What is acid reflux and GERD?
Acid reflux occurs when digestive fluid from the stomach flows back up into the esophagus — the tube that carries food from the mouth to the stomach. Because the esophagus sits close to the heart, this backflow causes a burning sensation in the chest known as heartburn, and sometimes burning in the throat as well.
Heartburn is the most recognizable symptom of acid reflux — that uncomfortable, burning feeling rising from the stomach toward the chest and throat. Most people experience heartburn from acid reflux occasionally, particularly after a large meal or when lying down immediately after eating. When acid reflux and heartburn occur more than twice a week, or persist over several weeks, it is classified as gastroesophageal reflux disease (GERD) — a chronic condition that requires medical attention.
How does acid reflux happen?
When we eat, food travels down the esophagus into the stomach. At the junction between the esophagus and stomach, a ring of muscle called the lower esophageal sphincter opens to allow food and liquid through, then closes again to keep stomach contents down.
Acid reflux and heartburn occur when this sphincter relaxes at the wrong moment — particularly when lying flat or bending forward — allowing stomach acid to flow upward into the esophagus. Because the esophageal lining is not designed to withstand stomach acid, even brief contact causes irritation, inflammation, and that characteristic heartburn and burning sensation in the chest.
Symptoms of chronic GERD
The primary symptom of GERD is persistent heartburn, but acid reflux can also present as:
- Regurgitation — a sour or bitter taste in the mouth from stomach acid or bile
- Pain in the upper abdomen or chest
- Difficulty swallowing
- A sensation of a lump in the throat
At night, acid reflux and GERD may also cause:
- Persistent cough
- Laryngitis (voice box inflammation)
- Wheezing, or worsening of existing asthma symptoms
Complications of untreated GERD
Occasional acid reflux and heartburn that resolve quickly are generally not dangerous. However, chronic GERD left untreated over the long term can lead to serious health complications:
- Esophagitis — chronic acid reflux causes inflammation of the esophageal lining, which over time can develop into painful ulcers, bleeding, and difficulty swallowing.
- Esophageal stricture — repeated inflammation from acid reflux can cause scar tissue to form, narrowing the esophagus and interfering with the movement of food and liquid to the stomach.
- Barrett’s esophagus — approximately 10% of people with chronic GERD lasting more than one year develop this condition, in which the esophageal lining cells change in response to prolonged acid reflux exposure. These altered cells carry a risk of becoming cancerous, potentially leading to esophageal cancer.
- Esophageal cancer — two main types can develop in the esophagus: adenocarcinoma (lower esophagus) and squamous cell carcinoma (middle and upper esophagus). Adenocarcinoma of the lower esophagus is directly linked to Barrett’s esophagus caused by chronic acid reflux and heartburn over many years.
Treatment and lifestyle changes for acid reflux and GERD
Mild heartburn from occasional acid reflux typically resolves on its own. Those who experience acid reflux frequently may find relief with over-the-counter medication from a pharmacy. However, if heartburn and acid reflux symptoms occur more than twice a week, recur over several weeks, or are worsening, consult a gastroenterologist. A doctor may prescribe medication specifically for GERD alongside recommending the following lifestyle adjustments:
- Maintain a healthy weight — excess abdominal fat can press on the stomach, increasing the likelihood of acid reflux and heartburn.
- Avoid tight-fitting clothing — clothing that compresses the abdomen can reduce lower esophageal sphincter efficiency, making acid reflux more likely.
- Quit smoking — smoking weakens the lower esophageal sphincter, making acid reflux and heartburn more frequent.
- Wait before lying down after meals — allow at least 2–3 hours after eating before lying down to reduce the risk of acid reflux.
- Sleep on your left side — starting sleep on the left side reduces the likelihood of nighttime acid reflux and heartburn.
- Elevate the head of the bed — raising the head of the bed or mattress by 6–9 inches lifts the upper body from the waist up, reducing nighttime acid reflux. Note that simply propping up pillows under the head is not sufficient — the whole torso needs to be elevated, not just the head.
When should you see a doctor about acid reflux and heartburn?
Acid reflux and heartburn may seem like minor inconveniences, but when symptoms are persistent and left unaddressed, a small problem can develop into something far more serious. If you notice that acid reflux or heartburn is occurring more frequently than usual, or if over-the-counter medication is no longer providing relief, do not delay in seeking specialist advice.
For appointments or consultations, please contact Bangkok Hospital Pattaya’s Gastrointestinal and Liver Center through any of our available channels. Tel. 0 3825 9999
Frequently Asked Questions About Acid Reflux, Heartburn, and GERD
What is the difference between acid reflux, heartburn, and GERD?
