Understanding Gastro-Oesophageal Reflux (GERD): Causes, Symptoms & Treatments
After you eat, do you typically experience a burning feeling in your chest? Or do you wake up with a bitter taste in your mouth in the middle of the night? These may be symptoms of gastro-oesophageal reflux disease (GERD), which is a common disorder that goes unnoticed most of the time.
GERD develops when stomach acid continues to come back up into the oesophagus, resulting in irritation and discomfort. Untreated, it can cause more serious health issues such as damage to the oesophagus. There is help if you identify the symptoms and seek the right treatment early.
In this guide, we’ll explore the two main types of GERD (NERD and ERD), their causes, symptoms, and the most effective treatments available.
What is Gastro-Oesophageal Reflux ( GERD )?
GERD (gastro-oesophageal reflux disease) is a long-term digestive disorder where stomach acid/contents leak back into the oesophagus (the tube connecting your mouth to your stomach). This occurs when the lower oesophageal sphincter (LES), a muscle valve, relaxes differently or weakens.
How GERD Affects the Body?
Prolonged exposure to acid can cause:
- Irritation of the oesophagus and scarring
- Continuous pain that disrupts sleep or daily life
- Greater chance of complications such as oesophageal ulcers or Barrett’s oesophagus (a precancerous condition)
Types of GERD
GERD is subdivided into types:
1. Non-Erosive Reflux Disease (NERD)
- A more common form of GERD
- Patients have typical reflux symptoms (heartburn, regurgitation) along with normal endoscopic macroscopic findings.
- Largely associated with lifestyle factors such as diet and stress
2. Erosive Reflux Disease (ERD)
- Appearance of visible erosions/ulcers along with the presence of erosions in the oesophagus as a result of stomach acid
- Symptoms may be worse and can appear as follows:
- Frequent heartburn
- Painful swallowing
- Bleeding (in rare cases)
- Needs care to avoid becoming a medical case
Causes and Risk Factors
There are many reasons for GERD.
1. Lifestyle Factors
- Diet: Fatty, spicy, and acidic (such as coffee, chocolate, citrus) foods
- Binge eating or midnight snacks
- Smoking and heavy alcohol drinking (relaxes the LES)
- Obesity and inactivity (increasing abdominal pressure)
2. Medical Conditions
- Hiatal hernia (stomach pushes up into the chest)
- Pregnancy (changes in hormones and the physical pressure on the stomach)
- Diabetes (which can cause delayed gastric emptying)
3. Medications
- NSAIDs (e.g., ibuprofen)
- Drugs for high blood pressure, such as amlodipine (Norvasc), nifedipine (Procardia, Adalat), others
- Certain muscle relaxants
Common Symptoms of GERD
There are several symptoms of GERD; however, common symptoms include:
1. Digestive Discomfort
- Heartburn (burning feeling behind the breastbone, moves up the chest)
- Repeated episodes of acid reflux (sour or bitter taste in the mouth, regurgitation)
2. Swallowing Difficulties
- Dysphagia (sensation that food is sticking in the throat)
- Painful swallowing
3. Other Possible Symptoms
- Persistent cough or sore throat (as a result of acid erosion)
- Hoarseness or laryngitis
- Pain in the chest (often thought to be a heart attack)
Diagnosis of GERD
If your symptoms are severe, your physician might recommend:
1. Medical/Medication History & Physical Examination
- Symptoms and lifestyle habits explained
2. Diagnostic Tests
- Upper endoscopy: A camera is used to inspect the oesophagus for injury
- 24-hour pH monitoring: A measure of the acid in the oesophagus
- Manometry: Tests how well the muscles in the oesophagus are working
Treatment Options for GERD
1. Lifestyle Modifications
- Avoid triggers (spicy, fried, caffeinated)
- Eat smaller, frequent meals
- Elevate the head of your bed
- Lose weight if needed
2. Medications
- Antacids (quick relief)
- H2 blockers (such as ranitidine) – help reduce the amount of acid produced
- PPIs (such as omeprazole) – long-term suppression of acid
- Prokinetics – make the stomach empty faster
3. Surgical Options
- Fundoplication – wrapping the stomach around the LES to strengthen it
- LINX device – keeps the acid where it belongs
When to See a Specialist
If you have any of the following symptoms, see a gastroenterologist:
- Symptoms persist despite medications
- Dysphagia or unexplained weight loss
- Severe symptoms (bleeding, stabbing pain, etc.)
Living with GERD: Tips for Daily Life
1. Food and Drink Choices
- Avoid: Spicy foods, alcohol, carbonated beverages
- Opt for: Oatmeal, lean proteins, bananas, ginger tea
2. Habits to Maintain
- Wait 2–3 hours after eating before lying down
- Wear loose clothing (tight waistbands exert pressure on the abdomen)
- Mindful eating (chew slowly, avoid overeating)
Conclusion
GERD is a manageable condition with the right approach—lifestyle changes, medications, or surgery can provide relief. Early intervention helps prevent complications and improves long-term health.
If you’re struggling with persistent reflux symptoms, the specialists at Chase Lodge Hospital can help. Book an appointment today for a personalised treatment plan.
For more information, visit the NHS Guide on Heartburn and Acid Reflux.
