Gastro Esophageal Reflux Disease (GERD) Quiz
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Acid reflux
Gastric discomfort
Heartburn
Pain in the middle of the upper stomach
Gas
There is a feeling that the stomach is burning
Feeling stressed
Not seeing your symptoms? No worries!
What is Gastro Esophageal Reflux Disease (GERD)?
A condition where stomach acid flows back up the esophagus (food pipe). It can be caused or worsened by obesity, alcohol, and caffeine. Eating habits also play a role - eating large meals quickly or lying down after meals are known triggers.
Typical Symptoms of Gastro Esophageal Reflux Disease (GERD)
- Previously treated for H. pylori
- Abdominal bloating after meals
- Heartburn with discomfort in the upper stomach area
- Heartburn with acid reflux or sour taste in throat
- Heartburn that feels like a burning liquid rising up
- Nausea or vomiting after eating
- Pain in the upper abdomen
- Pressure and tightness in my throat
Diagnostic Questions for Gastro Esophageal Reflux Disease (GERD)
Your doctor may ask these questions to check for this disease:
- Have you been treated for H. pylori infection?
- Do you have abdominal bloating after meals?
- Do you have heartburn with discomfort in your upper stomach area?
- Do you have heartburn with acid reflux or sour taste in your throat?
- Does your heartburn feel like a burning liquid rising up?
Treatment of Gastro Esophageal Reflux Disease (GERD)
Treatment starts with lifestyle changes like eating smaller meals and taking a walk after heavy meals. Medications to reduce stomach acid or speed up digestion may be helpful. In severe cases, patients can undergo procedures or surgery.
Reviewed By:
Scott Nass, MD, MPA, FAAFP, AAHIVS (Primary Care)
Dr. Nass received dual medical degrees from the David Geffen School of Medicine at UCLA and Charles R. Drew University in Medicine and Science. He completed Family Medicine residency at Ventura County Medical Center with subsequent fellowships at Ventura, University of North Carolina-Chapel Hill, George Washington University, and University of California-Irvine. He holds faculty appointments at Keck School of Medicine of USC, Loma Linda University School of Medicine, and Western University of Health Sciences.
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Feb 13, 2025
Following the Medical Content Editorial Policy
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Symptoms Related to Gastro Esophageal Reflux Disease (GERD)
Diseases Related to Gastro Esophageal Reflux Disease (GERD)
FAQs
Q.
Confused by Radiology Results? Why Your Scan is Complex + Medical Next Steps
A.
Radiology reports often sound alarming because they are written for doctors, list every finding including harmless incidental changes, and use neutral terms like lesion or nonspecific that do not automatically mean cancer. There are several factors to consider. See below to understand more, including how to review results with your clinician, which findings usually need no action versus repeat imaging or referral, when to seek urgent care, and why some issues like GERD may not show clearly on scans.
References:
* Johnson AJ, et al. Patient Understanding of Radiology Reports: A Systematic Review. J Am Coll Radiol. 2017 Jul;14(7):903-911. doi: 10.1016/j.jacr.2017.02.007. Epub 2017 Apr 19.
* Singh V, et al. Communicating Incidental Findings on Imaging: A Practical Approach. Radiographics. 2017 May-Jun;37(3):983-999. doi: 10.1148/rg.2017160086.
* Hanna MH, et al. Communicating Uncertainty in Diagnostic Imaging. AJR Am J Roentgenol. 2018 Feb;210(2):237-246. doi: 10.2214/AJR.17.18950. Epub 2017 Nov 20.
* Boland GW, et al. Communicating Follow-Up Recommendations for Incidental Findings on Imaging: A Multidisciplinary Perspective. J Am Coll Radiol. 2020 Feb;17(2):215-223. doi: 10.1016/j.jacr.2019.09.006. Epub 2019 Oct 29.
* Johnson CD, et al. Making Radiology Reports Patient-Friendly: A Practical Approach for Radiologists. Radiographics. 2021 Mar-Apr;41(2):E16-E17. doi: 10.1148/rg.2021200194.
