Your esophagus is the tube that carries food from your mouth to your stomach. Gastroesophageal reflux disease (GERD) happens when a muscle at the end of your esophagus does not close properly. This allows stomach contents to leak back, or reflux, into the esophagus and irritate it.

You may feel a burning in the chest or throat called heartburn. Sometimes, you can taste stomach fluid in the back of the mouth. If you have these symptoms more than twice a week, you may have GERD. You can also have GERD without having heartburn. Your symptoms could include a dry cough, asthma symptoms, or trouble swallowing.

Anyone, including infants and children, can have GERD. If not treated, it can lead to more serious health problems. In some cases, you might need medicines or surgery. However, many people can improve their symptoms by

• Avoiding alcohol and spicy, fatty or acidic foods that trigger heartburn
• Eating smaller meals
• Not eating close to bedtime
• Losing weight if needed
• Wearing loose-fitting clothes

Most of us get heartburn from time to time. It may come as a burning sensation in the chest, or a bitter taste in the back of the throat. Heartburn is one word people use to describe reflux. It happens when stomach contents come back upwards. Reflux is sometimes painless: You may have trouble swallowing or get a dry cough, perhaps some wheezing.

Occasional reflux episodes are normal. Like millions of Americans, you can manage reflux by avoiding foods that don’t agree with you—things that are fatty, spicy or acidic—or by eating smaller meals. If reflux occurs less than once a week, you can usually cope by making lifestyle changes or using over-the-counter medications.

“We all have a little reflux when we burp or belch,” says Dr. John Pandolfino of Northwestern University. But of the 20 million or more Americans with reflux, about 5% have significant episodes 2 or 3 times per day. When severe events occur this often, it’s not ordinary reflux. It may be gastroesophageal reflux disease (GERD). You may need prescription medications to control it.

GERD should be taken seriously. Stomach (gastric) contents contain acid needed to digest food. In reflux, these contents wash upward into the esophagus, a slender tube connecting the mouth and the stomach. Because the lining of the esophagus isn’t meant to touch gastric acid, the acid can irritate the lining of the esophagus and lead to bleeding and scarring. In adults, GERD can raise the risk of cancer of the esophagus. And if you have asthma, GERD can make it worse.

As for babies, reflux is common in healthy infants. Most babies outgrow reflux by 13 months, but if they don’t, they too may have GERD.

GERD can harm a child’s ability to feed and grow. It can also increase the risk for inhaling stomach contents into the lungs. This can be life-threatening.

People of any age can have GERD. Available medications, whether over-the-counter or prescription, can make the acid in the esophagus less intense. But medications don’t prevent GERD. Surgery can be an option if symptoms are severe and medicine and lifestyle changes don’t seem to help.

Dr. Michael Raymond Ruggieri, Sr., of Temple University is researching the root causes of GERD. The problem isn’t that the stomach makes too much acid. In GERD, the special set of muscles between the esophagus and the stomach is weakened.

“The stomach muscle fibers are not doing their job, and we’re trying to understand why they’re not,” says Dr. Ruggieri. His team is among the first to look at how nerves receive and send messages to these muscle fibers. Their goal is to develop drugs that prevent GERD altogether.

If you have reflux twice or more per week, talk to your health care provider. It’s best to start treatment early to prevent GERD from leading to more serious health problems.

How To Steer Clear of Reflux

• Maintain a healthy weight.
• Eat smaller meals.
• Avoid triggering foods, including alcohol.
• Don’t lie down for 3 hours after a meal.
• Raise the head of your bed 6 to 8 inches by putting wood blocks under the bedposts.
• For an infant, try burping frequently during feeding. Keep the infant upright for 30 minutes after feeding.
• If you have reflux twice or more per week, see your health care provider.

What is GER?

Gastroesophageal reflux (GER) happens when your stomach contents come back up into your esophagus. Many people have GER once in a while, and GER often happens without causing symptoms. In some cases, GER may cause heartburn, also called acid indigestion.

Does GER have another name?

Doctors also refer to GER as

• acid indigestion
• acid reflux
• acid regurgitation
• heartburn
• reflux

How common is GER?

Having GER once in a while is common.

What is GERD?

Gastroesophageal reflux disease (GERD) is a more severe and long-lasting condition in which GER causes repeated symptoms that are bothersome or leads to complications over time.

If you think you may have GERD, you should see your doctor.

How common is GERD?

Researchers estimate that about 20 percent of people in the United States have GERD.

