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Acid reflux (GERD)

Morbus refluxus gastrooesophagealis · Refluxní choroba jícnu (GERD)

What it is

The valve at the top of the stomach leaks acid upward.

Symptoms & signs

  • Heartburn after meals
  • acid taste
  • night cough
  • hoarseness
  • chest pain
  • worse lying down

🚩 Get help if…

  • call 112 / 911 now Chest pain spreading to the arm, jaw or with sweating
  • call 112 / 911 now Vomiting blood or black tarry stools
  • see a doctor soon Food sticking when swallowing or pain on swallowing
  • see a doctor soon Weight loss or heartburn starting after 55

Where it strikes

Medical treatment

  • PPI for 4–8 weeks — heals inflammation well, is then taken for years by many who no longer need it, and stopping causes rebound acid mixed evidence
  • Alginate after meals trials support
  • H2 blocker at night mixed evidence
  • Fundoplication or a LINX device when drugs fail — it works, and about a fifth are left bloated or unable to belch mixed evidence
  • Vonoprazan (Voquezna), a potassium-competitive acid blocker — FDA-approved 2023–24 for erosive oesophagitis and heartburn

Natural & lifestyle

  • Raise the head of the bed 15 cm
  • no food 3 h before bed
  • weight loss
  • smaller meals
  • cut alcohol, coffee, fat, mint
  • left-side sleeping

Emerging & experimental

  • Anti-reflux mucosectomy

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Melatonin — small trials found symptom relief close to omeprazole early / small studies
  • Aloe vera syrup — a small randomised trial eased heartburn early / small studies
  • D-limonene (orange-peel extract) — small trials early / small studies
  • Acupuncture — small trials in people who do not respond to PPIs mixed evidence
  • Apple cider vinegar before meals — popular; untested, and it can worsen heartburn anecdotal / traditional

ICD codes