Acid Reflux vs GERD:
When Should You See a Specialist?

Most adults experience heartburn occasionally — usually after a heavy or spicy meal. This is normal. But when symptoms occur more than twice a week and affect your quality of life, you may have GERD (Gastro-Oesophageal Reflux Disease) — a chronic condition that, if untreated, can cause oesophageal damage and even cancer.

Acid Reflux vs GERD: Key Difference

• Acid Reflux: Occasional backflow of stomach acid into the oesophagus. Managed with lifestyle changes and antacids.
• GERD: A chronic condition where the lower oesophageal sphincter (LES) is weak or malfunctions repeatedly, causing frequent acid reflux episodes that damage the oesophageal lining over time.

Symptoms of GERD

• Heartburn — a burning sensation in the chest, especially after eating or lying down
• Regurgitation — sour or bitter-tasting acid backing up into the throat or mouth
• Difficulty swallowing (dysphagia)
• Chest pain — can mimic cardiac pain (always rule out heart disease first)
• Chronic cough, especially at night
• Hoarseness or a sore throat in the morning
• Worsening asthma — GERD can trigger or worsen respiratory symptoms

Complications of Untreated GERD

• Oesophagitis: Inflammation and erosion of the oesophageal lining, causing pain, bleeding and ulcers
• Barrett Oesophagus: Precancerous change in the oesophageal lining — requires regular endoscopic surveillance
• Oesophageal stricture: Narrowing of the oesophagus due to scar tissue
• Oesophageal cancer: Long-standing Barrett oesophagus increases cancer risk significantly

Treatment

Lifestyle Changes First

• Elevate the head of the bed by 15-20 cm
• Avoid eating within 2-3 hours of bedtime
• Eat smaller, more frequent meals
• Avoid triggers: spicy food, fatty food, caffeine, alcohol, chocolate, carbonated drinks
• Maintain a healthy weight
• Quit smoking — weakens the lower oesophageal sphincter

Medications

Proton Pump Inhibitors (PPIs) such as omeprazole are the mainstay of medical treatment. Medications control symptoms but do not cure the underlying sphincter weakness.

Surgery: Laparoscopic Nissen Fundoplication

For patients who do not respond to medications or who do not wish to take lifelong medication, laparoscopic Nissen fundoplication is the surgical solution. It involves wrapping the upper stomach around the lower oesophagus to strengthen the sphincter. Performed with 3-4 tiny incisions, overnight stay, and excellent long-term symptom improvement.

Frequently Asked Questions