Q.
Confused by the Hype? The Science of Moringa Benefits & Medical Next Steps
A.
Moringa’s science-backed benefits include high nutrient and antioxidant content, with early evidence for blood sugar and cholesterol support, but studies are small and it is not a cure-all. There are several factors to consider for safety and next steps, including possible GI side effects and interactions with diabetes, blood pressure, and blood-thinning medications and during pregnancy or thyroid, liver, or kidney disease; see below for who should avoid it, how to choose a quality product and dose, and when to speak with a doctor.
References:
* Ganesan, K., & Xu, B. (2022). Moringa oleifera: A Systematic Review of Its Phytochemistry, Health Benefits, and Food Applications. *Foods*, *11*(13), 1957. https://pubmed.ncbi.nlm.nih.gov/35885235/
* Adedapo, A. A., & Moges, S. (2022). A Comprehensive Review on the Pharmacological Potential of Moringa oleifera in the Management of Metabolic Syndrome. *Molecules*, *27*(10), 3290. https://pubmed.ncbi.nlm.nih.gov/35631779/
* Kumar, D., Ganesan, M. K., Karwa, M., Maurya, N., & Tripathi, S. (2021). A comprehensive review on Moringa oleifera: The miracle tree. *Journal of Ethnopharmacology*, *274*, 114002. https://pubmed.ncbi.nlm.nih.gov/33857508/
* Alhakmani, F., Alhakmani, M., Alshammari, N., Alfhili, M. A., & Alruwaili, M. K. (2021). The Therapeutic Potential of Moringa oleifera for Metabolic Disorders: A Review. *Molecules*, *26*(18), 5621. https://pubmed.ncbi.nlm.nih.gov/34576625/
* Oyeyinka, A. T., & Afolayan, A. J. (2019). Moringa oleifera Lam. A plant with multipurpose medicinal applications: A review. *Plant Foods for Human Nutrition*, *74*(3), 332–359. https://pubmed.ncbi.nlm.nih.gov/31214777/
Q.
Nexium Not Working? Why Your Chest Is Still Burning & Medically Approved Steps
A.
If your chest still burns on Nexium, there are several factors to consider, including incorrect timing, an inadequate dose or the wrong medication, strong lifestyle triggers, or a different diagnosis that may even require urgent care. Evidence-based next steps include taking it 30 to 60 minutes before breakfast for 4 to 8 weeks, combining with lifestyle changes, discussing add-on or alternative therapies, and asking about tests to confirm GERD, with full details below that can affect your next healthcare decisions.
References:
* Savarino V, et al. Management of refractory gastroesophageal reflux disease. Therap Adv Gastroenterol. 2017 Mar;10(3):305-317.
* Gyawali CP, et al. Refractory gastroesophageal reflux disease: a clinical update. Curr Opin Gastroenterol. 2017 Jul;33(4):254-259.
* Katzka DA, et al. Approach to the Patient With Refractory GERD. Gastroenterology. 2019 Jul;157(1):44-57.
* Ness-Jensen E, et al. Non-erosive reflux disease (NERD) and refractory GERD. Curr Opin Gastroenterol. 2019 Jul;35(4):336-342.
* Kahrilas PJ, et al. Functional Heartburn and Non-Cardiac Chest Pain: The Rome IV Criteria. J Neurogastroenterol Motil. 2017 Jul;23(3):328-335.
Q.
Constant Acid? Why Your Chest Is Burning & Medically Approved Next Steps
A.
Constant chest burning is most often heartburn from acid reflux or GERD, but several other causes and red flags can mimic it; there are several factors to consider. See below for causes, urgent warning signs, and how doctors diagnose it. Start with proven steps like avoiding triggers, smaller meals, not lying down after eating, elevating the bed, and short-term use of antacids, H2 blockers, or PPIs with medical guidance; if symptoms occur more than twice weekly, persist for weeks, or include trouble swallowing or bleeding, see a clinician, and seek emergency care for chest pain with shortness of breath, sweating, or radiation. Full next steps, including tests and when surgery is considered, are provided below.
