming, light jogging, and yoga for GERD can help relieve or prevent symptoms. It reduces extra body fat that may be making the symptoms worse.

Moreover, it can help relieve stress and anxiety, improving overall well-being. However, high-impact exercises like running, weightlifting, and cycling can worsen symptoms. 

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Is yoghurt good for acid reflux?

Yoghurt, which is low in fat, is excellent for those who have acid reflux. It contains probiotics that help normalise bowel function. Furthermore, yoghurt soothes stomach discomfort by providing a cooling sensation. 

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Is milk good for acid reflux?

Nonfat milk can act as a temporary barrier between the acidic stomach contents and the stomach lining, offering immediate relief to heartburn symptoms. However, not all types of milk offer relief. Milk with any amount of fat aggravates acid reflux.
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Do I have GERD or gastritis?

While both GERD and gastritis involve inflammation, they differ based on the location of inflammation in the GI tract. GERD includes inflammation in the oesophagus, whereas gastritis includes inflammation in the stomach.
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Updated on : 21 February 2023


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