The four major symptoms of GERD are: q Heartburn (uncomfortable, rising, burning sensation behind the breastbone). q Regurgitation of gastric acid or sour contents into the mouth. q Difficult and/or painful swallowing. q Chest pain. Heartburn is the most common symptom of GERD. In some patients it may be accompanied by other GERD symptoms, such as regurgitation of gastric contents into the mouth, chest pain and difficulty swallowing.

The major factor is meals. Meals stimulate the stomach to produce more acid that can reflux up into the esophagus. In some patients, lying down or taking certain medications can worsen acid reflux. Spicy foods do not cause GERD, although they do seem to worsen GERD symptoms in some people. Food (in general) can make GERD worse. This is because food fills the stomach and induces more transient relaxations of the lower esophageal sphincter.

Proton pump inhibitors, such as Prilosec OTC® and Aciphex® , are another type of acid reducer. They suppress stomach acid. By drastically reducing the acid, these drugs can help stop the irritation and allow the damaged tissue in the esophagus to heal.

Along with lifestyle changes, nonprescription medications may be needed to control occasional heartburn. Medications used for home treatment of GERD include antacids, or nonprescription medicines that reduce or block acid. These include H2 blockers (for example, Pepcid) or a proton pump inhibitor (for example, Prilosec OTC). For more information about prescription forms of these drugs, see the Medications section of this topic.

GERD stands for Gastroesophageal Reflux Disease. Gastroesophageal reflux describes a backflow of acid from the stomach into the swallowing tube or esophagus. Almost everyone experiences gastroesophageal reflux at some time. The usual symptom is heartburn, an uncomfortable burning sensation behind the breastbone, most commonly occurring after a meal. In some individuals this reflux is frequent or severe enough to cause more significant problems, that is a disease.

Not everyone with gastroesophageal reflux disease has heartburn. Other symptoms of GERD include regurgitation of bitter acid up into the throat while sleeping or bending over; bitter taste in the mouth; persistent dry cough; hoarseness (especially in the morning); feeling of tightness in the throat, as if a piece of food is stuck there; wheezing; and bad breath. The most common symptoms in children are repeated vomiting, coughing, and other respiratory problems.

The symptoms of GERD may include persistent heartburn, acid regurgitation, nausea, hoarseness in the morning, or trouble swallowing. Some people have GERD without heartburn. Instead, they experience pain in the chest that can be severe enough to mimic the pain of a heart attack. GERD can also cause a dry cough and bad breath. Some people with LPR may feel as if they have food stuck in their throat, a bitter taste in the mouth on waking, or difficulty breathing although uncommon.

What causes GERD? GERD is caused by reflux of stomach acid into the esophagus. In most patients this is due to a transient relaxation of the "gate" or sphincter that keeps the lower end of the esophagus closed when a person is not swallowing food or liquids. This transient relaxation happens a few times each day in people without GERD. Why it happens more frequently in GERD patients isn't known. The esophagus is not able to cope with acid as well as the stomach and is easily injured.

GERD afflicts people of every socioeconomic class, ethnic group and age. However, the incidence does seem to increase quite dramatically above the age of 40. Greater than 50 percent of those afflicted with GERD are between the ages of 45-64 (both male and female).

Only a minority of patients develop complications of GERD. These complications include breaks in the lining of the esophagus (esophageal erosions), esophageal ulcer, and narrowing of the esophagus (esophageal stricture). In some patients, the normal esophageal lining or epithelium may be replaced with abnormal (Barrett's) epithelium. This condition (Barrett's esophagus) has been linked to cancer of the esophagus and must be carefully watched.

Smoking doesn't cause GERD and there is little evidence that smoking significantly worsens GERD. Stopping smoking is a good idea anyway.

Unfortunately, GERD, in general, cannot be cured at present. In some cases, it may be a temporary condition associated with a specific aggravating factor such as pregnancy. In such cases, GERD will go away on its own when the pregnancy has ended. In most cases GERD is a chronic condition. However, it can be effectively managed with medications and lifestyle modifications in almost everybody. In severe cases, surgery is an option.

If you think you might have GERD - see your doctor who can determine if you have GERD and, if so, can evaluate its severity.