References:
* Gyawali CP, Kahrilas PJ, Patel A, Pandolfino JE. Modern management of gastroesophageal reflux disease. Nat Rev Gastroenterol Hepatol. 2023 Feb;20(2):93-109. doi: 10.1038/s41575-022-00701-w. Epub 2022 Oct 26. PMID: 36284206.
* Jung HK, Tae CH, Lee JS, Kim S, Park JM, Cho YS, Eun CS, Lim HC, Hong SJ, Song KH, Kim SK, Lee SJ, Park MI. 2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease. J Neurogastroenterol Motil. 2021 Jan 30;27(1):7-26. doi: 10.5056/jnm20147. PMID: 33525866; PMCID: PMC7839352.
* Ali Khan S, Chang ML. Medical Therapy for Gastroesophageal Reflux Disease. J Clin Gastroenterol. 2022 Jan 1;56(1):10-16. doi: 10.1097/MCG.0000000000001596. PMID: 34560799.
* Richter JE, Rubenstein JH. Presentation and Epidemiology of Gastroesophageal Reflux Disease. Gastroenterology. 2021 Jul;161(1):30-41. doi: 10.1053/j.gastro.2021.03.076. PMID: 33866085.
* Yadlapati R, Pandolfino JE, Kahrilas PJ. Refluxogenic Mechanisms, Reflux Syndromes, and Current Practice Guidelines for GERD. Gastroenterology. 2021 Oct;161(4):1122-1132.e1. doi: 10.1053/j.gastro.2021.06.075. PMID: 34320297.
Q.
Is Creatine Safe? Side Effects Reality & Medically Approved Next Steps
A.
For most healthy adults, creatine monohydrate is considered safe at 3 to 5 grams per day, with expected water weight gain and occasional stomach upset, and long term studies show no kidney harm in healthy users. There are several factors to consider; see below for medically approved dosing, hydration and brand guidance, who should avoid or get medical advice first such as people with kidney or liver disease, pregnancy, under 18, or on kidney affecting meds, when to get lab tests, and red flag symptoms that require urgent care.
References:
* Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AE, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS, Ziegenfuss TN. Creatine supplementation: an update. J Int Soc Sports Nutr. 2021 Oct 22;18(1):68. doi: 10.1186/s12970-021-00438-w. PMID: 34679770. Available from: pubmed.ncbi.nlm.nih.gov/34679770/
* Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017 Jun 13;14:18. doi: 10.1186/s12970-017-0173-z. PMID: 28615963. Available from: pubmed.ncbi.nlm.nih.gov/28615963/
* Naderi A, de Oliveira E, de Oliveira G, Ziegenfuss TN, Zandi S, Agha-Alinejad H. Long-Term Effects of Creatine Monohydrate on Renal Function in Athletes: A Review. J Sports Sci Med. 2019 Aug 26;18(3):584-590. PMID: 31427847. Available from: pubmed.ncbi.nlm.nih.gov/31427847/
* Arazi H, Taati B, Tarofee H, Hosseini R. Creatine supplementation and its effects on the cardiovascular system. J Int Soc Sports Nutr. 2020 Jan 21;17(1):5. doi: 10.1186/s12970-020-0337-4. PMID: 31969240. Available from: pubmed.ncbi.nlm.nih.gov/31969240/
* de Oliveira G, Silva H, da Silva D, de Medeiros R, Pires A, de Moura F, da Silva J, da Silva L. Creatine supplementation and gastrointestinal distress: a systematic review and meta-analysis. Eur J Sport Sci. 2023 Feb;23(2):162-172. doi: 10.1080/17461391.2021.1993414. Epub 2021 Oct 27. PMID: 34706596. Available from: pubmed.ncbi.nlm.nih.gov/34706596/
Q.
Chest Fire? Why Your Stomach is Pushing Up: Hiatal Hernia Medical Next Steps
A.
