Understanding Gastroesophageal Reflux Disease and How to Treat It
January 21, 2025 By: General Surgery Team

Content medically reviewed by Troy Duininck, MD
Many people occasionally experience heartburn, an uncomfortable burning sensation in your chest that occurs when stomach acid flows back into your esophagus—often a result of consuming certain foods or beverages. However, if heartburn happens more than twice a week, you might have gastroesophageal reflux disease (GERD).
“Anyone can develop GERD, and it can lead to more serious health issues if it’s not treated,” said Dr. Troy Duininck, general surgeon at Essentia Health. “That’s why it’s important not to ignore symptoms and talk to your provider about your treatment options.”
More Than Just Heartburn
Frequent heartburn, which occurs in the middle of your chest behind your breastbone, is one of the most common signs of GERD. Another common symptom is regurgitation—which occurs when stomach contents come up through your esophagus and into your throat or mouth, causing you to taste stomach acid or food.
However, not everyone with GERD has heartburn or regurgitation. Additional symptoms include –
- Chronic dry cough
- Nausea
- Pain in the chest
- Trouble swallowing
For some people, GERD can trigger asthma symptoms, such as wheezing and shortness of breath.
What Causes GERD?
When the lower esophageal sphincter, the muscle that serves as a valve between the esophagus and stomach, becomes weak, GERD can develop. Risk factors include –
- Being overweight
- Being pregnant
- Smoking
- Taking certain medications, such as certain sedatives, non-steroidal anti-inflammatory drugs (NSAIDs), calcium channel blockers, and some asthma medicines
Having a hiatal hernia can also put you at higher risk for GERD or make symptoms worse. A hiatal hernia is a condition in which the upper part of the stomach presses upward into the chest due to an opening in the diaphragm. This can allow stomach acid to flow through the opening.
Why It’s Important to Treat GERD
“In addition to damaging the esopahgus, GERD can cause problems in the throat, mouth, or lungs,” Dr. Duininck said. “The sooner you get treatment, the better it is for your overall health.”
If not treated, GERD can lead to –
- Barrett’s esophagus. With this condition, the lining of the esophagus changes. Tissue similar to the intestinal lining replaces the normal lining of the esophagus. Rarely, this can lead to esophageal cancer.
- Esophageal stricture. This is a narrowing of the esophagus that can cause problems with swallowing.
- Esophagitis. This condition causes inflammation that can trigger ulcers and bleeding in the lining of the esophagus.Additional complications can develop, including asthma, hoarseness, laryngitis, and chronic cough.
Making Lifestyle Changes
Your provider may make a diagnosis based on your symptoms alone. For many people, lifestyle changes and medication can effectively treat GERD.Your provider may recommend –
- Changing your diet. Certain foods and beverages can trigger GERD symptoms. Avoiding chocolate, caffeine, and alcohol, as well as spicy, acidic, and fatty foods can help.
- Losing weight. Abdominal fat can cause pressure in the abdomen and affect the lower esophageal sphincter, which means dropping pounds can improve symptoms.
- Quitting smoking. Stopping smoking helps to strengthen the lower esophageal sphincter.
If you experience GERD symptoms while sleeping or lying down, finish meals at least three hours before bed. Elevating your head by six to eight inches with extra pillows can also help prevent regurgitation during the night.Medicines that help control stomach acid, such as antacids, H2 blockers, and proton pump inhibitors, can also help control GERD.
When Is Surgery Necessary?
“If lifestyle changes and medicines don’t improve symptoms or you have signs of complications from GERD, surgery might be a good treatment option,” Dr. Duininck said. “Your provider may first do tests to confirm your diagnosis and ensure your symptoms are not due to another condition.”
Tests your provider may use to make a definitive diagnosis include –
- Upper gastrointestinal (GI) endoscopy. An endoscope, a flexible tube with a camera, is threaded down your throat and into your stomach to look for signs of damage.
- Esophageal pH monitoring. This involves wearing a monitor that receives information from a capsule inserted into the lining of your esophagus. This test allows your provider to detect stomach acid in the esophagus and analyze how your symptoms, diet, and sleep relate.
Another test your provider may recommend before surgery is esophageal manometry, in which a thin catheter with pressure sensors is passed through your nose, down the esophagus, and into the stomach. The test shows how well your esophagus functions by measuring muscle contractions as you swallow water. Your provider might do this to rule out other conditions besides GERD that could be causing your symptoms.
Types of Surgery to Treat GERD
Based on the testing results, your provider may determine that surgery is the best treatment option for you. Usually, surgery greatly improves quality of life, although it doesn’t cure GERD in most cases. Possible surgical treatments include –
- Fundoplication. This is the most common surgery for GERD and has a high rate of success for long-term improvement of symptoms. If you have a hiatal hernia, the surgeon may also repair it during the procedure.
In fundoplication, a surgeon wraps the first part of the stomach around the end of your esophagus, adding pressure to the lower esophageal sphincter and helping to stop regurgitation. Side effects of surgery can include gas bloat and difficulty swallowing, which usually go away within three months following surgery. This surgery is done laparoscopically and is often done as an outpatient surgery.
- Weight loss surgery. For overweight people who qualify, weight loss surgery can sometimes cure GERD. Fundoplication surgery for patients who are obese or morbidly obese will often not be effective, therefore wight loss prior to surgery or a weight loss operation is critical to treatment. If you are a candidate for this type of surgery, your provider will discuss your options with you.