Gastroesophageal reflux disease: What you need to know

Gastroesophageal reflux disease (GERD) is a common condition that affects the digestive system, causing uncomfortable symptoms and sometimes leading to complications if left untreated. While it may sound complex, GERD simply refers to a persistent form of acid reflux, where stomach acid flows back into the oesophagus—the tube that connects your mouth to your stomach.

We speak to a leading gastroenterologist who helps you understand what GERD is, its causes, symptoms, and treatment options.

What causes GERD?

GERD occurs when the lower oesophageal sphincter (LES), a muscular ring at the bottom of the oesophagus, becomes weakened or relaxes at the wrong time. The LES usually acts as a barrier, preventing stomach acid from moving upwards. When it doesn’t function properly, acid can escape into the oesophagus, leading to irritation and discomfort.

Several factors can contribute to GERD, including obesity, smoking, pregnancy, and certain medical conditions like a hiatal hernia (where a portion of the stomach moves into the chest). Additionally, some foods and drinks—such as fatty meals, spicy dishes, caffeine, and alcohol—can trigger or worsen symptoms.

What are the symptoms of GERD?

The most common symptom of GERD is heartburn, which feels like a burning sensation in the chest, often occurring after eating or when lying down. However, GERD can cause other symptoms as well. These include:

• Regurgitation: The sensation of acid or food coming back up into the mouth or throat.
• Difficulty swallowing (dysphagia): A feeling that food is stuck in the oesophagus.
• Chronic cough, hoarseness, or a sore throat, especially in the morning.
• Chest pain that may mimic heart-related pain but is caused by acid irritation.

If these symptoms persist more than twice a week, it’s important to consult a doctor for an accurate diagnosis.

How is GERD diagnosed?

Diagnosing GERD typically begins with a discussion of your symptoms and medical history. Your doctor may recommend tests to confirm the condition, such as:

• Endoscopy: A small camera is used to examine the oesophagus and stomach for signs of irritation or damage.
• pH monitoring: A device is used to measure the level of acid in your oesophagus over a 24-hour period.
• Barium swallow: X-rays taken after drinking a special liquid highlight abnormalities in the oesophagus.

How is GERD treated?

Treatment for GERD often combines lifestyle changes, medication, and, in some cases, surgery. Lifestyle adjustments such as maintaining a healthy weight, avoiding trigger foods, and eating smaller meals can significantly reduce symptoms.

Medications like antacids, proton pump inhibitors (PPIs), or H2 blockers can neutralise stomach acid or reduce its production. In severe cases, surgical procedures such as fundoplication, which strengthens the LES, may be recommended.

GERD is a manageable condition, and with proper care, you can reduce its impact on your daily life.