Understanding GERD: Symptoms, Causes, and Treatment with St. Luke’s
A burning sensation in the chest after a meal may seem like a minor inconvenience. But when heartburn and acid reflux happen frequently, they may be signs of gastroesophageal reflux disease, or GERD.
GERD is a chronic digestive condition in which stomach contents repeatedly flow back into the esophagus, causing bothersome symptoms or complications. It can affect people of all ages and interfere with eating, sleeping, and daily activities.
What Is GERD?
At the lower end of the esophagus is a ring of muscle called the lower esophageal sphincter. It opens to allow food into the stomach and then closes to help prevent stomach contents from flowing backward.
When this muscle weakens or relaxes when it should not, stomach contents can flow back into the esophagus, irritating its lining.
Common Symptoms of GERD
• Heartburn: A burning sensation behind the breastbone, often after eating or when lying down.
• Regurgitation: Stomach contents flowing back into the throat or mouth, sometimes leaving a sour or bitter taste.
Some people also experience chronic cough, hoarseness, or a lump-in-the-throat sensation. These symptoms can have other causes, so proper evaluation is important.
Risk Factors and Symptom Triggers
Being overweight or having obesity, pregnancy, and smoking can increase the likelihood of reflux.
Certain foods, drinks, and eating habits may worsen symptoms, including:
• Large meals or eating close to bedtime
• Fatty or spicy foods
• Coffee and alcoholic drinks
Triggers vary from person to person. Identifying what worsens your symptoms can help guide changes to your diet and habits.
When to Seek Medical Advice
Consult a doctor if reflux symptoms are frequent, severe, or affect your daily activities. You should also seek advice if you regularly need over-the-counter antacids for relief.
Seek prompt medical attention for difficulty or pain with swallowing, unexplained weight loss, persistent vomiting, or signs of bleeding, such as vomiting blood or passing black, tarry stools. New or severe chest pain requires urgent assessment and should not be assumed to be reflux.
Possible Complications of GERD
GERD does not cause complications in everyone. However, persistent reflux can sometimes lead to:
• Esophagitis: Inflammation of the esophageal lining, which may cause ulcers or bleeding.
• Esophageal stricture: Narrowing caused by scar tissue, which can make swallowing difficult.
• Barrett’s esophagus: Changes in the esophageal lining associated with an increased risk of a type of esophageal cancer. Only a small proportion of people with Barrett’s esophagus develop cancer.
Reflux may also contribute to chronic cough, hoarseness, or worsening asthma symptoms in some people.
Treatment and Relief for GERD
Treatment depends on your symptoms, medical history, and response to care. Your doctor may recommend:
• Eating smaller meals and avoiding overeating
• Waiting at least three hours after eating before lying down or going to bed
• Elevating the head of your bed or using a wedge to raise your upper body for nighttime symptoms
• Limiting foods and drinks that trigger your symptoms
• Losing weight if you are overweight or have obesity
• Quitting smoking
• Taking medicines as directed, including acid-suppressing treatments such as proton pump inhibitors
When Symptoms Persist Despite Treatment
Some patients continue to experience symptoms despite medication. This does not always mean that a loose valve is the cause.
A gastroenterologist can review how medicines are being taken and recommend tests to determine whether symptoms are caused by ongoing reflux or another condition. Testing may include endoscopy, reflux monitoring, or assessment of esophageal muscle function.
Selected patients with confirmed GERD may benefit from an endoscopic or surgical procedure.
Anti-Reflux Mucoplasty at St. Luke’s
St. Luke’s Medical Center–Global City offers Anti-Reflux Mucoplasty (ARM-P) through its Institute of Digestive and Liver Diseases (IDLD).
ARM-P is a minimally invasive endoscopic procedure performed through the mouth, without external abdominal incisions. It treats and reshapes tissue at the junction of the esophagus and stomach to help strengthen the barrier against reflux.
Early studies suggest that ARM-P may improve symptoms and allow some patients to reduce or discontinue acid-suppressing medication. Results vary, and evidence on long-term outcomes is still developing.
ARM-P is suitable only for selected patients after careful evaluation. Your gastroenterologist can explain its potential benefits, risks, recovery requirements, and alternatives.
Find the Right Care for Your Symptoms
Frequent reflux deserves proper evaluation. Consult a St. Luke’s gastroenterologist to discuss your symptoms and develop a treatment plan suited to your needs.
For more information, visit the Institute of Digestive and Liver Diseases on the 2nd Floor, Main Building at St. Luke's Medical Center – Global City, or call (+63 2) 8789-7700 ext. 2042/ 2046.
