What should you know about the etiology of GERD?

A ring of muscle at the lower end of the oesophagus normally helps keep stomach contents down. If it relaxes at the wrong time, or if pressure in the abdomen rises, acid and food can travel upward and irritate the oesophageal lining. A hiatus hernia can alter the position of this barrier.

Symptoms may include burning behind the breastbone, a sour taste, regurgitation, cough or chest tightness. Some people notice symptoms after meals, when bending over or when lying down. Obesity can increase abdominal pressure, while some medicines, foods and smoking may aggravate symptoms in particular people.

Notice whether symptoms follow large meals, late eating, alcohol, smoking or particular foods, and share the pattern with a clinician. Smaller meals, remaining upright after eating and raising the head end of the bed may help some people. Weight management, if relevant, can reduce pressure on the abdomen.

A clinician may recommend a treatment trial or further assessment depending on symptom duration, severity and warning signs. Do not continue non-prescription reflux medicines for a prolonged period without reviewing whether they are still appropriate.

Seek urgent help for chest tightness with breathlessness, sweating, fainting or pain spreading to the arm or jaw, because heart and lung problems can resemble reflux. Arrange prompt assessment for trouble swallowing, food sticking, vomiting blood, black stools, repeated vomiting or unexplained weight loss.

Ask whether your symptoms fit acid reflux, whether a medicine or hiatus hernia could contribute, how long to try lifestyle changes, and which warning signs require review. Mention nighttime symptoms, cough and any difficulty swallowing.