Acid reflux is the backflow of stomach acid into the esophagus. Heartburn is the burning sensation in the chest that acid reflux causes. GERD is the chronic form of acid reflux — diagnosed when heartburn and acid reflux occur more than twice a week or persist over several weeks. While occasional acid reflux and heartburn are common and usually harmless, GERD requires medical assessment and treatment.
What does heartburn from acid reflux feel like?
Heartburn typically feels like a burning sensation rising from the stomach toward the chest and throat. Other acid reflux symptoms include regurgitation of a sour or bitter taste, upper abdominal or chest pain, difficulty swallowing, and a feeling of a lump in the throat.
Can acid reflux cause symptoms other than heartburn?
Yes. Especially at night, GERD can cause a persistent cough, laryngitis, and wheezing. People with existing asthma may find their symptoms worsen. These less obvious acid reflux symptoms are sometimes called atypical or extra esophageal GERD symptoms and can be mistaken for other conditions.
What causes acid reflux and heartburn?
Acid reflux and heartburn occur when the lower esophageal sphincter relaxes at the wrong moment, allowing stomach acid to flow back into the esophagus. This is more likely after eating large meals, when lying flat or bending forward, and in people who smoke, are overweight, or wear tight clothing around the abdomen.
Is acid reflux and heartburn dangerous?
Occasional acid reflux and heartburn that resolve quickly are generally not dangerous. However, chronic GERD left untreated can lead to serious complications including esophagitis, esophageal stricture, Barrett’s esophagus, and in some cases esophageal cancer. Persistent heartburn and acid reflux symptoms should not be ignored.
What is Barrett’s esophagus?
Barrett’s esophagus is a condition in which the cells lining the esophagus change in response to prolonged acid reflux exposure from chronic GERD. It occurs in approximately 10% of people with GERD lasting more than one year. Because these altered cells carry a risk of becoming cancerous, regular monitoring is important for anyone diagnosed with this condition.
Can GERD and acid reflux lead to cancer?
In some cases, yes. Chronic acid reflux can lead to Barrett’s esophagus, which in turn carries a risk of developing into esophageal adenocarcinoma — a type of cancer affecting the lower esophagus. This is one of the key reasons why persistent heartburn and acid reflux should be evaluated and treated rather than managed with antacids alone.
How is GERD treated?
Treatment typically involves a combination of medication prescribed by a doctor and lifestyle modifications. Medication may include acid-reducing drugs. Lifestyle changes for acid reflux and heartburn include maintaining a healthy weight, quitting smoking, avoiding tight clothing, waiting 2–3 hours after eating before lying down, sleeping on the left side, and elevating the head of the bed by 6–9 inches.
Can I treat acid reflux and heartburn with over-the-counter medication?
Over-the-counter antacids and acid reducers can provide relief for occasional acid reflux and heartburn. However, if symptoms occur more than twice a week, persist over several weeks, or keep recurring, over-the-counter medication is not a long-term solution. Consult a gastroenterologist for a proper diagnosis and treatment plan.
Does sleeping position affect acid reflux and heartburn?
Yes. Lying flat immediately after eating increases the risk of acid reflux and heartburn. Starting sleep on the left side can reduce nighttime acid reflux. Elevating the head of the bed by 6–9 inches — by raising the mattress itself, not just propping up pillows — lifts the entire upper body from the waist up, helping prevent stomach acid from flowing back into the esophagus during sleep.
When should I see a doctor about acid reflux and heartburn?
Consult a gastroenterologist if acid reflux or heartburn occurs more than twice a week, if symptoms recur over several weeks, if you experience difficulty swallowing, if over-the-counter medication is not providing relief, or if you notice any worsening of symptoms. Early evaluation can prevent long-term complications from chronic acid reflux and GERD.
Is GERD related to gastric cancer?
GERD itself is not a direct cause of gastric (stomach) cancer, but chronic acid reflux is a known risk factor for conditions affecting the upper digestive tract. Barrett’s esophagus — a complication of long-term acid reflux and GERD — is specifically linked to esophageal cancer. If you have concerns about persistent heartburn or acid reflux, a specialist consultation and endoscopy can provide a clear picture.
Reference,
Heartburn – Symptoms & causes – Mayo Clinic
Gastroesophageal reflux disease (GERD) – Symptoms and causes – Mayo Clinic
GERD (Chronic Acid Reflux): Symptoms, Treatment, & Causes (clevelandclinic.org)
