Almost everyone’s had a case of heartburn. An oversized meal or particularly spicy food causes you to feel a distinctive painful sensation in your chest or back of your throat. But when you get heartburn multiple times a week and certain foods aren’t necessarily the cause, it might be more than heartburn. It might be a condition known as GERD. GERD can be most easily described as persistent heartburn. But beneath the surface, it’s much more complicated than that.

GERD stands for gastroesophageal reflux disease. When you eat food, it travels down the esophagus to the stomach. There is a muscle separating the esophagus from the stomach known as the lower esophageal sphincter (LES), which closes during digestion and prevents stomach acid from rising or “refluxing” into the esophagus. In people with gastroesophageal reflux disease, the LES is either abnormally weak or it relaxes unexpectedly for minutes at a time. This gives the stomach acid an opportunity to rise up into the esophagus. When it makes contact with your esophagus and throat, the acid causes irritation, and as a result, a form of heartburn. GERD, if left untreated, can severely damage the esophagus causing ulcers, narrowing of the esophagus, or even esophageal cancer.

GERD and heartburn are the result of the same esophageal inaction; when the LES fails to close properly, stomach acids make their way to the esophagus. But the major difference is that heartburn happens occasionally and disappears after a few minutes to a few hours. GERD is when heartburn happens two or more times per week. It also does not require overeating or food triggers like heartburn.

Since GERD affects the esophagus, there can be other symptoms as well. You may taste food in the back of your throat or even vomit after eating. The acid can also affect your throat, causing hoarseness or a sore throat that does not go away. There’s also a chance you could experience no symptoms, known as silent reflux.

The main reason GERD occurs is the weakening of the lower esophageal sphincter. But there are physical and lifestyle factors that increase your odds of developing GERD.

Physical Risk Factors

There are common physical risk factors that create a more conducive environment for GERD. One is known as hiatal hernia. This is a condition where the stomach pushes above the diaphragm and allows acid reflux to occur more easily. Another less frequent cause is scleroderma, a chronic connective tissue disease most often characterized by a hardening of the skin. Pregnancy or being overweight can also contribute to GERD.

Lifestyle Risk Factors

Sometimes GERD is brought on by lifestyle choices, the most common being the types of food you eat. Foods that are spicy, fried, or acidic can trigger GERD. Alcohol and caffeine can also contribute, as does smoking.

Children with GERD

Babies and children may experience GERD because their esophagus is still developing and not fully prepared to handle all the tasks required to prevent acid reflux. Most children outgrow GERD as they develop, but it is possible for GERD to continue and lead to bigger problems. In babies with GERD, it is typical for them to vomit and spit up frequently after age one, wheeze, and have difficulty gaining weight.

If GERD is not treated in children, it can add complications to their life. They are more likely to have difficulty with their esophagus causing irritation, bleeding, asthma, and trouble swallowing.

Someone who experiences heartburn more than twice a week on a consistent basis might need to head to the doctor. A physician may diagnose GERD just by your description of symptoms without performing extensive tests.

But if further investigation is needed, there are a number of tests that can confirm GERD.

• Endoscopy: An endoscopy gives a doctor the chance to look at your esophagus closely by passing a tube down your throat. This can determine if the esophagus has been damaged by stomach acids.

• 24-hour pH probe: The best way to determine acid reflux, the 24-hour pH probe sends a tube into your esophagus. However, unlike an endoscopy, the tube remains in place for a day. It sits near the LES and checks the acid level near that area. If the results are high, it is an indication of GERD.

• Barium X-ray: By swallowing a chalky liquid known as barium, an X-ray can track the progress of the liquid through your body and point out any problems with the esophagus, stomach, or upper intestine.

There are two common treatments for GERD: lifestyle changes and medication.

You can get relief from GERD symptoms by avoiding foods that trigger reflux including:

• Chocolate

• Caffeine, alcohol, or carbonated beverages

• Acidic fruits and foods

• Spicy foods

For someone who is overweight, a change in diet may also result in weight loss, which can lessen the impact of GERD. In addition, eating food slowly and in smaller portions can give the stomach time to process foods.

Some lifestyle changes may even make things more comfortable. Raising the head of the bed can prevent acids from moving into the esophagus with a little help from gravity. Wearing loose clothing that does not restrict the stomach may help. Finally, for those who smoke, it might be time to put the pack down for good; smoking also triggers acid reflux.

A doctor may also recommend medication. The most common, antacids and acid reducers, can be purchased over the counter. Antacids neutralize acid in the stomach while acid reducers decrease production of acid. Antacids are designed to provide immediate, short-term relief from heartburn. On the other hand, acid reducers offer relief from heartburn symptoms for a longer period of time. They usually begin working within an hour of being taken.

Your doctor may also prescribe proton pump inhibitors, which diminish the amount of acid produced by the whole body instead of just in the stomach area. For heartburn that cannot be cured by acid reducers or antacids, proton pump inhibitors can provide long-lasting relief - though they do take more time to act than other medications.

Finally, there are prescriptions designed to strengthen the lower esophageal sphincter and move contents through the stomach. These are known as prokinetics. Unfortunately, they come with a number of side effects that prevent them from being completely effective.

If all else fails, the last option is surgery. There are different procedures depending on the patient, but the goal of each is to strengthen the LES.

GERD is Serious

If GERD is left untreated, it can bring on some major illnesses. If the esophagus is continually battered with stomach acid, it can narrow and make it hard to breathe and swallow. Ulcers and bleeding in the lining of the esophagus can also occur. The condition also opens you up to Barrett’s esophagus, which is a pre-cancerous condition that replaces the regular cells in your esophagus with cells closer to the intestinal lining. Finally, recent studies have shown that long-term GERD highly increases your risk of esophageal cancer by almost 44 times. GERD may seem like simple heartburn, but diagnosis is imperative before it grows into a life-threatening condition.