Who is more likely to have GERD?

Anyone can develop GERD. You are more likely to have GERD if you

• are overweight or have obesity
• are a pregnant woman
• take certain medicines
• smoke or are regularly exposed to secondhand smoke

Your lower esophageal sphincter and diaphragm most often prevent GER, which is when stomach contents come back up into your esophagus. However, many people have GER once in a while.

GERD may develop if your lower esophageal sphincter becomes weak or relaxes when it shouldn’t. Factors that may affect the lower esophageal sphincter and lead to GERD include

• being overweight or having obesity
• being pregnant
• smoking or inhaling secondhand smoke

Some medicines can cause GERD or make GERD symptoms worse. Examples include

• benzodiazepines, sedatives that make you calmer or sleepy
• calcium channel blockers, which are used to treat high blood pressure
• certain asthma medicines
• nonsteroidal anti-inflammatory drugs (NSAIDs)
• tricyclic antidepressants

A hiatal hernia can also increase the chance of getting GERD or make GERD symptoms worse. A hiatal hernia is a condition in which the opening in your diaphragm lets the upper part of the stomach move up into your chest.

Gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) commonly cause symptoms such as

• heartburn, a painful, burning feeling in the middle of your chest, behind your breastbone, rising from the lower tip of your breastbone toward your throat
• regurgitation, or stomach contents coming back up through your esophagus and into your throat or mouth, which may cause you to taste food or stomach acid

However, not all adults with GERD have heartburn or regurgitation. Other symptoms may include

• chest pain
• nausea
• problems swallowing or pain while swallowing
• symptoms of complications in the mouth, throat, or lungs, such as chronic cough or hoarseness

You should see a doctor if you think you have GERD, or if your symptoms don’t get better with over-the-counter medicines or lifestyle changes.

You should also see a doctor if you have symptoms that could be related to GERD complications or other serious health problems, such as

• chest pain
• loss of appetite
• persistent vomiting
• problems swallowing or pain while swallowing
• signs of bleeding in the digestive tract, such as
  • vomit that contains blood or looks like coffee grounds
  • stool that contains blood or looks black and tarry
• unexplained weight loss

How do doctors diagnose GER & GERD?

In most cases, doctors diagnose gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) by reviewing your symptoms and medical history. If your symptoms suggest you have GERD, your doctor may recommend treatment with medicines and lifestyle changes, instead of doing tests.

Your doctor may recommend medical tests if

• your symptoms suggest you might have a complication of GERD
• your symptoms suggest that you might have another health problem that causes symptoms similar to those of GERD
• your symptoms don’t improve after treatment with medicines and lifestyle changes

Your doctor may refer you to a gastroenterologist to diagnose and treat GERD.

What tests do doctors use to diagnose GERD?

Your doctor may order one or more of the following tests to help diagnose GERD and check for GERD complications or other health problems.

Upper gastrointestinal (GI) endoscopy

Upper GI endoscopy is a procedure in which a doctor uses an endoscope—a flexible tube with a camera—to see the lining of your upper GI tract, including your esophagus, stomach, and duodenum. During upper GI endoscopy, a doctor may obtain biopsies by passing an instrument through the endoscope to take small pieces of tissue from the lining of your esophagus. A pathologist will examine the tissue under a microscope. Doctors may order an upper GI endoscopy to check for complications of GERD or problems other than GERD that may be causing your symptoms.

Esophageal pH monitoring

Esophageal pH monitoring is the most accurate way to detect stomach acid in the esophagus. Two types of esophageal pH monitoring are

• catheter monitoring, in which a health care professional passes one end of a catheter—a thin, flexible tube—through your nose and into your esophagus to measure acid and nonacid reflux
• capsule monitoring, in which a health care professional uses an endoscope to place a small, wireless capsule on the lining of your esophagus to measure acid reflux

During esophageal pH monitoring, you’ll wear a monitor that receives information from the catheter or capsule and tracks information about your diet, sleep, and symptoms. Your doctor will use this information to see how your diet, sleep, and symptoms relate to acid reflux in your esophagus. Doctors may order this test to confirm the diagnosis of GERD or to find out if GERD treatments are working.

Your doctor may recommend that you make lifestyle changes and take medicines to manage symptoms of gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD). In some cases, doctors may also recommend surgery.

