Overview
Gastroesophageal reflux (GER) happens when stomach contents flow back up into the esophagus, the tube that carries food from your mouth to your stomach. It's common to have it now and then.
When reflux happens often or leads to symptoms or problems, it's called gastroesophageal reflux disease (GERD). It can happen when the ring of muscle at the bottom of the esophagus is weak or relaxes when it shouldn't. A hiatal hernia can make it more likely.
Symptoms
Not everyone with GERD has heartburn.
- Heartburn: a burning feeling in the middle of the chest, behind the breastbone, rising toward the throat
- Sour or bitter taste of food or acid coming back up (regurgitation)
- Upper middle belly pain or discomfort
Less common
- Trouble swallowing or pain when swallowing
- Long-lasting cough, hoarseness, or sore throat
- Nausea
- Bloating or gas
- Chest pain
How it usually goes
- After meals: Heartburn often starts within an hour of eating, especially big or fatty meals.
- At night: Lying down can make reflux worse.
- Weeks: If heartburn happens twice a week or more, or lasts weeks despite medicine, see a healthcare professional.
Look up a symptom: Bloating or gas · Cough · Heartburn · Nausea · Throat feels tight, or like a lump in the throat · Trouble swallowing or speech slowly changing · Upper middle belly pain (below the breastbone)
When to get medical care
Causes
GERD happens when the muscle at the bottom of the esophagus is weak or relaxes at the wrong time, letting stomach acid flow back up.
Things that make reflux more likely include being overweight, pregnancy, smoking, a hiatal hernia, large or late meals, and some medicines.
Does it spread or run in families?
- It isn't contagious. You can't catch it from someone else.
Who is more likely to get it
- Being overweight
- Pregnancy
- Smoking or secondhand smoke
- A hiatal hernia
- Certain medicines, like some pain relievers and blood pressure medicines
Possible complications
- Esophagitis: Inflamed esophagus; pain or trouble swallowing
- Barrett's esophagus: Changes in the lining of the esophagus; raises cancer risk
- Narrowed esophagus: Scarring that makes swallowing hard
Diagnosis
A healthcare professional usually diagnoses GERD from your symptoms and medical history. If symptoms don't get better with lifestyle changes and medicines, you may need tests.
Questions you may be asked
- How often you have heartburn, and when
- Whether food or sour liquid comes back up into your throat or mouth
- Whether you have trouble or pain swallowing
- Whether you've lost weight without trying, or seen blood in vomit or stool
- Which foods, drinks, or medicines make it worse
The exam
They'll do a physical exam and may press on your belly. Heartburn-like chest pain may need a heart check first.
Tests
Tests may be needed if symptoms don't improve or there are warning signs:
- Upper endoscopy: A thin tube with a camera looks at your esophagus and stomach, and can take small tissue samples.
- pH monitoring: Measures how much acid comes up into your esophagus over a day or two.
- Trial of medicine: Sometimes the first step is to see whether acid-lowering medicine helps.
Treatment
Lifestyle changes and over-the-counter medicines often control symptoms. If they don't, a healthcare professional may prescribe stronger medicine. Surgery is an option for some people.
Self-care
- Eat your last meal 2 to 3 hours before lying down or going to bed
- Raise the head of your bed 6 to 8 inches with a foam wedge or extra pillows under your head and upper back
- Cut back on trigger foods, like citrus, tomatoes, chocolate, mint, spicy or fatty foods, coffee, and alcohol
- Lose weight if you're overweight
- Quit smoking, if you smoke
- Eat smaller meals
Medicines
Many reflux medicines are sold without a prescription. Talk with a healthcare professional if you need them often.
| Medicine | Helps with | Good to know |
|---|---|---|
| Antacids Calcium carbonate (Tums) | Fast relief of mild, occasional heartburn | Don't use every day or for more than 2 weeks without asking a healthcare professional. Can cause constipation or diarrhea. |
| H2 blockers | Lowering stomach acid for several hours; good taken before a meal that usually triggers heartburn | Side effects are rare; headache is most common. Ask first if you have kidney problems. |
| Proton pump inhibitors (PPIs) | Frequent heartburn; better than H2 blockers at healing the esophagus | Generally safe. Side effects can include headache and diarrhea. Talk with your healthcare professional about long-term use. |
Medicine names link to drug information from the U.S. National Library of Medicine (MedlinePlus). OwieClear doesn't give doses: follow the label or your healthcare professional.
If over-the-counter medicines don't help, or you need them most days, see a healthcare professional. They may prescribe a proton pump inhibitor (PPI) for longer-term treatment. If medicines don't work or you want to stop them, surgery (fundoplication) is an option.
How it compares
| GERD | Heart attack | Stomach ulcer | Gallstones | |
|---|---|---|---|---|
| Where | Behind the breastbone | Chest, may spread to arm or jaw | Upper middle belly | Upper right belly |
| Feels like | Burning | Pressure or squeezing | Burning or gnawing | Steady, severe ache |
| Triggers | Meals, lying down | Exertion or none | Empty stomach or meals | Fatty meals |
| Helped by antacids | Yes | No | Sometimes | No |
| Emergency? | Usually not | Yes, call 911 | If bleeding | If fever or yellow skin |
Prevention
These habits help prevent reflux:
- Stay at a healthy weight
- Don't lie down for 2 to 3 hours after eating
- Eat smaller meals
- Limit foods and drinks that trigger your symptoms
- Don't smoke
Which doctor treats this
- Start with your primary care provider (family doctor or internist).
- They may send you to a gastroenterologist (stomach and gut doctor).
Children, pregnancy, and older adults
- Babies and children: Spitting up is normal in babies. See a healthcare professional if a baby isn't gaining weight, vomits forcefully, or seems in pain.
- Pregnancy: Heartburn is common in pregnancy. Ask your healthcare professional which antacids or medicines are safe.
- Older adults: New heartburn or trouble swallowing after age 50 should be checked.
Pregnancy and breastfeeding
- If you're pregnant or planning to be, tell your prenatal provider about this condition.
- Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
- Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
- Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.
Outlook
Most people can control GERD with lifestyle changes and medicine. Treating it helps prevent damage to the esophagus.
Myths and facts
Myth: Heartburn is always from eating too much.
Fact: It can happen from a weak valve, extra weight, pregnancy, or some medicines.
Myth: Milk soothes heartburn.
Fact: Milk may help for a moment, but it can make the stomach make more acid.
Getting ready for your visit
A little preparation helps.
What to bring
- How often you have heartburn and what seems to trigger it
- All medicines you take, including over-the-counter reflux medicines, pain relievers, and supplements
- Any trouble swallowing, weight loss, or bleeding
Questions to ask
- Do I need tests, like an endoscopy?
- Which medicine should I take, and for how long?
- Is it safe for me to take a PPI long-term?
- Which changes would help me most?
Research studies
Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.
Sources
- NIH (NIDDK): Acid Reflux (GER & GERD) in Adults
- NIH (NIDDK): Symptoms & Causes of GER & GERD
- NIH (NIDDK): Treatment for GER & GERD
- NIH (NIDDK): Eating, Diet, & Nutrition for GER & GERD
Last updated 2026-11-12.