Reflux disease: symptoms, causes, diagnosis

Author:
Annamaria Ambrosova
Do you often feel a burning sensation in your chest after meals or wake up with acid in your throat? You might be experiencing Gastroesophageal Reflux Disease (GERD), a common digestive disorder. GERD occurs when stomach contents, including acid, flow back into the esophagus (the tube that carries food from your mouth to your stomach), causing discomfort and sometimes more serious complications. In Western countries, up to 1 in 4 people may experience GERD, while it is less common in Asia. Understanding the causes, symptoms, and ways to manage GERD can help improve your comfort and prevent long-term damage.
Hands holding chest due to heartburn caused by reflux disease.
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What happens in GERD?

Normally, a valve-like barrier called the lower oesophageal sphincter (LES) prevents stomach contents from coming back up. GERD develops when this barrier weakens or relaxes too often, allowing acid, digestive enzymes, and sometimes bile to move into the oesophagus.

Your body tries to protect the esophagus through:

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  • Swallowing and esophageal movement, which help clear refluxed material
  • Saliva, which can neutralize some acid
  • The lining of the oesophagus, which resists damage if healthy

When these defenses are overwhelmed, irritation and inflammation occur, leading to symptoms.

Common symptoms

The classic signs of GERD include:

  • Heartburn – a burning feeling behind the breastbone
  • Regurgitation – the sensation of stomach contents rising into your throat or mouth

Some people have less obvious symptoms, including:

  • Chronic cough or worsening asthma
  • Hoarseness or laryngitis
  • Feeling of a lump in the throat
  • Chest discomfort not related to heart problems
  • Nausea or dental enamel damage

What increases the risk of GERD?

Several factors can make reflux more likely:

Lifestyle and Habits

  • Obesity – excess weight increases pressure on the stomach
  • Smoking – slows acid clearance
  • Alcohol – can increase stomach acid and impair oesophagus movement
  • Diet – fatty foods, chocolate, caffeine, spicy foods, and carbonated drinks can trigger symptoms

Physical factors

  • Hiatal hernia – a structural change that allows stomach acid to move up
  • Pregnancy – hormones and pressure from the uterus can increase reflux

Psychological factors

  • Stress, anxiety, and depression can amplify the perception of heartburn and reflux

How is GERD diagnosed?

Often, doctors can diagnose GERD based on your symptoms. An initial approach may include:

  • Trial of acid-suppressing medication, like Proton Pump Inhibitors (PPIs) – relief of symptoms suggests GERD

For more complicated cases or when symptoms do not improve, specialized tests may be used:

  • Endoscopy – a small camera looks directly at the esophagus for damage
  • pH monitoring – measures acid exposure in the esophagus over 1–4 days
  • Esophageal motility testing – checks for disorders that can mimic GERD

Treating GERD

The goal is to relieve symptoms and prevent damage to the esophagus.

Lifestyle changes

  • Lose excess weight if overweight
  • Stop smoking and limit alcohol
  • Avoid lying down soon after meals; wait 2–3 hours before bedtime

Medications

  • PPIs are the most effective for reducing acid production
  • Other treatments may include medications or behavioral approaches for people with reflux sensitivity or functional heartburn

With proper management, most people experience significant symptom relief and can prevent serious complications.

Conclusion

GERD is a common but manageable condition. Recognizing the signs, burning chest, regurgitation, chronic cough, or throat irritation, can help you take steps to protect your oesophagus. Lifestyle changes, medication, and medical guidance can greatly improve your comfort and quality of life. If symptoms are persistent, don’t ignore them, consult a healthcare professional for proper evaluation and treatment.

Reference list.

Bertin, L., Savarino, V., Marabotto, E., Ghisa, M., de Bortoli, N., & Savarino, E. V. (2026). Pathophysiology of gastroesophageal reflux disease. Digestion, 107(2), 185–201. https://doi.org/10.1159/000547023 Chatila, A. T., Nguyen, M. T. T., Krill, T., Roark, R., Bilal, M., & Reep, G. (2019). Natural history, pathophysiology and evaluation of gastroesophageal reflux disease. Disease-a-Month, 66(2), 100848. https://doi.org/10.1016/j.disamonth.2019.02.001 Sadafi, S., Azizi, A., Pasdar, Y., Shakiba, E., & Darbandi, M. (2024). Risk factors for gastroesophageal reflux disease: A population-based study. BMC Gastroenterology, 24(1), 64. https://doi.org/10.1186/s12876-024-03143-9 Taraszewska, A. (2021). Risk factors for gastroesophageal reflux disease symptoms related to lifestyle and diet. Roczniki Państwowego Zakładu Higieny, 72(1), 21–28. https://doi.org/10.32394/rpzh.2021.0145

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