Sep 1, 1999 Table of Contents

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.

Information from Your Family Doctor

Gastroesophageal Reflux Disease: More Than Heartburn

Am Fam Physician. 1999 Sep 1;60(3):885-886.

See related article on gastroesophageal reflux disease.

What is gastroesophageal reflux disease?

Gastroesophageal reflux disease (or GERD, for short) is what happens when liquids and food in your stomach go “the wrong way,” or back up into your throat. When this happens, the foods and liquids can irritate your throat.

Your esophagus isn't made to handle the acid in your stomach. This acid may also irritate your throat.

What are the common signs of GERD?

The most common sign is heartburn. Heartburn is a pain in the middle of your chest. The pain from heartburn can be very strong. Sometimes the pain can be so strong that you think you're having a heart attack.

GERD can cause other signs, too. You can even have GERD without having heartburn.

Sometimes GERD can cause problems in your throat. It can make you feel like you have a lump in your throat or like you always have to clear your throat. It can also cause hoarseness. You might be more hoarse when you first get up in the morning.

GERD can give you a burning feeling in your mouth. It can cause you to have a sore throat or to have trouble swallowing. You may feel like food is sticking in your throat. GERD may also make you feel like you're choking or that your throat is tight. A dry cough is another sign. GERD can also cause bad breath. It can even cause pain in your ears.

If you have any of these signs, you may have GERD. Be sure to tell your doctor about any of these signs.

How is GERD diagnosed?

Your doctor will ask you questions about your signs and do an exam. Many times, doctors can be fairly certain a person has GERD just by the signs. If your doctor thinks your signs are caused by GERD, medicine may help. If the medicine helps, you and your doctor will know that GERD was the cause of your problems. You may not need to have any special tests.

How is GERD treated?

Medicines can help stop the food and liquids from going back up into your throat. But you also have to make changes in your diet and your lifestyle.

How should I change my diet?

If you don't eat certain foods, your throat problems may get better. Here's a list of foods you should try not to eat (or only eat them once in a while and eat just a few bites):

  • Tomato-based foods, like spaghetti sauce, chili and pizza

  • Spicy foods

  • Garlic and onions

  • Mint flavoring, like peppermint and spearmint

  • Citrus fruits, like oranges and grapefruit

  • Drinks with caffeine, like coffee, tea and cola

  • Chocolate

  • Fatty (and fried) foods, like french fries and donuts

What lifestyle changes help GERD?

Here is a list of lifestyle changes that may help your GERD:

  • Stop smoking if you smoke.

  • Don't drink alcohol.

  • Lose weight if you're overweight.

  • Eat smaller meals.

  • Wear loose-fitting clothes.

  • Avoid eating and drinking about four hours before going to bed.

  • Avoid lying down within three hours of a meal.

  • Raise the head of your bed by putting blocks of wood under the bedposts (just using extra pillows won't help).

What medicines help GERD?

One kind of medicine that helps includes cimetidine (brand name: Tagamet), ranitidine (brand name: Zantac), famotidine (brand name: Pepcid) and nizatidine (brand name: Axid). You take this medicine two times a day.

Proton pump inhibitors also help; they include omeprazole (brand name: Prilosec) and lansoprazole (brand name: Prevacid). You take them once a day.

Another medicine that helps is sucralfate (brand name: Carafate). You take it four times a day.

Can't I just take over-the-counter drugs for heartburn?

The amount of medicine in the over-the-counter drugs for heartburn (like Pepcid, Zantac and Tagamet) is lower than the amount in the prescription form of these medicines. And before you try an over-the-counter medicine, it's important to see your doctor. Your doctor will help you get a medicine that works well for you.


This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Copyright © 1999 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

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