Gastroesophageal reflux disease (GERD) is an extremely common condition, affecting nearly 1 in 5 U.S. adults at least weekly and nearly 1 in 10 daily.^1-3 It affects women more commonly than men, and the peak ages are 30 to 60.⁴

Symptoms of GERD occur due to esophageal irritation from acidic stomach contents (including pepsin and sometimes bile acids) contacting the esophagus through the lower esophageal sphincter (LES).

A variety of symptoms can occur:

• Retrosternal discomfort (e.g., pain, burning)
• Acid regurgitation
• Nausea and/or vomiting
• Laryngitis
• Cough
• Dental erosions
• Wheezing
• Difficulty swallowing

Normally, the LES only relaxes when one is swallowing food. Otherwise, it has enough tone to limit retrograde flow of acidic contents into the esophagus. With long-term acid exposure, the esophagus may become inflamed (esophagitis) and constrict (stricture), and it can also develop columnar metaplasia (Barrett’s esophagus) or adenocarcinoma.

There are many factors that cause GERD, and these should be systematically evaluated when creating a treatment plan that aims to cure rather than just treat this disease. The quality-of-life burden is significant and may be greater than that of congestive heart failure, coronary heart disease, and diabetes.⁵