Heartburn, acid reflux and dyspepsia are the characteristic symptoms used to describe a burning sensation in the chest, and if you experience these symptoms more than twice a week for several weeks, you may be diagnosed with gastroesophageal reflux disease, meaning the reflux of stomach contents into the mouth or esophagus, or GERD. The article summarizes the key clinical points of GERD and provides a systematic overview of the disease for patients and clinicians (see the figure below for a diagram). GERD diagram: When your lower esophageal sphincter (weak) does not close properly, acid or food from the stomach can flow back into your esophagus, causing irritation in the esophagus. Treatment includes medications, diet and lifestyle change programs, and sometimes surgery may be recommended. Symptoms The most common symptoms of GERD are a burning sensation in the chest, known as heartburn, and reflux of food or fluid into the throat. Other symptoms include chronic dry cough, asthma, sore or hoarse throat, and dental erosion. The differential diagnosis must be taken seriously. If you feel pressure or pain in your chest, shortness of breath, nausea or vomiting, this may be a sign of a heart attack – seek emergency care immediately. Other tests include: endoscopy, in which the doctor uses video or photographs to look at the esophagus; x-ray scans of the upper gastrointestinal tract to detect esophageal disease or other disorders; and manometry, which assesses the contraction of the esophageal muscles. There are many treatments that can be tried at home. As the disease continues to change and progress, you may need at least 1 treatment option. Medications: Medications available over the counter include antacids, as well as medications that inhibit acid production, i.e., reduce acid in the stomach – H2 receptor blockers (such as ranitidine) and proton pump inhibitors (such as omeprazole). Dietary changes: Some people find it may be beneficial to avoid chocolate, coffee, mint, greasy or spicy foods, tomato products, and alcohol. Other treatments: include quitting smoking, avoiding overeating, avoiding eating 2-3 hours before bedtime, and trying to lose weight if you are overweight or obese. If your symptoms worsen at night, propping the head of your bed too high by 6-8 inches may help. Be aware that using extra pillows or cushions will not help relieve GERD symptoms. Sometimes your doctor may recommend surgery for GERD, most commonly a laparoscopic fundoplication. The procedure involves folding the upper part of the stomach (the fundus) to completely enclose the lower part of the esophagus so that positive pressure in the stomach is transmitted to this “new collar” around the esophagus, creating a one-way valve so that food can flow from the esophagus into the stomach, but not back into the esophagus from the stomach. Sometimes the doctor may recommend bariatric surgery. If left untreated, GERD can cause many esophageal disorders, including ulcers, swallowing problems, or lead to the formation of Barrett’s esophagus, which increases the risk of progression to esophageal cancer.