Overview
Gastro-oesophageal reflux disease (GERD, also spelled GORD in the UK) is a chronic condition where stomach acid flows back up into the oesophagus, causing heartburn and other symptoms. It results from a weakening or inappropriate relaxation of the lower oesophageal sphincter, the muscular valve between the stomach and oesophagus.
How common is it?
Reflux disease is common. NIDDK estimates that about 1 in 5 people in the United States have GERD. Frequency varies between countries and with the definition used.
Causes and risk factors
Stomach acid repeatedly reaching the oesophageal lining causes irritation and inflammation. Over time, untreated GERD can cause oesophagitis, Barrett's oesophagus (a precancerous change), and oesophageal cancer.
Common risk factors
- Obesity (particularly abdominal obesity)
- Hiatus hernia
- Pregnancy
- Smoking
- Alcohol
- Certain foods: spicy food, fatty food, chocolate, citrus, caffeine, mint
- Medications: NSAIDs, calcium channel blockers, tricyclic antidepressants
- Delayed stomach emptying (gastroparesis)
Symptoms
- Heartburn: burning sensation rising from stomach to chest
- Acid taste in mouth or regurgitation of food
- Difficulty swallowing
- Persistent cough, especially at night
- Hoarse voice, particularly in the morning
- Chest pain (must be distinguished from cardiac pain)
When to see a doctor
See a GP for heartburn most days, symptoms not improving with treatment, difficulty or pain swallowing, persistent vomiting or unexplained weight loss. Call your local emergency number for new tight or squeezing chest pain, pain spreading to an arm, neck or jaw, or severe breathing difficulty. Do not assume chest pain is reflux.
Diagnosis
Gastro-oesophageal reflux disease (GORD, also called GERD) is usually assessed from symptoms and response to treatment. Endoscopy may be needed for swallowing problems, other warning signs or persistent symptoms despite treatment. A specialist may use reflux monitoring when the diagnosis remains uncertain.
Treatments
Proton pump inhibitors (PPIs)
Omeprazole, lansoprazole, and others are the most effective drug treatment, reducing stomach acid production. Taken 30 to 60 minutes before the first meal of the day for best effect.
Lifestyle modifications
Elevating the head of the bed by 15 to 20cm, avoiding food 2 to 3 hours before bed, losing weight if overweight, and avoiding trigger foods all reduce symptoms.
Fundoplication surgery
Laparoscopic surgery that wraps the top of the stomach around the lower oesophagus to strengthen the sphincter. An option for those who do not want long-term medication or in whom it is ineffective.
Self-care and lifestyle
- Eat smaller, more frequent meals rather than large ones
- Avoid lying down within 3 hours of eating
- Lose weight if BMI is above normal
- Elevate the head of your bed on blocks or wedge pillow
Prevention
Maintaining a healthy weight, not smoking, limiting alcohol, and avoiding known trigger foods reduce the risk and severity of GERD.
Sources for targeted updates
Updated: 24 October 2026. Targeted corrections to diagnosis, urgent-care guidance, frequency, key facts. This update covers the named sections; a full review of the remaining guide is pending.