What is GERD? Causes, Symptoms, Diagnosis & Treatment Options

Gastroesophageal Reflux Disease (GERD) is a chronic digestive condition in which stomach acid frequently flows back into the food pipe (oesophagus). While occasional acid reflux is common and usually harmless, repeated reflux can irritate the lining of the oesophagus and lead to complications if left untreated.

GERD affects a significant portion of the adult population globally, including in India, where dietary habits, obesity rates and lifestyle factors contribute to its rising prevalence.

The lower oesophageal sphincter (LES) is a ring of muscle at the junction of the oesophagus and stomach. It normally relaxes to let food pass into the stomach and then closes to prevent acid from flowing back up.

In GERD, the LES becomes weak or relaxes abnormally, allowing acidic stomach contents to enter the oesophagus and cause irritation.

• Hiatal hernia
• Obesity and excess abdominal weight
• Pregnancy
• Smoking and excessive alcohol intake
• Eating large meals or lying down right after eating
• Diets high in fatty, fried or spicy food, caffeine and carbonated drinks
• Certain medications, including some painkillers, calcium channel blockers and antihistamines
• Stress and irregular eating patterns

GERD symptoms can be typical or atypical:

Typical symptoms:

• Heartburn – burning sensation in the chest, usually after meals or at night
• Regurgitation of food or sour liquid
• Difficulty swallowing (dysphagia)
• Feeling of a lump in the throat

Atypical / extra-oesophageal symptoms:

• Chronic cough
• Hoarseness or sore throat
• Disturbed sleep due to nocturnal reflux
• Worsening of asthma symptoms
• Dental erosion

Consult a qualified doctor if you experience:

• Heartburn more than twice a week
• Symptoms that persist despite over-the-counter antacids
• Difficulty or pain when swallowing
• Unintentional weight loss, vomiting blood or black stools
• Chest pain (which may also signal heart issues and requires urgent evaluation)

A doctor typically diagnoses GERD based on symptoms and response to treatment. Investigations that may be advised in specific cases include:

• Upper gastrointestinal endoscopy
• Ambulatory 24-hour pH monitoring
• Oesophageal manometry
• Barium swallow X-ray

GERD management is typically multi-layered:

1. Lifestyle modifications

• Smaller, frequent meals
• Avoid lying down for 2–3 hours after eating
• Elevate the head of the bed
• Lose excess weight
• Limit trigger foods (fried, spicy, caffeinated)
• Quit smoking and reduce alcohol intake

2. Medications

• Antacids – for short-term symptom relief
• H2 receptor blockers – reduce acid production
• Proton Pump Inhibitors (PPIs) such as esomeprazole – the most effective class for reducing gastric acid production and healing oesophageal damage

3. Endoscopic / surgical options

• Reserved for severe or refractory cases, decided by a gastroenterologist

Proton pump inhibitors block the H+/K+ ATPase enzyme in the stomach lining, dramatically reducing acid production. This gives the inflamed oesophagus and stomach lining time to heal and provides long-lasting symptom relief.

Esomeprazole is one of the most commonly prescribed PPIs and is available in both oral and injectable forms for different clinical scenarios.

• GERD is a chronic but manageable condition
• Lifestyle changes are the first line of treatment
• PPIs offer effective, long-term acid suppression when prescribed appropriately
• Persistent or alarming symptoms must be evaluated by a doctor

This article is intended for general educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always consult a qualified healthcare provider for any medical concern.