GERD Symptoms and Treatment: Managing Acid Reflux

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal conditions, affecting approximately 20% of the Western population weekly. While heartburn is the hallmark symptom, GERD produces a surprisingly diverse range of manifestations that are often not recognized as reflux-related.

Typical symptoms include heartburn (retrosternal burning sensation), acid regurgitation (sour liquid reaching the throat or mouth), and dysphagia (difficulty swallowing). Atypical or extra-esophageal symptoms include: chronic cough (particularly nocturnal), hoarseness and throat clearing, globus sensation (feeling of a lump in the throat), dental erosions (from acid reaching the mouth), sleep disturbance, and non-cardiac chest pain.

GERD complications develop when acid exposure to the esophageal mucosa is prolonged: esophagitis (inflammation), esophageal stricture (narrowing causing dysphagia), and Barrett's esophagus (a precancerous change in the esophageal lining present in approximately 10% of GERD patients, requiring surveillance endoscopy). Barrett's increases esophageal adenocarcinoma risk by 30–125 times.

First-line treatment combines lifestyle modifications with medication: eat smaller, more frequent meals; avoid lying down within 3 hours of eating; elevate the head of the bed 15–20 cm; avoid trigger foods (fatty foods, citrus, tomato, chocolate, caffeine, alcohol, mint); lose weight if overweight. Proton pump inhibitors (PPIs) are the most effective pharmacological treatment, typically given for 4–8 weeks, then reassessed.

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