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Understanding and Managing GERD: A Comprehensive Guide for All Ages

Dr. Craig Smith, MD

4 Min read

Gastroesophageal reflux disease (GERD) is a chronic condition characterized by the regurgitation of stomach contents into the esophagus, throat, and mouth. It manifests with symptoms occurring more than twice a week or persisting for extended periods. This comprehensive guide explores the diverse symptoms experienced by adults, infants, and older children, as well as when to seek medical attention, available treatments, preventive measures, potential complications, and the underlying causes of GERD.

Symptoms of GERD in Adults

  1. Burning Pain in the Chest

  2. The hallmark symptom of GERD in adults is a burning sensation in the chest or upper stomach, commonly referred to as heartburn. Distinguishing this pain from a heart attack is crucial, as GERD-related chest pain is typically felt just beneath the skin and may radiate from the stomach to the throat.

    To alleviate heartburn, individuals can try:

    • Loosening belts and waistbands

    • Chewing over-the-counter antacids

    • Sitting up straight to reduce lower esophagus pressure

    • Exploring natural remedies like apple cider vinegar, licorice, or ginger

  3. Unpleasant Taste in the Mouth

  4. GERD may cause a bitter or sour taste in the mouth, indicating the regurgitation of stomach contents into the throat. In cases of laryngopharyngeal reflux, symptoms involve the throat, larynx, voice, and nasal passages.

  5. Difficulty Swallowing and Respiratory Symptoms

  6. GERD can make swallowing challenging, leading to coughing or wheezing, particularly after eating or when lying down. Some individuals may also experience nausea.

  7. Dental Issues

  8. Not all GERD sufferers exhibit digestive symptoms. Dental problems, such as enamel erosion due to frequent acid reflux into the mouth, might be the initial sign. Protective measures include:

    • Chewing antacids to neutralize saliva acid

    • Rinsing with water and baking soda after reflux

    • Using fluoride rinse to remineralize teeth

    • Switching to nonabrasive toothpaste

    • Chewing xylitol gum to stimulate saliva flow

    • Wearing a dental guard at night

GERD Symptoms in Babies

  1. Excessive Spitting Up

  2. While occasional reflux is normal in healthy babies, persistent, forceful, or frequent spitting up may indicate GERD, especially if it continues beyond 24 months.

  3. Coughing and Gagging

  4. Babies with GERD may cough, choke, or gag as stomach contents move up into the throat, potentially causing breathing difficulties or recurrent lung infections.

  5. Discomfort and Sleeping Issues

  6. Discomfort during or after feeding, arching of the back, colic episodes lasting over three hours a day, and disrupted sleep patterns are common indicators of GERD in infants.

  7. Refusal to Eat and Weight Concerns

  8. Uncomfortable eating experiences may lead to a baby refusing food, resulting in weight concerns. Parents can implement various strategies, such as feeding smaller amounts more frequently and adjusting feeding positions.

GERD Symptoms in Older Children

GERD symptoms in older children mirror those in adults and infants. Abdominal pain after eating, difficulty swallowing, nausea, vomiting, belching, and hoarseness may be present. Children associating food with discomfort may resist eating.

When to Seek Medical Attention

The American College of Gastroenterology recommends consulting a doctor if over-the-counter medications are used for GERD symptoms more than twice a week. Medical attention is also necessary if vomiting becomes severe, with alarming signs like green or bloody vomit.

Medical Treatments

Physicians may prescribe:

  • H2 blockers or proton pump inhibitors: These reduce stomach acid.

  • Prokinetics: These help empty the stomach more quickly.

  • Surgery: In cases where medications prove ineffective.

Similar treatments apply to children experiencing GERD symptoms.

Prevention of GERD

Implementing lifestyle changes can minimize GERD symptoms:

  • Eating smaller, more frequent meals

  • Limiting intake of citrus, caffeine, chocolate, and high-fat foods

  • Consuming foods that aid digestion

  • Choosing water over carbonated drinks and alcohol

  • Avoiding late-night meals and tight clothing

  • Remaining upright for at least two hours after eating

  • Elevating the head of the bed by 6 to 8 inches

Complications of GERD

Persistent exposure of the esophagus to stomach acid can lead to complications:

  • Esophagitis: Irritation of the esophageal lining

  • Reflux Laryngitis: Voice disorders causing hoarseness and throat discomfort

  • Barrett’s Esophagus: Growth of abnormal cells, potentially progressing to cancer

  • Esophageal Strictures: Scar tissue formation restricting eating and drinking

Causes of GERD

The lower esophageal sphincter (LES), a muscular ring at the esophagus's bottom, allows food entry into the stomach. In GERD, the LES fails to fully close, permitting food and liquid to flow back into the throat. Risk factors include obesity, pregnancy, hiatal hernias, certain medications, and smoking.

Studies reveal a link between smoking and GERD, emphasizing smoking cessation as a potential remedy.


GERD symptoms, if left unaddressed, can result in long-term damage to the digestive system. However, simple lifestyle changes can often manage symptoms effectively. When self-help strategies prove insufficient, medical intervention, including medication or surgery, may be necessary. Understanding the varied symptoms in adults, infants, and older children, along with preventive measures and potential complications, empowers individuals to take proactive steps towards managing and mitigating the impact of GERD on their overall health.

About the Author

In 1984, Dr. Craig Smith founded Lifesource. As a coach, he's worked with world-class athletes and guided thousands towards successful weight loss. Driven by a desire to elevate his understanding of the human body, he returned to the rigors of medical school in his 50s, achieving his goal of becoming a physician at 56. Now in his 60s, Dr. Smith leads by personal example, continuing to inspire, educate and empower individuals from all walks of life to achieve their health and fitness goals. If you wish to train and diet online with Dr. Smith, hear his message and schedule a 45-minute consultation on the New You page.