GERD and Acid Reflux: Causes, Treatment, and When to See a GI
Almost everyone has heartburn now and then. When acid reflux happens often, or causes damage, it is called GERD (gastroesophageal reflux disease). GERD is very common and very treatable.
What causes GERD?
A ring of muscle at the bottom of the esophagus normally keeps stomach acid where it belongs. In GERD this valve relaxes too often or is weak, and acid flows back up. Things that make reflux worse include extra weight, large or late meals, a hiatal hernia, smoking, alcohol, and certain foods such as fatty or spicy dishes, chocolate, coffee, and mint.
Symptoms
- Heartburn: a burning feeling in the chest, often after meals or at night
- Sour taste or food coming back up (regurgitation)
- Chronic cough, hoarseness, or throat clearing
- Chest pain (always rule out heart problems first)
Warning signs: see a doctor soon
- Trouble or pain when swallowing
- Unplanned weight loss
- Vomiting, black stools, or vomiting blood
- Anemia (low blood count)
- New symptoms after age 60
Treatment
Lifestyle changes
- Eat smaller meals and stop eating 3 hours before bed
- Raise the head of your bed 6 to 8 inches
- Lose weight if you are overweight
- Stop smoking and limit alcohol
- Notice and avoid your personal trigger foods
Medicines
Antacids give quick, short relief. H2 blockers (such as famotidine) and proton pump inhibitors (PPIs, such as omeprazole) lower acid and allow the esophagus to heal. Newer acid blockers are also available for some patients. We help you find the lowest effective dose.
Procedures
For people whose reflux is not controlled by medicine, or who prefer not to take it long term, there are endoscopic and surgical options that strengthen the valve.
Upper endoscopy and Barrett's esophagus
An upper endoscopy (EGD) lets us look at the esophagus and stomach. It is recommended for warning signs, symptoms that don't improve, and for some people with long-standing reflux, to check for Barrett's esophagus, a change in the lining that can rarely lead to cancer. Procedure instructions are available in four languages.
Clinical trials
We are preparing to offer clinical trials for GERD. See our Clinical Trials page.
Make an appointment
Our gastroenterologists in Temple City care for patients from Arcadia, San Gabriel, Pasadena, Monrovia, Monterey Park, and across the San Gabriel Valley. We accept most PPO plans (see accepted insurances), and our doctors speak English, Vietnamese, and Mandarin. Schedule an appointment or call 626-898-4560.
This article is for general education and is not a substitute for medical advice. Talk with your doctor about your own health.
Quick Answers
When should I see a doctor for heartburn?
See a doctor if you have heartburn more than twice a week, if medicines don't help, or right away if you have trouble swallowing, weight loss, vomiting, black stools, or anemia.
Is it safe to take acid-reducing medicine long term?
For many people, yes, when there is a clear reason. Your doctor will use the lowest dose that controls symptoms and review the need regularly.
Do I need an endoscopy for GERD?
Not always. An upper endoscopy is recommended for warning signs, symptoms that don't improve with treatment, or long-standing reflux with risk factors for Barrett's esophagus.