Lifestyle changes

Lifestyle changes may reduce your symptoms. Your doctor may recommend

• losing weight if you’re overweight or have obesity
• elevating your head during sleep, either by safely putting blocks under your bedposts to raise the head of your bed 6 to 8 inches or by placing a foam wedge under your head
• quitting smoking, if you smoke
• changing your eating habits and diet

Over-the-counter and prescription medicines

You can buy many GERD medicines over the counter. However, if you have symptoms that will not go away with over-the-counter medicines, you should talk with your doctor. Your doctor may prescribe one or more medicines to treat GERD.

Antacids. Doctors may recommend antacids to relieve mild heartburn and other mild GER and GERD symptoms. Antacids are available over the counter. Antacids can help relieve mild symptoms. However, you shouldn’t use these medicines every day or for severe symptoms, except after discussing your antacid use with your doctor. These medicines can have side effects, such as diarrhea or constipation.

H2 blockers. H2 blockers lower the amount of acid your stomach makes. H2 blockers can help heal the esophagus, but not as well as proton pump inhibitors (PPIs) can. You can buy H2 blockers over the counter, or your doctor can prescribe one.

Proton pump inhibitors (PPIs). PPIs lower the amount of acid your stomach makes. PPIs are better at treating GERD symptoms than H2 blockers, and they can heal the esophageal lining in most people with GERD. You can buy PPIs over the counter, or your doctor can prescribe one. Doctors may prescribe PPIs for long-term GERD treatment.

PPIs are generally safe and effective. Side effects are uncommon and may include headache, diarrhea, and upset stomach. Research also suggests that taking PPIs may increase the chance of Clostridioides difficile (C. diff) infection. Experts are still studying the effects of taking PPIs for a long time or in high doses. Talk with your doctor about the risks and benefits of taking PPIs.

Other medicines. If antacids, H2 blockers, and PPIs don’t improve your symptoms, your doctor may recommend other medicines.

Surgery and other medical procedures

Your doctor may recommend surgery if your GERD symptoms don’t improve with lifestyle changes and medicines, or if you wish to stop taking long-term GERD medicines to manage symptoms. You’re more likely to develop complications from surgery than from medicines.

Fundoplication. Fundoplication is the most common surgery for GERD. In most cases, it leads to long-term improvement of GERD symptoms. During the operation, a surgeon sews the top of your stomach around the end of your esophagus to add pressure to the lower esophageal sphincter and help prevent reflux.

Surgeons may perform fundoplication as laparoscopic or open surgery. In laparoscopic fundoplication, which is more common, surgeons make small cuts in the abdomen and insert special tools to perform the operation. Laparoscopic fundoplication leaves several small scars. In open fundoplication, surgeons make a larger cut in the abdomen.

Bariatric surgery. If you have GERD and obesity, your doctor may recommend weight-loss surgery, also called bariatric surgery, most often gastric bypass surgery. Bariatric surgery can help you lose weight and reduce GERD symptoms.

Endoscopy. In a small number of cases, doctors may recommend procedures that use endoscopy to treat GERD. For endoscopy, doctors insert an endoscope—a small, flexible tube with a light and camera—through your mouth and into your esophagus. Doctors may use endoscopic procedures to sew the top of your stomach around the lower esophageal sphincter or to deliver radiofrequency energy to the sphincter. Doctors don’t use these procedures often.

The next time you reach for a nonprescription drug to treat your upset stomach or heartburn, consider whether you should use one of the many antacids that don’t have aspirin.

Why? Aspirin-containing medicines to treat heartburn, sour stomach, acid indigestion or upset stomach can cause stomach or intestinal bleeding, especially in some people, warns the U.S. Food and Drug Administration.

Aspirin is commonly used to reduce pain and fever. It is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding, including in the stomach and gastrointestinal tract (digestive tract).

“We’re focusing on bleeding risk specifically with antacid-aspirin products used to treat upset stomach or heartburn. We’re not telling people to stop taking aspirin altogether,” says Karen Murry, M.D., Deputy Director of the Office of Nonprescription Drugs at the FDA.

Cases of bleeding are rare. When the FDA reviewed its Adverse Event Reporting System database, it found new cases of serious bleeding caused by aspirin-containing antacid products despite an agency warning in 2009 about such a risk. Some of those patients required a blood transfusion.

“Take a close look at the Drug Facts label. If the product has aspirin, consider choosing something else for your stomach symptoms,” Murry says. “Unless people read the Drug Facts label when they’re looking for stomach symptom relief, they might not even think about the possibility that a stomach medicine could contain aspirin.”

