Gastroesophageal reflux disease (GERD)

Stomach contents are normally prevented from moving to the esophagus (a tube connecting the mouth with the stomach) by the esophageal sphincter (a valve-like ring of muscle at the end of the esophagus).

When this muscle relaxes or is generally weak, GERD may occur, causing backflow of food and acid into the food pipe. This can occur in healthy people occasionally but is a frequent problem among those with GERD.


  1. Because reflux from the stomach consists of acid, the main symptom of GERD is frequent heartburn or a feeling of indigestion.
  2. A bitter acid taste in the mouth.
  3. If the stomach fluid reaches the larynx (breathing tube), coughing spells can occur

Other possible symptoms:
Nausea or vomiting
Bad breath
Difficulty or pain when swallowing
Tooth decay

Factors contributing to GERD:

  • Being pregnant is a major risk factor for GERD due to
    increased pressure on the abdomen and hormonal changes
  • Being overweight or obese
  • Smoking
  • Consuming alcoholic, caffeinated, or carbonated beverages
  • Eating large meals
  • Sleeping immediately after having food

Taking certain medicines, such as aspirin and certain drugs for asthma, high blood pressure, allergies, depression, sleep disorders, and pain

Complications : if left untreated may cause chronic GERD leading to  complications such as

  • Esophagitis (inflammation of the esophageal lining)
  • Narrowing of the esophagus due to scarring
  • Ulcers in the esophagus
  • Barrett esophagus (change in the cells of the esophageal lining, with an increased risk of cancer)

Diagnosis and Treatment:

If the symptoms are severe, testing can help in further evaluation.

  • Upper Endoscopy (examination of the esophagus and stomach through a flexible tube with a camera)
  • Barium (radiological contrast) swallow test.
  • In some cases it may be necessary to do a pH-monitoring test (for stomach acidity) and manometry test (to measure the strength of the esophageal sphincter). These tests involve passing a tube up the nose and down the throat to the end of the esophagus.

Based on the severity of the symptoms and the test results your physician may prescribe medications like Antacids , PPIs (proton pump inhibitors)  and H2 blockers.

Prevention of GERD:

  • The position of your body after eating. (An upright posture helps prevent reflux.) 
  • The size of the meal. (Smaller meals reduce reflux) 
  • Avoiding meals up to 2–3 hours prior to bedtime may be helpful. 
  • Eat food slowly and chew thoroughly. 
  • Avoiding certain foods, such as chocolate, citrus fruits, onions, peppermint ,tomato, or spicy or fried foods (these substances irritate the esophagus or weaken the sphincter and can cause reflux.)
  • Quit or avoid smoking.
  • Losing weight can help prevent symptoms. 
  • Avoid clothing that is tight around the abdomen. 
  • Sleep at a slight angle with the head slightly elevated. 
  • Reducing stress

When to see a doctor:
if you have chest pain, especially if you also have shortness of breath, or jaw or arm pain. These may be signs and symptoms of a heart attack.

Heart attack and stomach ulcers may mimic heartburn.
Also if you Experience severe or frequent GERD symptoms
-Dr. Krishna Priya




Heart burn and indigestion are very common in pregnancy, especially in last few months of pregnancy.

Heart burn and indigestion occur in pregnancy due to the hormonal changes that occur in later months of pregnancy, to facilitate baby’s growth. As the growing baby presses on the intestines and stomach,  heart burn and regurgitation of food may occur. Stress may also be considered as one of the causes of heart burn and indigestion in pregnancy or otherwise.

 Normally, a valve that is present between esophagus and stomach prevents the acid released in stomach from entering or going back into esophagus. The raised progesterone hormone levels in pregnancy relax this valve and allows acid to enter into esophagus causing a burning sensation in the center of chest and upper part of the abdomen which is called heart burn. It is not related to heart as the name suggests.

 Symptoms of indigestion may include vomiting sensation (nausea), vomiting, pain or discomfort in chest and stomach, loss of hunger, feeling full, burps, seen any time of the day or after eating food or drinking fluids.

Generally, no investigation may need to be done in the beginning stages unless there is a suspicion for obstruction or an ulcer in digestive system or an underlying serious disease condition. Mild symptoms can be managed by following a few of the tips mentioned below. Severe symptoms may demand prescription of medications along with the home remedies for an effective treatment.

Medications which may be of help are antacids which neutralize the acid released in stomach and give relief, acid-suppressing medicines which decrease release of the acid and anti-emetics for vomiting.

Avoiding a heart burn and indigestion is considered as the best approach. A few tips which may be of help are

  • Eating small, regular and frequent meals rather than 3 large meals in a day.
  • Sitting straight while eating food which eases off the pressure on stomach and helps in better digestion.
  • Having healthy foods like green leafy vegetables, fresh fruits and vegetables.
  • Cutting down spices in food, avoiding oily, fatty and spicy food.
  • Drinking at least 2-3 litres of water daily.
  • Walking for a few minutes after having food, rather than lying down immediately
  • walking for around 5-10 minutes often in a day without sitting or lying down for long hours (avoiding a sedentary lifestyle)
  • Eating an early dinner, at least 1-3 hours before going to bed.
  • Adding one or two pillows while sleeping which keeps the head slightly elevated and propped up….This avoids reflux of stomach contents into food pipe.
  • Avoiding smoking and alcohol consumption.
  • Avoiding foods that triggers ingestion for you
  • Bending over immediately after eating etc.


– Dr. Divya Teja Pasupuleti