What is GERD? Symptoms, Causes, Treatment & Diet Tips

What is GERD?

GERD is short for gastroesophageal reflux disease, and happens when stomach acid frequently flows back into the esophagus, the tube connecting your mouth to your stomach. This repeated backwash of acid irritates the esophageal lining and, over time, can cause inflammation and other complications.¹

How is GERD different from occasional heartburn?

GERD is different from occasional heartburn or acid reflux in that it occurs more frequently; for instance, it constitutes as GERD if you experience mild acid reflux twice a week or more, or moderate to severe acid reflux more than once a week. While occasional heartburn is a nuisance, GERD is a chronic condition that requires ongoing management.^3,4

What causes GERD?

GERD is caused by frequent acid reflux.¹ When you swallow, a circular band of muscle at the bottom of the esophagus called the lower esophageal sphincter (LES) relaxes to let food pass into the stomach, then closes again. If the LES weakens or relaxes at the wrong time, stomach acid can flow back into the esophagus and cause irritation.¹

Risk factors that increase your chance of developing GERD^1,3:

• Obesity or excess weight
• Hiatal hernia – when the upper part of the stomach pushes through the diaphragm and into the chest
• Pregnancy
• Smoking or exposure to secondhand smoke
• Connective tissue disorders
• Delayed gastric emptying, potentially due to GLP-1 medications

Factors that can aggravate acid reflux include:^1,4

• Eating large meals late at night
• Consuming fatty or fried foods, alcohol, or coffee
• Taking certain medications, like aspirin or anti-inflammatory drugs

What are the symptoms of GERD?

GERD symptoms can affect your daily comfort, sleep, and overall quality of life. Each person may not experience GERD in the same way.⁴ Some common symptoms of GERD include:^1,3,4

• Burning sensation in the chest (heartburn) which may worsen after eating
• Backwash of sour liquid or food in the throat
• Difficulty swallowing
• Sensation of a lump in the throat
• Pain in the chest or upper belly
• Nausea or frequent burping
• Disrupted sleep

When to see a doctor about GERD

Seek medical help right away if you have chest pain, especially if you also have shortness of breath, or jaw or arm pain, as these may be symptoms of a heart attack. Make an appointment if you have severe or frequent GERD symptoms or take OTC heartburn medicines more than twice a week.^1,4

How is GERD diagnosed?

To diagnose you with GERD, your doctor will probably conduct a physical exam and ask you about the history of your symptoms, including how long you’ve been experiencing them. Your doctor may also want to check for any complications through the following additional assessments:^2,3

• Upper endoscopy
• Ambulatory acid (pH) probe test
• Esophageal manometry
• X-ray of your upper digestive tract
• Transnasal esophagoscopy

What are GERD treatment options?

Treatment for GERD typically follows a stepped approach: starting with lifestyle changes and OTC medications, then escalating if needed. Most people can manage GERD with lifestyle changes and medicine.³

Lifestyle changes to manage GERD^2,4

• Maintain a healthy weight — Excess pounds put pressure on the abdomen, pushing up the stomach and causing acid to reflux.
• Quit smoking — Smoking decreases the lower esophageal sphincter's ability to function properly.
• Elevate the head of your bed — Raise the head end 6 to 9 inches using blocks or a wedge to reduce nighttime reflux.
• Don't lie down after a meal — Wait at least 2–3 hours after eating before lying down or going to bed.
• Eat slowly and chew thoroughly — Put down your fork between bites and avoid eating large meals.
• Wear loose-fitting clothing — Tight waistbands put pressure on the abdomen and the LES.
• Start on your left side when lying down to help reduce reflux.

Over-The-Counter Medications

Over-the-counter (OTC) medications may alleviate your GERD symptoms, at least temporarily. These OTC medications include antacids; medications to reduce acid production, or H-2-receptor blockers; or medications to block acid production and heal the esophagus, or proton pump inhibitors.².

Prescription drugs & surgery

If OTC options don't provide adequate relief within a few weeks, your doctor may prescribe stronger treatments including prescription-strength PPIs, prescription-strength H2 blockers, or a newer class of medicines called potassium-competitive acid blockers.²

In severe cases, surgical options may be employed to help tighten the LES and keep the stomach’s contents from refluxing.²

Can diet relieve GERD symptoms?

Diet is one of the most effective levers for managing GERD symptoms. Avoiding certain trigger foods and adopting better eating habits can make a significant difference.⁴

What foods can trigger GERD?⁴

• Fried or fatty foods
• Chocolate
• Peppermint
• Alcohol
• Coffee
• Carbonated drinks
• Tomato sauce and citrus fruits or juices
• Ketchup, mustard and vinegar

What eating habits can help manage GERD?^2,3,4

• Eating smaller portions
• Stop eating 2-3 hours before bedtime
• Eat slowly and chew thoroughly
• Avoid laying down after eating
• Sleep on your left side
• Maintain a healthy weight

What happens if GERD is left untreated?

If left untreated, chronic GERD can lead to serious complications over time:^1,3,4

• Esophagitis — Stomach acid breaks down esophageal tissue, causing inflammation, bleeding, and sometimes open sores (ulcers).
• Esophageal stricture — Scar tissue from acid damage narrows the food pathway, leading to swallowing problems.
• Barrett's esophagus — Acid damage causes changes in the tissue lining the lower esophagus.
• GERD can also worsen asthma or cause chronic cough and hoarseness.

Can TUMS help with GERD?

While products like TUMS Ultra Strength 1000 help to relieve occasional acid reflux and heartburn, it is not a recommended treatment for GERD. TUMS is an antacid containing calcium carbonate that neutralizes stomach acid on contact, providing fast relief for occasional heartburn and acid indigestion. However, antacids alone won’t heal an esophagus that’s been damaged by stomach acid.²

If you think you are experiencing GERD, be sure to speak with your doctor. They can point you in the right direction of a treatment protocol specific to your needs.

If you believe that your occasional reflux is due to GLP-1 usage, TUMS is the #1 physician recommended product for heartburn caused by GLP-1 therapy.*

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