Heartburn, acid reflux, and hyperacidity all refer to a burning-like sensation in the chest, or to reflux of stomach contents into the mouth or esophagus (the tube linking the throat to the stomach). If these symptoms occur more than twice a week for several weeks, it is possible that you have gastroesophageal reflux (GERD). The most common symptoms of GERD are a burning sensation in the chest (heartburn) and reflux of food or fluid into the throat. Other symptoms include chronic dry cough, wheezing or asthma, sore throat or hoarseness, and tooth decay. If you have chest tightness or chest pain, shortness of breath, nausea, vomiting, or pain in your back or arms, you may be having a heart attack. You should seek emergency medical attention as soon as possible. Diagnosis A doctor can make a diagnosis based on symptoms and whether treatment is working. Other tests include: 1. endoscopy, which uses a camera to look into the esophagus; 2. x-ray of the upper gastrointestinal tract to look for esophageal strictures or other problems; and 3. manometry to detect contractions of the esophageal muscles. Treatment A variety of treatments can be tried. One or a combination of methods can be used. 1. Medications: Over-the-counter medications include gastric mucosal protectors and two drugs that reduce acid secretion: H2 receptor blockers (e.g., ranitidine) and proton pump inhibitors (e.g., omeprazole). 2. Dietary modifications: Avoiding chocolate, coffee, mints, greasy or spicy, tomatoes and avoiding alcohol may help. 3. Other treatments include quitting smoking, avoiding overfeeding, avoiding eating 2-3 hours before bedtime, and losing weight. If symptoms get worse at night, then the back of the head can be slightly elevated while sleeping. Using a pillow alone will not help. Surgery Certain cases require surgical treatment, most commonly laparoscopic fundoplication. This procedure involves folding the stomach close to the opening of the esophagus to block the reflux of stomach contents. Certain patients require weight loss surgery. Complications If left untreated, GERD can cause diseases of the esophagus, including esophageal ulcers, dysphagia, or Barret’s esophagus (which can develop into esophageal cancer).