What Are the Symptoms of GERD in Adults?

Gastroesophageal reflux disease or GERD describes chronic heartburn that can damage the lining of the esophagus and cause other problems.

Acid reflux is a condition in which the acid from the stomach backs up into the esophagus, which is the tube that carries food from the mouth to the stomach. When acid reflux occurs more than twice weekly, is chronic, or causes uncomfortable symptoms or damage, it is considered to be gastroesophageal reflux disease (GERD).

Symptoms of gastroesophageal reflux disease (GERD) in adults include:

• Heartburn, which is burning pain or discomfort in the chest, stomach, abdomen, or throat
• Regurgitation, which is when acid and undigested food back up into the throat or mouth 
• Stomach pain
• Chest pain
• Difficulty swallowing
• Feeling as if food is stuck in the throat
• Hoarseness/changes in voice
• Sore throat
• Unexplained dry cough
• Belching 
• Nausea 
• Vomiting (may be bloody)
• Bloating
• Bloody or black stools
• Unexplained weight loss
• Wheezing
• Bad breath
• Hiccups
• Breathing problems
• Tooth erosion

Gastroesophageal reflux disease (GERD) occurs when the lower esophageal sphincter becomes weak or relaxes, causing stomach contents to back up into the esophagus. 

Causes of lower esophageal sphincter weakness or relaxation include:

• Being overweight or obese, which puts increased pressure on the abdomen 
• Pregnancy, which also puts increased pressure on the abdomen
• Hiatal hernia 
• Smoking or inhaling secondhand smoke
• Certain medicines
  • Asthma medications 
  • Calcium channel blockers
  • Antihistamines
  • Painkillers
  • Sedatives
  • Antidepressants 
  • Anticholinergics 
  • Dopamine-active drugs 
  • Progestin 
• Alcohol use 
• Laying down after eating
• Scleroderma

After a history and physical examination, tests used to diagnose acid reflux and gastroesophageal reflux disease (GERD) include: 

• Upper gastrointestinal (GI) endoscopy and biopsy
• Upper GI series
• Esophageal pH and impedance monitoring
• Esophageal manometry 
• Stool occult blood test

Some people can manage gastroesophageal reflux disease (GERD) on their own with lifestyle changes or by taking non-prescription medicines. 

Home remedies to relieve gastroesophageal reflux disease (GERD) include:

• Lose weight if you are overweight or obese
• Raise the head of the bed 6 to 8 inches using blocks of wood or rubber under 2 legs of the bed or a foam wedge under the mattress
• Avoid foods that worsen symptoms 
  • Coffee
  • Chocolate
  • Alcohol
  • Peppermint
  • Fatty or greasy foods
  • Spicy foods
• Avoid medications such as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn) that may aggravate GERD
• Take medications with plenty of water
• Don’t smoke
• Don’t overeat
• Don’t eat 2 to 3 hours before bed
  • Lying down with a full stomach can make reflux worse
• Wear loose clothing around the stomach area

If lifestyle changes do not relieve symptoms of gastroesophageal reflux disease (GERD), medications used to treat the condition include: 

• Antacids
  • Works best for mild symptoms
  • Only work for a short time
  • Available without a prescription
  • Examples include aluminum hydroxide and magnesium hydroxide (Maalox), calcium carbonate and magnesium hydroxide (Rolaids), sucrose and calcium carbonate (Tums), and simethicone (Mylanta)
• Histamine blockers
  • Stronger and longer-lasting than antacids
  • Many available without a prescription
  • Examples include cimetidine (Tagamet HB), famotidine (Pepcid AC), and nizatidine (Axid AR)
• Proton pump inhibitors (PPIs)
  • Used for frequent and more severe symptoms
  • Some are available over-the-counter (OTC) and some require a prescription
  • Examples include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole (Protonix), and rabeprazole (AcipHex) 
• Prokinetics
  • Used to help the stomach empty faster
  • Examples include bethanechol (Urecholine) and metoclopramide (Reglan) 
• Antibiotics
  • Can help the stomach empty faster
  • Erythromycin has fewer side effects than prokinetics

In severe cases of gastroesophageal reflux disease (GERD) surgery may be recommended when symptoms do not improve with lifestyle changes or medications. 

Surgery used to treat gastroesophageal reflux disease (GERD) includes: 

• Fundoplication
  • A laparoscopic procedure in which a thin tube with a tiny video camera is inserted into the abdomen and the top part of the stomach is sewn around the esophagus to reduce reflux
• Endoscopic techniques
  • Endoscopic sewing uses small stitches to tighten the sphincter muscle
  • Radiofrequency creates heat lesions, or sores, to help tighten the sphincter muscle
  • Results for endoscopic techniques are not as good as those for fundoplication