Gastroesophageal Reflux Disease (GERD)

Understanding the Causes, Symptoms, and Treatments for Chronic Acid Reflux

What Is GERD?

Gastroesophageal Reflux Disease (GERD) is a chronic condition in which acid and stomach contents repeatedly flow backward (reflux) into the esophagus—the tube that connects your mouth to your stomach. This occurs when the lower esophageal sphincter (LES), a ring of muscle that normally closes tightly after swallowing, becomes weakened or relaxes inappropriately.

GERD is more than occasional heartburn. It’s a persistent condition that can interfere with daily life and may lead to complications if not managed properly.

What Causes GERD?

GERD can be caused by a combination of anatomical, lifestyle, and medical factors, including:

• Weak LES tone or dysfunction
• Hiatal hernia
• Delayed gastric emptying (gastroparesis)
• Obesity or increased abdominal pressure
• Pregnancy
• Certain foods and beverages (caffeine, alcohol, chocolate, spicy or acidic foods)
• Smoking
• Medications that relax the LES (e.g., calcium channel blockers, certain asthma medications)

While occasional acid reflux is common, GERD is diagnosed when reflux becomes frequent (typically ≥2 times per week) and causes bothersome symptoms or esophageal injury.

Common Symptoms of GERD

GERD can present in various ways. Classic and atypical symptoms may include:

Typical Symptoms:

• Frequent heartburn (burning sensation in the chest)
• Acid regurgitation or sour taste in the mouth
• Chest discomfort, especially after meals or lying down
• Excessive belching or bloating
• Difficulty swallowing (dysphagia)

Atypical or Extraesophageal Symptoms:

• Chronic cough
• Laryngitis or hoarseness
• Sore throat or postnasal drip
• Asthma-like symptoms or worsening asthma
• Erosion of tooth enamel

GERD vs. Occasional Heartburn

Heartburn is a symptom—GERD is a chronic medical condition. Not everyone with heartburn has GERD, but persistent or worsening symptoms may indicate a need for evaluation by a specialist.

When to Seek Medical Care

You should see a gastroenterologist if:

• You experience symptoms more than twice per week
• Over-the-counter antacids or acid reducers no longer help
• You have difficulty swallowing, unexplained weight loss, or anemia
• You have a history of Barrett’s esophagus or other esophageal issues
• Your symptoms disturb sleep or interfere with eating

GERD Complications (If Left Untreated)

Persistent GERD can damage the lining of the esophagus and lead to:

• Esophagitis (inflammation of the esophagus)
• Esophageal strictures (narrowing due to scar tissue)
• Barrett’s esophagus (a precancerous condition)
• Esophageal ulcers or bleeding
• Increased risk of esophageal adenocarcinoma

How GERD Is Diagnosed

At Salem Gastro, we use a combination of clinical evaluation and diagnostic tools to determine the presence and severity of GERD:

Upper Endoscopy (EGD)

Visualizes the esophagus and stomach to detect signs of irritation, inflammation, erosions, or Barrett’s changes.

Bravo pH Monitoring

Measures acid exposure over 48 hours via a small capsule placed in the esophagus.

Esophageal Manometry

Assesses the function and strength of the esophagus and LES—especially useful before anti-reflux surgery.

Impedance-pH Testing

Used for patients with non-acidic reflux or those not responding to standard therapies.

Treatment Options

1. Lifestyle Modifications

Foundational for all GERD patients, including:

• Eating smaller, low-fat meals
• Avoiding trigger foods and beverages
• Waiting at least 2–3 hours after eating before lying down
• Elevating the head of the bed
• Weight loss (if overweight)
• Smoking cessation

2. Medication Therapy

• Antacids – quick relief for occasional symptoms
• H2 blockers (e.g., famotidine) – reduce stomach acid
• Proton Pump Inhibitors (PPIs) (e.g., omeprazole) – most effective for healing and symptom control

3. Advanced Management

For patients who don’t respond to medication or who prefer alternatives:

• Evaluation for anti-reflux surgery (e.g., fundoplication or LINX device)
• Surveillance endoscopy for Barrett’s esophagus

Living with GERD

With the right treatment plan, most patients experience excellent symptom control and improved quality of life. At Salem Gastro, we focus on helping you identify triggers, tailor your treatment, and monitor for complications when needed.

Related Services at Salem Gastro

• Esophageal dilation for strictures
• Endoscopic evaluation of Barrett’s esophagus
• Pathology review of biopsies
• Surgical referral coordination

Get Relief from GERD

If you’re living with frequent heartburn, regurgitation, or other signs of acid reflux, don’t wait to seek help.
Our team can help diagnose the root cause of your symptoms and build a personalized treatment plan that works for your lifestyle.