How will you know what over-the-counter (OTC, or nonprescription) medicine to take to get relief from indigestion? The Drug Facts label will not only tell you if the medicine contains aspirin but also will list the risk factors for bleeding. If the medicine has aspirin, consider finding another product. There are plenty of stomach medicines that don’t contain aspirin.

Who’s at Higher Risk of Bleeding

Because aspirin thins the blood, the FDA believes the aspirin in these combination medicines is contributing to major bleeding events. People with one or more risk factors have a higher chance of serious bleeding with aspirin-containing antacid products.

You are at higher risk for bleeding with these products if you:

• Are 60 or older.
• Have a history of stomach ulcers or bleeding problems.
• Take drugs that reduce the ability of your blood to clot (also known as anticoagulants or blood-thinning drugs).
• Take steroid medicine, such as prednisone, to reduce inflammation.
• Take other medicines containing NSAIDs, such as ibuprofen or naproxen.
• Drink three or more alcoholic drinks every day.

Warning signs of stomach or intestinal bleeding include feeling faint, vomiting blood, passing black or bloody stools, or having abdominal pain. Those are signs that you should consult a health care professional right away.

What if you’ve been taking these products for a long time?

“Some people may have been taking aspirin-containing antacid products frequently for a long time. Apart from the bleeding risk, it’s not normal to have frequent or chronic upset stomach or heartburn. You should talk to a health care professional if that’s happening,” Murry says.

Take aspirin regularly? If your health care professional has advised you to take an aspirin a day to help prevent a heart attack or other condition, don’t stop without talking with them first. “Make sure you discuss what kind of medicine you can take in case you get an upset stomach,” Murry says.

How to Settle an Upset Stomach

People have many alternatives for treating heartburn, sour stomach, acid indigestion and upset stomach. Read the Drug Facts label and look for products that contain an “antacid” or “acid reducer.”

For example, there are numerous nonprescription medicines that contain only an antacid, such as calcium carbonate, magnesium hydroxide, or another antacid,” Murry says. These products can be used to treat heartburn, sour stomach, acid indigestion and upset stomach.

For frequent heartburn, there are acid reducers, such as proton pump inhibitors (esomeprazole, lansoprazole, omeprazole), or H2 blockers (cimetidine, famotidine).

What’s the Bottom Line?

Talk to your health care provider if you experience symptoms such as heartburn or regurgitation (the feeling of food or liquid coming into the chest) that don’t get better.

• Based on your symptoms, your health care provider may prescribe medications along with lifestyle changes.
• If you have been diagnosed with gastroesophageal reflux disease (GERD), consult your health care provider before adding any complementary health products or practices to your management program.

How much do we know about the usefulness of complementary approaches for GERD?

A growing body of research shows that some complementary approaches, such as acupuncture, breathing exercises, and alginates (compounds found in brown algae or seaweed) may improve GERD symptoms and quality of life.

Physical and Psychological Approaches

• Acupuncture may be an effective treatment, alone or in conjunction with conventional therapies, to improve GERD-related symptoms such as heartburn and acid reflux.
• Some studies suggest that breathing exercises, or diaphragmatic breathing training, can reduce GERD symptoms by strengthening the diaphragm and reducing acid in the esophagus, but more research is needed to be sure.
• A few small studies suggest that hypnosis and relaxation techniques may improve GERD symptoms alone or in combination with medications for some patients. Larger, high-quality studies are needed to find out whether these methods are helpful in the long term.

Nutritional Approaches

• Research shows that alginates, which are derived from carbohydrates found in brown algae or seaweed, are an effective treatment for reducing GERD symptoms by creating a foam or raft that rests over the gastric content in the esophagus to prevent reflux.
• Only a few small studies have been conducted on melatonin for GERD symptoms, so there isn’t enough evidence to determine its effectiveness for this condition.

What do we know about the safety of complementary approaches for GERD?

• Acupuncture is generally considered to be safe, and relatively few complications have been reported.
• Diaphragmatic breathing has been shown to be a safe approach for managing GERD.
• Alginates are considered to be safe, and no serious side effects have been reported.
• Short-term use of melatonin supplements appears to be safe for most people, but information on the long-term safety of supplementing with melatonin is lacking. There’s not enough information yet about possible side effects of high-dose melatonin supplements to have a clear picture of overall safety.

What Is Gastroesophageal Reflux Disease (GERD)?

