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Acid Reflux (GERD)

Persistent heartburn is not normal — it's treatable.

Gastroesophageal reflux disease is when stomach acid chronically refluxes into the oesophagus, causing heartburn, regurgitation, and — if untreated — damage. Most cases respond to lifestyle change and acid suppression.

Causes & risk factors

  • Weak lower oesophageal sphincter
  • Hiatal hernia
  • Obesity
  • Pregnancy
  • Smoking and alcohol
  • Certain foods (spicy, fatty, citrus, coffee)

Symptoms

  • Burning behind the breastbone, worse after meals or lying down
  • Sour taste or regurgitation
  • Chronic cough, especially at night
  • Hoarseness or sore throat
  • Difficulty swallowing

How it's diagnosed

  • Clinical in typical cases
  • Trial of PPI therapy
  • Endoscopy for alarm symptoms or >50 with new onset
  • pH monitoring in refractory cases

Evidence-based treatment

  • Weight loss if overweight
  • Smaller, earlier dinners; avoid lying down for 3 hours after
  • Elevate head of bed by 6 inches
  • H2 blockers or PPIs
  • Fundoplication for severe, drug-resistant cases

Related symptoms

Acid Reflux (GERD) — FAQ

Are PPIs safe long-term?

Short- to medium-term use is well-studied and safe. Long-term use has small associations with bone loss, B12 deficiency, and kidney issues — worth reviewing annually whether the dose is still needed.