Acid reflux is a condition in which the acid from the stomach backs up into the esophagus, the tube that brings food from the mouth to the stomach.
When acid reflux happens more than twice weekly, is chronic, or causes uncomfortable symptoms or damage, it is considered to be GERD, which stands for gastroesophageal reflux disease.
There are two main types of GERD:
- Recurrent but nonprogressive GERD
- Affects about 80% of people diagnosed
- Usually able to be controlled with medications
- Progressive GERD
- Affects the remaining 20% of patients
- Can result in severe complications, such as strictures or Barrett esophagus
- Surgery may be needed
There are four stages of GERD:
- Stage 1: Mild GERD
- Mild symptoms once or twice monthly
- Treatment involves lifestyle changes and over-the-counter (OTC) acid reducers
- Stage 2: Moderate GERD
- Symptoms are more frequent
- Requires daily prescription medication
- May affect daily activities
- Associated with esophageal inflammation
- Stage 3: Severe GERD
- Symptoms are poorly controlled even with prescription medicines
- Quality of life is affected
- Erosive esophageal inflammation is likely
- Surgery may be needed to fix the problem
- Stage 4: Reflux induced precancerous lesions or esophageal cancer
- About 10% of patients with chronic GERD will develop stage 4
- Is a result of years of untreated severe reflux
- If untreated, a precancerous condition called Barrett’s esophagus may develop
- Treatment and close follow-up and management is recommended
What Are Symptoms of GERD?
Symptoms of GERD (gastroesophageal reflux disease) include:
- Heartburn: burning pain or discomfort in the chest, stomach, abdomen, or throat
- Regurgitation: acid and undigested food back up into the throat or mouth
- Stomach pain
- Difficulty swallowing
- Feeling as if food is stuck in the throat
- Hoarseness/changes in voice
- Chest pain
- Unexplained dry cough
- Sore throat
- Belching
- Nausea
- Vomiting (may be bloody)
- Bloating
- Bloody or black stools
- Unexplained weight loss
- Bad breath
- Wheezing
- Hiccups
- Breathing problems
- Tooth erosion
How Is GERD Diagnosed?
GERD (gastroesophageal reflux disease) is diagnosed with a patient history and physical examination. Tests used to diagnose GERD include:
- Upper gastrointestinal (GI) endoscopy and biopsy
- Upper GI series
- Esophageal pH and impedance monitoring
- Esophageal manometry
- Stool occult blood test
What Is the Treatment for GERD?
Mild cases of GERD (gastroesophageal reflux disease) may be managed with lifestyle changes or by taking non-prescription medicines.
Home treatment to relieve symptoms of GERD includes:
- Avoid foods that worsen symptoms
- Coffee
- Chocolate
- Alcohol
- Peppermint
- Fatty or greasy foods
- Spicy foods
- Lose weight if you are overweight or obese
- Don’t overeat
- Don’t eat 2 to 3 hours before bed
- Lying down with a full stomach can make reflux worse
- 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 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
- Wear loose clothing around the stomach area
If lifestyle changes do not relieve symptoms of GERD, medications used to treat the condition include:
- Antacids
- Histamine blockers
- Proton pump inhibitors (PPIs)
- Prokinetics
- Antibiotics
In severe cases of GERD, surgery may be recommended when symptoms do not improve with lifestyle changes or medications.
Surgery used to treat GERD includes:
- Fundoplication
- Endoscopic techniques
From 
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https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults
https://emedicine.medscape.com/article/176595-treatment#d1
https://houstonheartburn.com/four-stages-of-gerd/