Gastroesophageal reflux disease (GERD) is a chronic digestive disorder that causes stomach contents to back up from the stomach into the esophagus. It happens when a muscle at the end of the esophagus, the tube that carries food from the mouth to the stomach, doesn’t close properly.

The most common symptoms of GERD are a burning sensation in the chest or back of the throat, called heartburn, and stomach contents coming back up through your esophagus and into your throat or mouth, called regurgitation. Many people experience both symptoms, but some can have one without the other. Other symptoms can include a dry cough, asthma symptoms, or trouble swallowing.

Approximately 20 percent of the U.S. population has GERD. While almost everyone will experience heartburn from time to time, symptoms that occur more than twice a week are usually GERD and should be discussed with a health care provider.

Lifestyle modifications are the first steps for treating GERD. These include changing eating habits or avoiding certain foods, elevating the head of the bed for sleeping, reaching and maintaining a healthy weight, and quitting smoking. Over-the-counter antacids, histamine-2 (H2) blockers, and proton pump inhibitors (PPIs) can relieve heartburn symptoms. Read the labels carefully and talk with your health care provider about any prescription medications you use because of potential interactions. Contact your health professional if using over-the-counter medicines more than 2 weeks as prescription H2 blockers and PPIs may be necessary.

Several severe complications can occur for people with ongoing GERD, including:

• Peptic stricture—This is a narrowing of the esophagus that causes difficulty swallowing and food “sticking” in the throat.
• Barrett’s esophagus—The pink, smooth, flat lining of the esophagus changes to a thick, red lining. This condition can be a risk factor for esophageal cancer.
• Esophageal cancer—If left untreated, GERD is a major risk factor for esophageal cancer.

Stress and anxiety can increase GERD symptoms, especially among people who do not respond well to PPI therapy.

About Complementary Health Approaches

Complementary approaches can be classified by their primary therapeutic input (how the therapy is taken in or delivered), which may be:

• Nutritional (e.g., special diets, dietary supplements, herbs, probiotics, and microbial-based therapies).
• Psychological (e.g., meditation, hypnosis, music therapies, relaxation therapies).
• Physical (e.g., acupuncture, massage, spinal manipulation).
• Combinations such as psychological and physical (e.g., yoga, tai chi, dance therapies, some forms of art therapy) or psychological and nutritional (e.g., mindful eating).

Nutritional approaches include what the National Center for Complementary and Integrative Health (NCCIH) previously categorized as natural products, whereas psychological and/or physical approaches include what was referred to as mind and body practices.

What the Science Says About the Effectiveness and Safety of Complementary Health Approaches for GERD

Research has shown promising results for some complementary and integrative health approaches for treating GERD, especially in conjunction with conventional therapies.

Physical and Psychological Approaches

Acupuncture

There is some evidence that acupuncture, alone or in combination with medication, may reduce GERD symptoms.

• A 2017 review of 12 studies with a total of 1,235 participants determined that participants who received acupuncture combined with standard medication had superior improvement of GERD symptoms and lower recurrence rates compared to those who received only standard medication.

Safety

• Relatively few complications from using acupuncture have been reported. However, complications have resulted from use of nonsterile needles and improper delivery of treatments.
• When not delivered properly, acupuncture can cause serious adverse effects, including infections, punctured organs, and injury to the central nervous system.
• The U.S. Food and Drug Administration (FDA) regulates acupuncture needles as medical devices and requires that they be sterile and labeled for single use only.

Diaphragmatic Breathing

There is some evidence that diaphragmatic breathing exercises, a type of respiratory physiotherapy, can relieve mild GERD symptoms by strengthening the diaphragm and improving the function of the antireflux barrier.

• A 2023 review of 11 studies found that diaphragmatic breathing and other respiratory physiotherapy improves GERD symptoms and, in some cases, may reduce PPI use.
• A 2016 review of four prospective controlled trials found that breathing training had a positive effect on strengthening the diaphragm and reducing GERD symptoms. However, there is a lack of consensus on overall effectiveness due to differences in training methods and ways of measuring results.

Safety

• Diaphragmatic breathing is considered to be a safe and cost-effective treatment for mild GERD with few side effects.

Other Physical and Psychological Approaches

• A few small studies suggest hypnosis, relaxation techniques, and cognitive behavioral therapy (CBT) may help improve symptoms for some people who do not respond well to PPIs and may also have anxiety disorders or depression.
• A small study of 39 people with GERD and supragastic belching, which can have a significant impact on quality of life, found CBT relieved symptoms for up to 12 months.

