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Gastroesophageal reflux disease, or GERD, is acid reflux that keeps happening: stomach contents travelling back up into the food pipe often enough to cause symptoms or damage. Day to day that means burning behind the breastbone, a sour taste in the throat, and symptoms that worsen after meals or lying down.
Occasional reflux after a large meal is common, and on its own it is not GERD. Emergency Care BC defines GERD as reflux that causes damage or affects quality of life. What matters is not whether reflux happens, but how often.
GERD is also an umbrella term. Erosive esophagitis is a finding rather than a symptom: what a doctor sees at endoscopy when reflux has worn breaks into the lining. Symptoms and damage do not always match. Functional dyspepsia, or indigestion, centres on pain and fullness in the upper abdomen instead. These overlap, so clinicians often assess for more than one at once.
The pattern differs between people.
Some risk factors cannot be changed:
Others can often be worked on, usually with support from a health care team:
GERD is usually a clinical diagnosis, based on heartburn with or without regurgitation and a review of your medicines, with a trial of acid suppressing medicine. Upper endoscopy, or gastroscopy, is arranged when there are alarm features or when symptoms carry on despite treatment, because it shows whether the lining is eroded and whether Barrett\’s esophagus is present. If the picture stays unclear, a gastroenterologist may add pH monitoring, esophageal manometry or a barium swallow. Endoscopy is not used as a screening test for long standing reflux alone, which the Canadian Task Force on Preventive Health Care recommends against.
Care aims to reduce how much acid reaches the esophagus and keep symptoms manageable. Depending on your history and what any endoscopy showed, a health care team may discuss:
These are decisions for you and your own clinician, based on your history and your other medicines.
Many people keep having symptoms while already taking standard acid suppressing medicine, and there is no agreement on how that group should be managed. Studies are testing potassium competitive acid blockers, longer acting acid suppression, endoscopic and surgical techniques, and Barrett\’s esophagus surveillance. Researchers are also studying non acid reflux and esophageal hypersensitivity, which may explain why symptoms and visible damage so often fail to match.
Taking part is voluntary. You give informed consent first, you can stop at any time without affecting your regular care, and no one can say in advance whether a study will help you personally.
This page is written in plain language for people considering clinical research. It is general health information, not medical advice, and it does not replace a conversation with your own doctor or nurse practitioner.
Heartburn is a symptom: burning that rises from the stomach into the chest. GERD is the ongoing condition behind it, where reflux happens often enough to cause symptoms or damage. Erosive esophagitis is a finding rather than a symptom, what a doctor sees at endoscopy when reflux has worn visible breaks into the lining of the esophagus. Functional dyspepsia, which most people call indigestion, centres on pain, burning or fullness in the upper abdomen with no structural cause found. Because they overlap, doctors often look at more than one possibility at once.
The Canadian Task Force on Preventive Health Care recommends against screening adults who have chronic GERD for esophageal cancer or for Barrett's esophagus. That recommendation does not cover people who have alarm features such as trouble swallowing, bleeding, repeated vomiting or unexplained weight loss, or people already known to have Barrett's esophagus, and it does not replace advice about your own situation. Esophageal cancer is uncommon in Canada: the same guideline reports about 6 new cases per 100,000 Canadians in 2019.
Studies often look for people whose symptoms have not settled with usual acid suppressing treatment, because that is where the biggest open questions are. Joining is voluntary, you give informed consent first, and you can withdraw at any time without affecting your regular care. A research team will explain the study and answer your questions before you decide anything.
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