GERD 101: What is it and how do I manage it?

Michael Kinning, DO, is a gastroenterologist at Trinity Health Medical Group, Gastroenterology – Muskegon. Dr. Kinning and his team offer specialized care for individuals navigating digestive health issues. 

Some of these issues may be the result of gastroesophageal reflux disease, commonly known as GERD. Affecting millions of Americans each year, GERD is more than occasional heartburn. From symptoms and causes to diagnosis and treatment, Dr. Kinning provides the insights to help you know when it’s time to get advice from your doctor.

What is GERD, and what is it caused by?
Michael Kinning, DO: GERD, or gastroesophageal reflux disease, is a long-term digestive disorder where stomach contents flow back into the esophagus. This can irritate the lining of the esophagus, leading to symptoms of heartburn, chest pain, and regurgitation. Occasional reflux is normal, but persistent symptoms may require long-term management.

GERD is usually caused by a weakened or dysfunctional lower esophageal sphincter (LES). This muscle stops stomach contents from flowing back into the esophagus. Other contributing factors include obesity, pregnancy, alcohol consumption, and smoking. 

While lifestyle and environmental factors are the primary causes, there may also be a genetic predisposition. A family history of GERD, Barrett’s esophagus, or esophageal cancer can slightly increase one’s risk.

Read: Discover the Latest Trends in Digestive Health: Diet, Home Remedies and Supplements 

What are common symptoms of GERD, and how are they different from other digestive issues? What about uncommon symptoms?
Dr. Kinning: Typical symptoms include heartburn and regurgitation of food or sour liquid. These symptoms often worsen after eating or when lying down. 

GERD can be confused with other conditions, so it’s important to note the pattern and frequency of symptoms. Consult a health care provider for an accurate diagnosis. 

Worrisome symptoms include trouble swallowing, the feeling of food getting stuck, or vomiting. These symptoms should be investigated with an EGD (a scope procedure to look into the esophagus and stomach). GERD may also cause chest pain, however, chest pain related to the heart should be investigated first.

Less common symptoms can include a chronic cough, a sore throat, or hoarseness. You might also feel the sensation of a lump in your throat. Stomach acid can even cause tooth enamel erosion. 

These symptoms can be misleading and may not clearly indicate GERD, so persistent or unexplained issues should be evaluated by a medical professional.

How does lifestyle impact the development of GERD?
Dr. Kinning: Lifestyle plays a significant role in both the development and severity of GERD. Factors such as a high-fat diet, overeating, eating late at night, lack of physical activity, and stress can all contribute. Smoking and alcohol use also relax the LES, increasing reflux episodes. Making mindful changes in daily habits can greatly reduce the frequency and intensity of symptoms.

Lifestyle adjustments are often the first line of defense against GERD. These include:

• Losing excess weight
• Eating smaller, more frequent meals
• Avoiding meals two to three hours before bedtime
• Elevating your head during sleep
• Quitting smoking and limiting alcohol consumption

These steps help reduce pressure on the stomach and support better digestion, often significantly improving symptoms.

Read: Gut Health: How the Gut-Brain Connection Affects Your Overall Well-Being

What tests do doctors typically use to diagnose GERD?
Dr. Kinning: Diagnosis often starts with a review of symptoms and medical history. Endoscopy is the gold standard to examine the lining of the esophagus, stomach, and small intestine. There are some findings that are diagnostic for reflux.

If the endoscopy is normal, we may sometimes perform pH monitoring to determine if the symptoms are related to reflux events.

What are the most effective treatments for GERD?
Dr. Kinning: Treatment usually begins with lifestyle changes and over-the-counter medications. These include antacids, H2 blockers (medications that reduce stomach acid production), or proton pump inhibitors (PPIs). If symptoms are severe or persistent, prescription-strength medications may be necessary. 

If you are taking a PPI and still have breakthrough GERD symptoms, an endoscopy should be performed.

What steps can people take to prevent GERD?
Dr. Kinning: Preventing GERD largely mirrors the lifestyle changes used to manage it. Maintaining a healthy weight, eating a balanced diet, managing stress, and avoiding triggers (such as large meals and late-night snacking) can help prevent the condition from developing or worsening.

Watch: Gut Check: Your Colon Health and Colon Cancer Prevention

Should specific foods be avoided?
Dr. Kinning: Foods that commonly trigger reflux include:

• Spicy foods
• Fatty or fried items
• Chocolate
• Caffeine
• Citrus fruits
• Tomatoes
• Carbonated beverages

GERD is a manageable condition with the right knowledge and proactive care. Whether you’re experiencing symptoms for the first time or managing a long-term diagnosis, understanding the causes, treatments, and lifestyle strategies can help you take control of your health. 

If you’re unsure whether your symptoms are from GERD, talk to your primary care provider who can then refer you to a gastroenterologist to help with an evaluation and a personalized care plan. If you need a primary care provider, click here.

Learn more about digestive health care at Trinity Health Michigan.