Safety

• Hypnosis, relaxation techniques, and CBT are considered to be safe.

Nutritional Approaches

There is limited research on the effectiveness of nutritional approaches for treating GERD, including alginates, melatonin, probiotics, dietary supplements, and Chinese herbal medicine.

Alginates

There is evidence that alginates, which are derived from carbohydrates found in brown algae or seaweed, may control and relieve GERD symptoms.

• A 2017 review of 14 studies found alginate-based therapies were superior to either placebo or antacid therapy in 9 studies but were less effective compared to PPIs and H2 blockers used to treat GERD symptoms in 5 studies.

Safety

• Alginates are considered to be safe, and no serious side effects have been reported.

Melatonin

There has been some interest in melatonin for treating GERD symptoms because it is synthesized in the gastrointestinal tract and aids in the movement of food through the body.

• Two small studies suggest that melatonin may be as or more effective than 20 mg of the PPI omeprazole in reducing symptoms.
• A separate small study suggests that combining 3 mg a day of melatonin with 20 mg a day of omeprazole may be more effective than omeprazole alone.

Safety

• For melatonin supplements, particularly at doses higher than what the body normally produces, there’s not enough information yet about possible side effects to have a clear picture of overall safety. Short-term use of melatonin supplements appears to be safe for most people, but information on the long-term safety of supplementing with melatonin is lacking.
• As with all dietary supplements, people who are taking medicine should consult their health care providers before using melatonin. In particular, people with epilepsy and those taking blood thinner medications need to be under medical supervision when taking melatonin supplements.
• The 2015 guidelines by the American Academy of Sleep Medicine recommend against melatonin use by people with dementia.

More To Consider

• If you have GERD, you may have to try a few treatments—lifestyle changes, medicines, physical/psychological approaches—to see what works best for you. See what your health care provider recommends.
• If you’re considering a practitioner-provided complementary health practice such as acupuncture, ask a trusted source (such as the health care provider who treats your GERD or a nearby hospital) to recommend a practitioner. Find out about the training and experience of any practitioner you’re considering. NCCIH’s website offers some tips on how to find a complementary health practitioner.
• Keep in mind that some dietary supplements can interact with medications or other dietary supplements. They also may contain ingredients not listed on the label. Your health care provider can advise you about potential interactions. If you’re pregnant or nursing a child, or if you’re considering using a dietary supplement for a child, it’s especially important to consult your (or the child’s) health care provider.
• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.

How can changes in my eating habits improve GERD symptoms?

If you have gastroesophageal reflux disease (GERD) and you are overweight or have obesity, your doctor may suggest losing weight to reduce your GERD symptoms. Your doctor can recommend a healthy eating plan to help you lose weight.

If you have GERD symptoms at night or when you’re lying down, eating meals at least 3 hours before you lie down or go to bed may improve symptoms.

What should I avoid eating if I have GERD symptoms?

Some people who have GERD find that certain foods or drinks trigger symptoms or make symptoms worse. Foods and drinks that have been commonly linked to GERD symptoms include

• acidic foods, such as citrus fruits and tomatoes
• alcoholic drinks
• chocolate
• coffee and other sources of caffeine
• high-fat foods
• mint
• spicy foods

Talk with your doctor about your diet and foods or drinks that seem to increase your symptoms. Your doctor may recommend reducing or avoiding certain foods or drinks to see if GERD symptoms improve.

Without treatment, GERD can sometimes cause serious complications over time, such as esophagitis, esophageal stricture, and Barrett’s esophagus, as well as complications outside the esophagus.

Esophagitis

Esophagitis is inflammation in the esophagus. Esophagitis may cause ulcers and bleeding in the lining of the esophagus. Chronic esophagitis increases the chance of developing esophageal stricture and Barrett’s esophagus.

Esophageal stricture

An esophageal stricture happens when your esophagus becomes too narrow. Esophageal strictures can lead to problems with swallowing.

Barrett’s esophagus

GERD can sometimes lead to Barrett’s esophagus, a condition in which tissue that is similar to the lining of your intestine replaces the tissue lining your esophagus. A small number of people with Barrett’s esophagus develop a type of cancer called esophageal adenocarcinoma.

Complications outside the esophagus

Some people with GERD develop complications outside the esophagus, in the mouth, throat, or lungs. These complications may include

• asthma
• chronic cough
• hoarseness
• laryngitis—inflammation of your voice box that can cause you to lose your voice for a short time
• wearing away of tooth enamel