Gastroesophageal reflux disease (GERD) is a more serious, chronic—or long-lasting—form of GER. GER that occurs more than twice a week for a few weeks could be GERD, which over time can lead to more serious health problems. People with suspected GERD should see a health care provider.

Gastroesophageal reflux disease results when the lower esophageal sphincter—the muscle that acts as a valve between the esophagus and stomach—becomes weak or relaxes when it should not, causing stomach contents to rise up into the esophagus.

Abnormalities in the body such as Hiatal hernias may also cause GERD. Hiatal hernias occur when the upper part of the stomach moves up into the chest. The stomach can slip through an opening found in the diaphragm. The diaphragm is the muscle wall that separates the stomach from the chest. Hiatal hernias may cause GERD because of stomach acid flowing back up through the opening; However, most produce no symptoms.

Other factors that can contribute to GERD include:

  • obesity
  • pregnancy
  • certain medications, such as asthma medications, calcium channel blockers, and many antihistamines, pain killers, sedatives, and antidepressants
  • smoking, or inhaling secondhand smoke

People of all ages can develop GERD, some for unknown reasons. The main symptom of GERD is frequent heartburn, though some adults with GERD do not have heartburn.

Other common GERD symptoms include:

  • a dry, chronic cough
  • wheezing
  • asthma and recurrent pneumonia
  • nausea
  • vomiting
  • a sore throat, hoarseness, or laryngitis—swelling and irritation of the voice box
  • difficulty swallowing or painful swallowing
  • pain in the chest or the upper part of the abdomen
  • dental erosion and bad breath

Lifestyle changes and medications are often the first lines of treatment for suspected GERD. If symptoms improve with these treatment methods, a GERD diagnosis may not require additional testing. However, to confirm a diagnosis, a person may need testing if symptoms do not improve or if other concerning symptoms are present such as recent worsening of long-standing symptoms, symptoms starting over the age of 50, weight loss, bleeding, or trouble swallowing.

Treatment for GERD may involve one or more of the following, depending on the severity of symptoms: lifestyle changes, medications, or surgery.