What Is Acid Reflux (GERD)? Symptoms, Causes and Risks

Many people feel a burning sensation in the chest after a big meal and call it acidity. Sometimes it is just an occasional bother, and sometimes it is a long-term condition that needs a doctor's attention. This article explains the difference, using information from the US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

What is acid reflux?

Gastroesophageal reflux, often shortened to GER, happens when the contents of the stomach flow backward into the esophagus (the food pipe). The NIDDK says this is common and that it often causes no symptoms at all. When it does cause symptoms, the most familiar one is heartburn, which some people call acid indigestion. Other everyday names include acid reflux, acid regurgitation and simply reflux.

What is GERD?

Gastroesophageal reflux disease (GERD) is a more serious, longer-lasting form of reflux. In GERD, the reflux causes repeated and bothersome symptoms, or it leads to complications over time. According to NIDDK, researchers estimate that about 20 percent of people in the United States have GERD.

Common symptoms

The two most common symptoms are:

• Heartburn: a burning pain behind the breastbone that can travel up toward the throat.
• Regurgitation: stomach contents rising into the throat or mouth, sometimes leaving a sour or acidic taste.

Other possible symptoms include chest pain, nausea, and difficulty or pain when swallowing. GERD can also show up away from the food pipe, for example as a long-lasting cough, hoarseness or laryngitis (inflammation of the voice box, which can cause temporary loss of voice). Not everyone with GERD has heartburn or regurgitation.

Why does it happen?

Between the food pipe and the stomach sits a muscle valve called the lower esophageal sphincter. Together with the diaphragm, it normally keeps stomach contents where they belong. NIDDK explains that GERD may develop when this valve becomes weak or relaxes at the wrong times.

Things linked with this problem include:

• Being overweight or having obesity
• Pregnancy
• Smoking, or regular exposure to secondhand smoke
• A hiatal hernia, where the upper part of the stomach pushes up through the opening in the diaphragm

NIDDK also lists some medicine types that can cause or worsen GERD, including sedatives of the benzodiazepine family, calcium channel blockers used for high blood pressure, some asthma medicines, anti-inflammatory pain medicines (NSAIDs) and tricyclic antidepressants. Never stop or change a medicine on your own; ask your doctor if you are worried that one of your medicines is involved.

Possible complications

If GERD is not treated, NIDDK says it can lead to problems such as:

• Esophagitis: inflammation of the food pipe, which can cause ulcers and bleeding.
• Esophageal stricture: a narrowing that can make swallowing difficult.
• Barrett's esophagus: a change in the lining of the food pipe. A small number of people with it go on to develop a type of cancer called esophageal adenocarcinoma.
• Wearing away of tooth enamel, asthma, chronic cough and hoarseness.

When to see a doctor

NIDDK advises seeing a doctor if you think you may have GERD, or if your symptoms continue even after you have tried over-the-counter medicines or lifestyle changes. Get medical advice promptly if your symptoms might point to a complication or another serious problem. Signs listed by NIDDK include:

• Chest pain
• Loss of appetite
• Vomiting that keeps happening
• Trouble or pain when swallowing
• Vomit that contains blood or looks like coffee grounds
• Stool that is bloody, or black and tarry
• Weight loss that you cannot explain

Chest pain can have many causes, some of them urgent, so do not assume it is only acidity. This article is for education and cannot tell you what is causing your symptoms. In an emergency, call your local emergency number (112 in India, 911 in the United States).