Main symptoms
- •Heartburn (rising retrosternal burn)
- •Acid regurgitation
- •Worsened after meals or lying down
- •Chronic night cough
- •Laryngitis, hoarseness
- •Chest pain
- •Dental erosion
Risk factors
- ⚠️ Hiatal hernia
- ⚠️ Obesity (×2)
- ⚠️ Pregnancy
- ⚠️ Tobacco, alcohol
- ⚠️ Excess coffee/tea
- ⚠️ Large fatty meals
- ⚠️ Foods: chocolate, mint, citrus
- ⚠️ NSAIDs, calcium channel blockers
Management and treatments
**First-line**: PPIs (omeprazole, esomeprazole) for 4-8 weeks, one dose 30 min before breakfast. Generics 40-80 MAD/month, reimbursed 70-80%. **Antacids** (Maalox, Gaviscon) for symptom relief. **Alginate** is safe during pregnancy. **Surgery** (Nissen) is rare. Endoscopy for warning signs or GERD > 5 years (Barrett's screening).
Prevention
Weight loss if BMI > 25 (-5 kg = -30% symptoms), raise the head of the bed 15-20 cm, smaller frequent meals, dinner 3h before bedtime, stop tobacco/alcohol, avoid trigger foods, chewing gum 30 min after meals.
Frequently asked questions
Are PPIs dangerous long-term?+
Use > 1 year is linked to B12/Mg/Ca deficiencies, infections, osteoporosis. Re-evaluate every 6-12 months.
Can I stop PPIs abruptly?+
No — acid rebound. Taper gradually.
Can GERD mimic a heart attack?+
Yes — identical retrosternal pain. Over 50: 141 emergency to rule out a heart attack.
Does pregnancy worsen GERD?+
Yes (60-80%). Safe treatment: alginate, PPIs if needed (omeprazole allowed).
📖 Detailed article
To learn more about gastroesophageal reflux disease, read our cornerstone medically reviewed article.
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