What is CHRONIC ACID REFLUX?
It is also known as Gastroesophageal Reflux Disease (GERD), a long-term condition where stomach acid frequently flows back into esophagus, causing symptoms like frequent heartburn (more than twice weekly), regurgitation, chest pain, difficulty swallowing, chronic cough, or lump-in-throat feeling, due to a weakened lower esophageal sphincter. An esophageal sphincter is a ring of muscle at the top or bottom of the esophagus that acts as a valve, opening to let food pass into stomach and closing to prevent stomach content (acid, food) from backing up into esophagus.
Most people can manage the discomfort of GERD with lifestyle changes and medicines. And though it is uncommon, some may need surgery to help with symptoms.
( Esophagus is a tube through which food passes from the mouth to the stomach)
Symptoms
Common symptoms of GERD include
- A burning sensation in the chest, often called heartburn usually happens after eating and might be worse at night or while lying down.
- Backwash of food or sour liquid in the throat.
- Upper belly chest or pain.
- Trouble swallowing, called dysphagia.
- Sensation of lump in the throat.
If you have nighttime acid reflux, you also might experience:
- An ongoing cough
- Inflammation of the vocal chords, known as laryngitis.
- New or worsening asthma.
When to see a doctor
Seek medical help right away if you have chest pain, especially if you also have shortness of breath, or jaw or arm pain. These may be symptoms of heart attack.
Make an appointment with healthcare professional if you:
- Have severe or frequent GERD symptoms.
- Take nonprescription medicines for heartburn more than twice a week.
Causes
GERD is caused by frequent acid reflux or reflux of non acidic content from the stomach.
When you swallow, a circular band of esophagus, called the lower esophageal sphincter, relaxes to allow food and liquid to flow into the stomach. Then the sphincter closes again.
If the sphincter does not relax as is typical or it weakens, stomach acid can flow back into esophagus. This constant backwash of acid irritates the lining of esophagus, often causing it to become inflamed.
Risk Factors
Conditions that can increase the risk of GERD include:
- Obesity
- Bulging of the top of the stomach above the top of diaphragm, known as a hiatal hernia.
- Connective tissue disorders, such as scleroderma.
- Delayed stomach emptying.
Factors that can aggravate acid reflux include
- Eating large meals or eating late at night.
- Eating certain foods, such as fatty or fried foods.
- Drinking certain beverages, such as alcohol or coffee.
- Taking certain medicines such as aspirin.
Complications
Over time, long-lasting inflammation in the esophagus can cause:
- Inflammation of the tissue in the esophagus, known as esophagitis. Stomach acid can break down tissue in the esophagus. This can cause inflammation, bleeding and sometimes abn open sore, called an ulcer. Esophagitis can cause pain and make swallowing difficult.
- Narrowing of the esophagus, called esophageal stricture. Damage to the lower esophagus from stomach acid causes scar tissue to form. The scar tissue narrows the food pathway, leadng to problems with swallowing.
- Precancerous changes to the esophagus known as Barrett esophagus. Damage from acid can cause changes in the tissue lining the lower esophagus. These changes are associated with an increased risk of esophageal cancer.
How is GERD diagnosed?
A gastroenterologist will evaluate your esophagus to diagnose GERD. Tests may include:
- Esophagram– An esophagram is atype of X ray exam. It takes moving X-rays (floursoscopy) of your esophagus while you swallow a chalky liquid called barium.
- Upper endoscopy– An upper endoscopy involves looking inside your esophagus with a camera. The camera is on the end of thin tube that passes through your mouth while you are asleep under light sedation.
- Esophageal pH test– This test measures the acid content inside your esophagus through a small wireless receiver. Your provider places the receiver in your esophagus during an endoscopy.
- Esophageal manometry– This test measures the muscle activity in your esophagus, using pressure sensors embedded in a nasogastric tube. It can confirm if your LES or other muscles are not working right.
Management and treatment
Some people find they can reduce acid reflux with lifestyle adjustments, like changing their eating habits, reducing alcohol, tobacco and losing weight. Healthcare providers encourage this.
But if you have chronic acid reflux or GERD, they also recommend medicines to reduce your stomach acid, so reflux is less damaging. These medicines are easily available and highly effective.
You can use Antacids available in the market through Over the counter, and your healthcare provider may prescribe some other medicines also.
Anil Malik
Mumbai, India
24th December 2025