Chest burning after meals or when lying down is often acid reflux from a hiatal hernia, a common condition where part of the stomach pushes into the chest; most cases improve with smaller meals, bed elevation, avoiding trigger foods, weight management, and doctor-guided acid reducers, while surgery is reserved for persistent symptoms or complications. There are several factors to consider; see below for red flag symptoms that need urgent care, when chest pain could be a heart problem, how sliding and paraesophageal hernias differ, the tests used to confirm diagnosis, potential complications like Barrett’s esophagus, and the exact next steps to take with your clinician.
References:
* Kahrilas, P. J., & Kim, M. C. (2020). Hiatal Hernia and Reflux Disease. *Gastroenterology Clinics of North America*, *49*(3), 429–445. pubmed.ncbi.nlm.nih.gov/32736413/
* Low, D. E., & Dimeny, E. (2019). Diagnosis and management of hiatal hernia. *Journal of the American College of Surgeons*, *229*(2), 177–187. pubmed.ncbi.nlm.nih.gov/31202868/
* Ali, A. G., & Nuzhat, Y. (2021). The Role of Hiatal Hernia in Gastroesophageal Reflux Disease. *Journal of Clinical Gastroenterology*, *55*(3), 183–190. pubmed.ncbi.nlm.nih.gov/32487847/
* Hsu, C. Y., & Lee, H. S. (2019). Management of paraesophageal hernia. *Journal of Thoracic Disease*, *11*(Suppl 13), S1645–S1651. pubmed.ncbi.nlm.nih.gov/31807357/
* Furnée, E. J., & Draaisma, W. A. (2021). Current perspectives on the role of hiatal hernia in gastroesophageal reflux disease. *Langenbeck's Archives of Surgery*, *406*(8), 2821–2832. pubmed.ncbi.nlm.nih.gov/34190223/
Q.
Chest Fire? Why Your Throat Is Melting—How Omeprazole Ends the Burn
A.
A burning chest or throat is most often acid reflux or GERD; omeprazole, a proton pump inhibitor, lowers stomach acid by blocking acid pumps to relieve heartburn and let the esophagus heal, though it takes 1 to 4 days to work and is best taken 30 to 60 minutes before breakfast. There are several factors to consider, including lifestyle steps that boost relief, how long to try OTC therapy versus seeing a doctor, safety considerations with longer use, and red flags that need urgent care; see below for the complete details and next steps.
References:
* Strand DS, Kim D, Peura DA. Proton pump inhibitors: From the first to the latest generation. Drugs. 2017;77(10):1063-1077. doi: 10.1007/s40265-017-0750-7.
* Katz PO, Gerson LB, Vela JP. ACG Clinical Guideline: Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2013 May;108(5):792-808; quiz 809. doi: 10.1038/ajg.2013.194. Epub 2013 Apr 16.
* Malfertheiner P, Kandulski A, Venerito M. Gastroesophageal Reflux Disease (GERD) and Proton Pump Inhibitors (PPIs): Recent Innovations and Emerging Concerns. Curr Treat Options Gastroenterol. 2017 Sep;15(3):360-372. doi: 10.1007/s11938-017-0144-x.
* Abrahami D, McDonald EG, Schnitzer ME, Dascalakis G, Lee TC. Long-term use of proton pump inhibitors: a systematic review of the adverse events. Aliment Pharmacol Ther. 2019 Jun;49(11):1361-1372. doi: 10.1111/apt.15243. Epub 2019 Apr 17.
* Sachs G, Shin JM, Howden CW. Pharmacokinetics, pharmacodynamics and drug interactions of the proton pump inhibitors. Clin Pharmacokinet. 2002;41 Suppl 1:1-29. doi: 10.2165/00003088-200241001-00001.
Q.
Chest on Fire? Why Acid Reflux Persists & Medically-Approved Next Steps
A.
