Conditions / GERD
Gastroesophageal Reflux Disease
Affects an estimated 20% of Western adults
Overview
GERD occurs when the lower esophageal sphincter (LES) — a circular muscle between the esophagus and stomach — is chronically weak or frequently relaxes inappropriately, allowing stomach acid and pepsin to backflow into the unprotected esophagus.
How it's diagnosed
Symptoms ≥2×/week for 4+ weeks. Confirmed by upper endoscopy, 24-hr pH monitoring, or esophageal manometry. pH-impedance testing is the gold standard.
Triggers
- Fatty/fried foods
- Coffee & caffeine
- Alcohol
- Tomatoes & citrus
- Chocolate
- Peppermint
- Spicy food
- Large meals
- Eating within 3hrs of sleep
- Obesity
- Pregnancy
- NSAIDs & aspirin
- Smoking
Symptoms
- Heartburn (burning behind breastbone)
- Regurgitation of acid or food
- Chest pain (rule out cardiac first)
- Difficulty swallowing (dysphagia)
- Chronic sore throat
- Hoarseness
- Chronic dry cough
- Bloating
- Nausea
Complications if untreated
- Erosive esophagitis
- Barrett's esophagus (10–15% of chronic GERD)
- Esophageal stricture
- Esophageal adenocarcinoma (rare)
- Respiratory complications
Immediate relief
- Sit or stand upright
- Drink alkaline water (pH 8.8)
- Take antacid (calcium carbonate)
- Chew DGL licorice tablet
- Sip cool aloe vera juice
- Loosen tight clothing
Long-term management
- Lose weight if BMI >25
- Elevate head of bed 6–8 inches
- Stop eating 3hrs before bed
- Small frequent meals
- Eliminate top triggers
- Diaphragmatic breathing exercises
- PPI or H2 blocker as directed
Diet
Low-acid, low-fat Mediterranean-style diet. Target pH >5 for all foods. Eliminate: citrus, tomatoes, spicy food, alcohol, coffee, fried food, chocolate, mint. Emphasize: oatmeal, lean proteins, alkaline vegetables, ginger tea, aloe vera, chamomile tea.
When to see a doctor
See gastroenterologist if: symptoms >3 months, difficulty swallowing, unintentional weight loss, vomiting blood, black stools.
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