Gastroesophageal Reflux Disease (GERD)
Chronic acid reflux causing heartburn, regurgitation and oesophageal injury. One of the most common chronic GI conditions — lifestyle and acid suppression are first-line treatment.
What it is
GERD is the disease state of repeated reflux of stomach contents into the oesophagus, causing troublesome symptoms or oesophageal damage. The lower oesophageal sphincter normally prevents this; when it relaxes inappropriately or the stomach is distended, acid rises. About 20% of adults in Western countries have GERD symptoms weekly. Untreated chronic GERD can lead to oesophagitis, oesophageal strictures, Barrett's oesophagus (a precancerous change in lining) and oesophageal adenocarcinoma.
Key lab markers
- Haemoglobin — chronic blood loss from oesophagitis can cause iron-deficiency anaemia.
- GERD diagnosis is primarily clinical, not lab-based. Empiric treatment with a proton-pump inhibitor for 4–8 weeks is often the diagnostic test.
- Upper endoscopy — for alarm symptoms (dysphagia, weight loss, GI bleeding, age >60 with new symptoms).
- Ambulatory pH monitoring — when diagnosis is unclear or symptoms persist on PPI.
Symptoms
- Heartburn (burning sensation behind the breastbone, worse after meals or lying down)
- Regurgitation (sour or bitter taste in mouth)
- Chest pain
- Difficulty swallowing
- Chronic cough, sore throat or hoarseness
- Dental erosion
- Asthma-like symptoms
When to discuss with a doctor
Heartburn more than 2 days per week warrants a primary-care discussion. Alarm symptoms — difficulty swallowing, unintentional weight loss, blood in vomit or black stools, anaemia, or age over 60 with new symptoms — need prompt endoscopy. Lifestyle measures (weight loss, elevating the head of the bed, avoiding food within 3 hours of bedtime, identifying trigger foods) plus a proton-pump inhibitor is first-line therapy.