Recurring heartburn is usually acid reflux or GERD, often driven by a weak valve at the bottom of the esophagus, trigger foods or late meals, excess weight, hiatal hernia, pregnancy, or smoking. There are several factors to consider that can change the best plan for you; see below for key details and risks to watch for. Medically approved next steps start with smaller meals, avoiding late eating, elevating the head of the bed, weight loss, and quitting smoking, then using antacids, H2 blockers, or PPIs as directed and seeking care if symptoms persist or if you have warning signs like trouble swallowing, bleeding, black stools, or severe chest pain. Full guidance, including when to get urgent help and what tests or prescriptions may be needed, is below.
References:
* Katz PO, Dunbar LA, Adachi JA, Bate P, Vaezi MF, Adham M. ACG Clinical Guideline: Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2024 Apr 1;119(4):618-644. doi: 10.14309/ajg.0000000000002705. PMID: 38555139.
* Sifrim D, Tack J, Tütüian R, Vaezi MF. Management of refractory gastroesophageal reflux disease. Gut. 2021 Mar;70(3):617-626. doi: 10.1136/gutjnl-2020-322199. Epub 2020 Oct 13. PMID: 33055171.
* Scarpellini E, Pasquale L, Zola R, Santomauro R, Abenavoli L, Rindi G, Spaggiari G, Di Gregorio D, Gulli F, Bielli V, Spaggiari L, Di Lauro G, Tredici G, Cammarota G. Treatment of Refractory GERD: New Approaches to an Old Problem. J Clin Med. 2023 Apr 14;12(8):2917. doi: 10.3390/jcm12082917. PMID: 37190874; PMCID: PMC10143168.
* Kahrilas PJ, Omari RA, Lin S. Approaches to the patient with persistent heartburn despite proton pump inhibitor therapy. Best Pract Res Clin Gastroenterol. 2020 Dec;48-49:101704. doi: 10.1016/j.bpg.2020.101704. Epub 2020 Aug 1. PMID: 32900508.
* Fass R, Sifrim D. Management of Refractory GERD. Gastroenterology. 2021 Dec;161(6):1740-1748. doi: 10.1053/j.gastro.2021.08.055. Epub 2021 Aug 30. PMID: 34478051.
Q.
Constant Chest Fire? Why Your Internal Valve is Failing & Medical Next Steps
A.
There are several factors to consider: constant chest burning is most often GERD from a weak lower esophageal sphincter letting acid back up, but dangerous heart causes can mimic it and need urgent care if red flags like pressure, spreading pain, shortness of breath, sweating, or nausea occur. Next steps include targeted lifestyle changes, appropriate acid-reducing medicines, and timely medical evaluation with testing when symptoms persist or are severe, with procedures considered if medications fail; see below for complete guidance and key details that could change which steps are right for you.
References:
* Singh V, Singh AK. Gastroesophageal Reflux Disease: Pathophysiology and Clinical Manifestations. Indian J Gastroenterol. 2022 Dec 15;41(6):534-541. PMID: 36511674. DOI: 10.1007/s12664-022-01297-5.
* Katz PO, Dunbar LR, Hatlebakk JG. ACG Clinical Guidelines: Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2021 Sep 1;116(9):1738-1758. PMID: 34289387. DOI: 10.14309/ajg.0000000000001474.
* Yadlapati R. Treatment of GERD: Where Are We Now? Gastroenterol Clin North Am. 2021 Dec;50(4):711-722. PMID: 34857503. DOI: 10.1016/j.gtc.2021.09.006.
* Costantini M, Ruol A, Zaninotto G, Asolati M, Banzato A, Salvador R. The lower esophageal sphincter: recent insights into its pathophysiology and role in GERD. Front Surg. 2017 Oct 16;4:58. PMID: 29033486. DOI: 10.3389/fsurg.2017.00058.
* Yadlapati R, Vaezi MF, Kahrilas PJ, Dunbar KB, Gyawali CP. Diagnosis and Monitoring of Gastroesophageal Reflux Disease: A Clinical Review. JAMA. 2023 Apr 4;329(13):1106-1115. PMID: 37021199. DOI: 10.1001/jama.2023.3644.
