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Gastroesophageal Reflux Disease (GERD)

​Gastroesophageal reflux disease (GERD) is a common condition where stomach contents flow back into the esophagus (the swallowing tube). The main symptoms are:Heartburn (a burning feeling behind the breastbone)Regurgitation (sensation of food or acid coming back up)GERD is one of the most frequent conditions seen in primary care and gastroenterology clinics.

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Why is it important to treat GERD?

Reflux of acidic stomach contents can irritate the esophagus and, if left untreated, may lead to complications such as:

  • Esophagitis (inflammation of the esophagus)

  • Ulcers or strictures (narrowing of the esophagus)

  • Barrett’s esophagus, which increases the risk of esophageal cancer over many years (rare but serious)

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When should your doctor refer you to a Gastroenterologist?

Referral may be needed if you develop “alarm” symptoms, including:

  • Difficulty swallowing (dysphagia)

  • Painful swallowing (odynophagia)

  • Unexplained weight loss

  • Vomiting blood or black, tarry stools (signs of bleeding in the upper digestive tract)

  • Symptoms that do not improve with standard treatment

An endoscopy may be recommended to check for inflammation, narrowing, or precancerous changes in the esophagus.

 

How is GERD treated?

Lifestyle changes

  • Avoid foods that trigger symptoms (e.g., spicy, fatty, or acidic foods, caffeine, alcohol)

  • Avoid lying down for at least 2–3 hours after meals

  • Elevate the head of the bed when sleeping

  • Weight loss if overweight or obese

  • Stop smoking

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Medications

  • Proton pump inhibitors (PPIs): Reduce stomach acid and are the most effective medications for healing and symptom control

  • Other options may include H2 blockers or add-on treatments if PPIs alone are not enough

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Other treatments

If lifestyle changes and medications are not effective, your doctor may refer you to a Gastroenterologist to consider additional options, such as anti-reflux surgery or endoscopic therapies.

 

Reference:Katz PO, Dunbar KB, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ. ACG Clinical Guideline: Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2022;117(1):27-56. doi:10.14309/ajg.0000000000001538

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