GERD (Gastroesophageal Reflux Disease)

What is GERD?
GERD is a recurrent condition where gastric juices, containing acid, travel back from the stomach into the gullet (the swallowing pipe called the oesophagus).

  • The food in the stomach is partially digested by stomach acid and enzymes (special chemicals that act on food to break it down to simpler material that the body can use).  
  • Normally, the partially digested acidic content in the stomach is delivered by the stomach muscle into the small intestine for further digestion.  
  • In patients with GERD, stomach acid content regularly refluxes backwards into the oesophagus, causing inflammation and damage.

How do you get GERD?
Doctors know that in western countries, 40% of adults suffer from heartburn, the main symptom of GERD, and half of these also have oesophagitis.

  • In most people, GERD is caused by the digestive juices in the stomach, repeatedly moving upwards into the lower oesophagus (called acid reflux).  
  • The condition may be due to an abnormal mechanical working of the oesophagus (where it enters the stomach) since it can normally squeeze itself together to act as a shut-off valve, or tap, to keep stomach contents out.  
  • Sometimes, GERD is due to too much acid being produced by the stomach.  
  • It can occur in some people when the stomach does not empty quickly enough and becomes overfilled with digestion contents.

How serious is GERD?
In some patients, the damage to the oesophagus can be seen during an endoscopic examination. This involves a doctor feeding a tube with a special camera down the patient’s throat into the oesophagus. However, even when damage cannot be seen, patients can experience severe symptoms.

  • Heartburn is the most common symptom of GERD, which is a burning feeling rising from the stomach or lower chest up towards the neck.  
  • Other symptoms include regurgitation (food may come up into the mouth), chest pain, a difficulty in swallowing (a condition called dysphagia), hoarseness and asthma.  
  • If untreated, severe heartburn can reduce quality of life for sufferers. In severe cases of oesophagitis, the lining of the oesophagus may become ulcerated, leading to pain and possible narrowing due to scarring (making the swallowing of food and sometimes even liquids difficult).  
  • In people with oesophagitis, there may be an increased risk of cancer of the oesophagus.  
  • Stomach acid also plays a significant role in the development of peptic ulcers that can result in serious complications like bleeding and perforation of the stomach wall.

How long does GERD last?
The symptoms of GERD are frequent and may last several weeks, months or longer if left untreated. They can also re-occur after treatment.

How is GERD treated?
Medications commonly used in the treatment of GERD include:

Proton pump inhibitors — A variety of proton pump inhibitors are available by prescription, including omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix), and rabeprazole (Aciphex).
  • Acid suppressants, such as histamine H2-antagonists (blockers). Histamine is a chemical released in the body under many different conditions. In the stomach it can release more acid, so blocking histamine’s action reduces acid production.  
  • Proton-pump inhibitors also work on the cells in the stomach wall, which make acid, to reduce the amount of acid produced and released into the stomach chamber.  
  • Other medicines (called pro-kinetic agents) increase the movement of the stomach. They work by increasing the pressure of the lower oesophageal sphincter (the point where the oesophagus joins the stomach) and promote emptying of the stomach.  
  • Antacids are medicines that are commonly used to treat acid-related symptoms, like heartburn or indigestion, and work by neutralising acid in the stomach. However, they are not usually recommended to treat the frequent heartburn suffered by people with GERD.

Johns Hopkins patient information

Last revised:

Diseases and Conditions Center

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