Q.
Internal Fire? Why Your Stomach is Attacking and the Famotidine Path to Relief
A.
Burning in the chest or upper stomach is most often acid reflux or GERD from stomach acid irritating the esophagus; famotidine, an H2 blocker, reduces acid and can start helping in 30 to 60 minutes with relief lasting up to 12 to 24 hours, and works best alongside smaller meals, avoiding triggers, and staying upright after eating. There are several factors to consider, including when to choose famotidine vs a PPI, how long to use it, possible interactions and kidney or pregnancy considerations, and red flags like chest pain, bleeding, weight loss, or trouble swallowing that need prompt care. See complete details below to guide next steps and avoid missing issues that could change your treatment plan.
References:
* Smith JL, Graham DY. Histamine H2-receptor antagonists: a review of their pharmacology and use in the management of acid-related disorders. *Drugs*. 2012;72(2):163-182. PMID: 22097061.
* Kahrilas PJ, Spechler SJ. Gastroesophageal Reflux Disease (GERD): Pathophysiology, Diagnosis, and Treatment Options. *Gastroenterology*. 2021;161(3):850-862. PMID: 34293817.
* Herzig RS, Prinz C. Regulation of gastric acid secretion. *J Clin Gastroenterol*. 2020;54(9):743-749. PMID: 32970557.
* Katz PO, Gerson LB. Pharmacologic Management of Gastroesophageal Reflux Disease. *Gastroenterol Hepatol (N Y)*. 2022;18(8):534-544. PMID: 35995570.
* Shah N, Sharma A. The Role of H2 Receptor Antagonists in Acid-Related Disorders: An Update. *J Clin Gastroenterol*. 2021;55(5):373-379. PMID: 33923363.
Q.
Muffled Pain? Why Tylenol Resets Your Internal Thermostat + Next Steps for Relief
A.
Tylenol muffles pain and resets your internal thermostat by reducing brain prostaglandins and lowering the hypothalamic set point, easing headaches and fever discomfort without reducing inflammation or fixing the cause. There are several factors to consider for safe, effective relief, including correct dosing limits, hidden acetaminophen in combo cold medicines, when Tylenol may not be enough, urgent red flags, and non-drug steps; see the complete details below to choose the right next step in your care.
References:
* Anderson, R. G. (2009). Acetaminophen: a critical review of its mechanism of action. Clinical Therapeutics, 31(10), 1957-1964.
* Aronoff, D. M., & Blatteis, C. M. (2014). Antipyretic and analgesic mechanisms of paracetamol. Drugs, 74(2), 195-201.
* Ghanem, C. I., Saracino, M. A., Grillo, L. R., Mortensen, N., Moreira, M. D., Prada, A. F., ... & Filip, M. (2013). New developments in the mechanism of action of paracetamol (acetaminophen). Current Pharmaceutical Design, 19(21), 3695-3703.
* Mallet, C., & Davin, C. H. (2020). The analgesic and antipyretic activity of paracetamol: from mechanisms to clinical impact. Expert Review of Clinical Pharmacology, 13(2), 101-110.
* S-Graham, K. H. (2020). Recent insights into the mechanism of action of paracetamol (acetaminophen). The European Journal of Clinical Pharmacology, 76(11), 1493-1502.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Richter, J. E., & Rubenstein, J. H. (2018). Presentation and epidemiology of gastroesophageal reflux disease. Gastroenterology.
https://www.sciencedirect.com/science/article/pii/S0016508517359772Gyawali, C. P., & Fass, R. (2018). Management of gastroesophageal reflux disease. Gastroenterology.
https://www.sciencedirect.com/science/article/pii/S0016508517359899Tack, J., & Pandolfino, J. E. (2018). Pathophysiology of gastroesophageal reflux disease. Gastroenterology.
https://www.sciencedirect.com/science/article/pii/S0016508517362480