Gastroesophageal reflux disease (GERD) occurs when stomach acid repeatedly flows back into the tube

connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your
esophagus.

Many people experience acid reflux from time to time. However, when acid reflux happens repeatedly over
time, it can cause GERD.

Most people are able to manage the discomfort of GERD with lifestyle changes and medications. And
though it's uncommon, some may need surgery to ease symptoms.

Causes

GERD is caused by frequent acid reflux or reflux of nonacidic content from the stomach.

When you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal
sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again.

If the sphincter does not relax as it should or it weakens, stomach acid can flow back into your
esophagus. This constant backwash of acid irritates the lining of your esophagus, often causing it to
become inflamed.

Factors that can aggravate acid reflux include:

● Smoking
● Eating large meals or eating late at night
● Eating certain foods (triggers) such as fatty or fried foods
● Drinking certain beverages, such as alcohol or coffee
● Taking certain medications, such as aspirin

Symptoms

Common signs and symptoms of GERD include:

● A burning sensation in your chest (heartburn), usually after eating, which might be
worse at night or while lying down
 ● Backwash (regurgitation) of food or sour liquid
● Upper abdominal or chest pain
● Trouble swallowing (dysphagia)
● Sensation of a lump in your throat

GERD can impact a patient’s life in some of the following ways:

● Persistent Typical and Atypical Symptoms: May result in heartburn, chest pain, sore throat
and other symptoms despite medication.
● Sleeping Positions: Nighttime reflux can compromise sleep for people who sleep in a
typical horizontal position. This can affect alertness and productivity the following day.
● Diet: Dietary restrictions including regimented timing of meals and the need to avoid
consuming foods and beverages that trigger reflux.

Complications

Over time, chronic inflammation in your esophagus can cause:

● Inflammation of the tissue in the esophagus (esophagitis). Stomach acid can break
down tissue in the esophagus, causing inflammation, bleeding, and sometimes an
open sore (ulcer). Esophagitis can cause pain and make swallowing difficult.
● Narrowing of the esophagus (esophageal stricture). Damage to the lower esophagus
from stomach acid causes scar tissue to form. The scar tissue narrows the food
pathway, leading to problems with swallowing.
● Precancerous changes to the esophagus (Barrett esophagus). Damage from acid can
cause changes in the tissue lining the lower esophagus. These changes are
associated with an increased risk of esophageal cancer.

Lifestyle changes

Lifestyle changes may reduce your symptoms. Your doctor may recommend

● losing weight if you’re overweight or have obesity

 ● elevating your head during sleep by placing a foam wedge or extra pillows under your
head and upper back to incline your body and raise your head off your bed 6 to 8
inches
● quitting smoking. if you smoke
● changing your eating habits and diet

Over-the-counter and prescription medicines

Antacids. Doctors may recommend antacids to relieve mild heartburn and other mild GER and
GERD symptoms. Antacids are available over the counter. Antacids can help relieve mild
symptoms. However, you shouldn’t use these medicines every day or for severe symptoms,
except after discussing your antacid use with your doctor. These medicines can have side
effects, such as diarrhea or constipation.

H2 blockers. H2 blockers lower the amount of acid your stomach makes. H2 blockers can help
heal the esophagus, but not as well as proton pump inhibitors (PPIs) can. You can buy H2
blockers over the counter, or your doctor can prescribe one.

Proton pump inhibitors (PPIs). PPIs lower the amount of acid your stomach makes. PPIs are
better at treating GERD symptoms than H2 blockers, and they can heal the esophageal lining
in most people with GERD. You can buy PPIs over the counter, or your doctor can prescribe
one. Doctors may prescribe PPIs for long-term GERD treatment.

PPIs are generally safe and effective. Side effects are uncommon and may include headache,
diarrhea, and upset stomach

Other medicines. If antacids, H2 blockers, and PPIs don’t improve your symptoms, your doctor
may recommend other medicines.

Surgery and other medical procedures

Your doctor may recommend surgery if your GERD symptoms don’t improve with lifestyle
changes and medicines, or if you wish to stop taking long-term GERD medicines to manage
symptoms. You’re more likely to develop complications from surgery than from medicines.

Fundoplication. Fundoplication is the most common surgery for GERD. In most cases, it leads
to long-term improvement of GERD symptoms. During the operation, a surgeon sews the top
of your stomach around the end of your esophagus to add pressure to the lower esophageal
sphincter and help prevent reflux.

Surgeons may perform fundoplication as laparoscopic or open surgery. In laparoscopic

fundoplication, which is more common, surgeons make small cuts in the abdomen and insert
special tools to perform the operation. Laparoscopic fundoplication leaves several small
scars. In open fundoplication, surgeons make a larger cut in the abdomen.

Bariatric surgery. If you have GERD and obesity, your doctor may recommend weight-loss
surgery, also called bariatric surgery, most often gastric bypass surgery. Bariatric surgery can
help you lose weight and reduce GERD symptoms.
Endoscopy. In a small number of cases, doctors may recommend procedures that use
endoscopy to treat GERD. For endoscopy, doctors insert an endoscope—a small, flexible tube
with a light and camera—through your mouth and into your esophagus. Doctors may use
endoscopic procedures to sew the top of your stomach around the lower esophageal
sphincter or to deliver radiofrequency energy to the sphincter. Doctors don’t use these
procedures often.