Experiencing frequent heartburn? You may have GERD. Learn about the causes, lifestyle changes that help, and when medication or medical treatment is necessary.
GERD: More Than Just Heartburn
That burning sensation in your chest after a heavy meal might seem like a minor inconvenience, but when it happens frequently, it could signal Gastroesophageal Reflux Disease (GERD)—a chronic condition affecting millions of Filipinos. GERD occurs when stomach acid repeatedly flows back into the esophagus, the tube connecting your mouth and stomach, causing irritation and potential long-term damage.
While occasional acid reflux is normal and happens to almost everyone, GERD is diagnosed when reflux occurs more than twice a week or causes troublesome symptoms that affect quality of life. Left untreated, chronic GERD can lead to serious complications including esophageal inflammation, ulcers, and even increased cancer risk.
"GERD is one of the most common digestive conditions I see in my practice. The good news is that with proper lifestyle modifications and treatment, most patients achieve excellent symptom control and can enjoy their favorite foods again—in moderation." — Philippine Society of Gastroenterology
How GERD Develops
At the junction between your esophagus and stomach sits a ring of muscle called the lower esophageal sphincter (LES). Normally, this valve opens to let food into your stomach and closes to keep stomach contents from flowing backward.
In GERD, the LES becomes weak or relaxes inappropriately, allowing stomach acid—and sometimes bile—to wash back into the esophagus. Unlike the stomach, which has a protective lining, the esophagus isn't designed to handle acid, resulting in the burning sensation we call heartburn.
📊 GERD Risk Factors
- Obesity: Excess abdominal weight increases stomach pressure
- Hiatal hernia: Part of stomach pushes through diaphragm
- Pregnancy: Hormones and pressure from growing uterus
- Smoking: Weakens LES and reduces saliva production
- Certain medications: NSAIDs, calcium channel blockers, some sedatives
- Eating habits: Large meals, eating late at night, lying down after eating
Recognizing GERD Symptoms
Classic Symptoms
- Heartburn: Burning sensation in the chest, usually after eating, that may worsen when lying down or bending over
- Regurgitation: Sour or bitter-tasting acid backing up into your throat or mouth
- Dysphagia: Difficulty swallowing or sensation of food stuck in your throat
- Chest pain: Can mimic heart pain; always get chest pain evaluated
Atypical Symptoms
- Chronic cough: Especially at night or after meals
- Laryngitis: Hoarse voice, especially in the morning
- Asthma symptoms: Acid can trigger or worsen asthma
- Dental erosion: Acid wears away tooth enamel
- Bad breath: From regurgitated stomach contents
- Sleep disturbances: Symptoms often worse when lying down
- Globus sensation: Feeling of a lump in your throat
GERD Triggers: What to Avoid
Identifying and avoiding your personal triggers is crucial for GERD management. Common culprits include:
Foods and Beverages
- Fatty and fried foods: Slow stomach emptying and relax LES (crispy pata, lechon, fried chicken)
- Spicy foods: Can irritate esophagus (siling labuyo, hot sauce)
- Acidic foods: Citrus fruits, tomatoes, vinegar-based dishes (paksiw, adobo)
- Caffeine: Relaxes LES (coffee, tea, cola)
- Chocolate: Contains caffeine and theobromine that relax LES
- Alcohol: Relaxes LES and increases acid production
- Mint: Relaxes LES despite feeling soothing
- Carbonated beverages: Cause bloating and increase pressure
- Garlic and onions: Common triggers for many people
Lifestyle Factors
- Eating large meals
- Eating within 3 hours of bedtime
- Lying down after eating
- Wearing tight clothing around the waist
- Smoking
- Being overweight, especially around the midsection
Lifestyle Changes That Work
✅ GERD Management Strategies
- Eat smaller, more frequent meals: Large meals distend the stomach and increase reflux
- Don't lie down for 3 hours after eating: Let gravity help keep acid down
- Elevate the head of your bed: Use a 6-8 inch wedge or blocks under bedposts (extra pillows alone don't work as well)
- Lose weight if overweight: Even modest weight loss can significantly improve symptoms
- Quit smoking: Tobacco weakens the LES and reduces saliva
- Wear loose-fitting clothes: Avoid pressure on your abdomen
- Eat slowly and chew thoroughly: Reduces swallowed air and aids digestion
- Keep a food diary: Identify your personal triggers
Natural and Home Remedies
Many people find relief from these complementary approaches:
- Ginger: Has natural anti-inflammatory properties; try ginger tea or salabat
- Chewing gum: Stimulates saliva production, which neutralizes acid
- Aloe vera juice: May soothe esophageal irritation (use food-grade products)
- Chamomile tea: Can reduce inflammation and promote relaxation
- Baking soda: A teaspoon in water can neutralize acid (use sparingly; high in sodium)
- Banana: Natural antacid effect; coating properties
- Papaya: Contains enzymes that aid digestion
⚠️ Apple Cider Vinegar Myth
Despite popular claims, there's no scientific evidence that apple cider vinegar helps GERD—and it may actually worsen symptoms by adding more acid. Stick to proven remedies.
Medical Treatment Options
Over-the-Counter Medications
- Antacids: Neutralize stomach acid; quick but short-lasting relief (Tums, Maalox)
- H2 blockers: Reduce acid production for several hours (famotidine, ranitidine)
- Proton pump inhibitors (PPIs): Strongest acid blockers; heal esophageal damage (omeprazole, esomeprazole)
Prescription Treatments
- Higher-dose PPIs
- Prokinetics (strengthen LES, speed stomach emptying)
- Surgery (fundoplication) for severe cases not responding to medications
- LINX device (magnetic ring around LES)
When to See a Gastroenterologist
Consult a specialist if you experience:
- Symptoms more than twice weekly
- Symptoms not controlled by OTC medications
- Difficulty or pain when swallowing
- Unexplained weight loss
- Vomiting blood or having black stools
- Persistent symptoms for more than 2 weeks
- Symptoms interfering with sleep or daily activities
Potential Complications of Untreated GERD
- Esophagitis: Inflammation and erosion of esophageal lining
- Esophageal stricture: Scarring that narrows the esophagus
- Barrett's esophagus: Precancerous changes in esophageal cells
- Esophageal cancer: Rare but serious complication
"Most patients can control GERD through lifestyle changes and medications. The key is not to ignore symptoms or rely solely on antacids. If you're taking antacids daily, you need a proper evaluation and treatment plan." — Dr. Angela Sy, Gastroenterologist
Living Well with GERD
GERD doesn't have to control your life. With the right combination of lifestyle modifications, dietary changes, and medical treatment when needed, most people achieve excellent symptom control. Start with identifying your triggers, make gradual changes, and work with your healthcare provider to find the best approach for you.
Don't let heartburn burn a hole in your quality of life. Take control of your digestive health today.
