Acid reflux medicine: Types and when to seek help (2022)

In April 2020, the Food and Drug Administration (FDA) requested that all forms of prescription and over-the-counter (OTC) ranitidine (Zantac) be removed from the U.S. market. They made this recommendation because unacceptable levels of NDMA, a probable carcinogen (or cancer-causing chemical), were present in some ranitidine products. People taking prescription ranitidine should talk with their doctor about safe alternative options before stopping the drug. People taking OTC ranitidine should stop taking the drug and talk with their healthcare provider about alternative options. Instead of taking unused ranitidine products to a drug take-back site, a person should dispose of them according to the product’s instructions or by following the FDA’s guidance.

To treat acid reflux, a person has several over-the-counter (OTC) and prescription options to choose from. Medications for acid reflux offer either fast acting or long-term relief to the pain. In some cases, a doctor may recommend using combinations of medication.

This article looks at the different types of medicine for acid reflux, how to take them, and when to see a doctor.

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According to the American College of Gastroenterology (ACG), acid reflux or gastroesophageal reflux (GER) occurs when acid from the stomach flows into the esophagus.

The result is a burning sensation in the middle of the chest. It may also cause an acidic taste in the mouth and burning in the throat. A person may experience these symptoms for a few hours. People may know this sensation as heartburn.

Although many people experience heartburn occasionally, if it occurs two or more times a week, they may have gastroesophageal reflux disease (GERD).

A person experiences heartburn when stomach fluids remain in the esophagus long enough to damage its lining.

Find out more about the differences between heartburn and acid reflux here.

When treating acid reflux, doctors attempt to:

  • relieve pain and other symptoms
  • help the esophagus heal
  • prevent future episodes of heartburn and damage

Some lifestyle changes the ACG recommend include:

  • changes in diet to avoid foods that aggravate the condition
  • sleeping or lying with an elevated head
  • avoiding alcohol and tobacco products
  • avoiding eating for up to 2–3 hours before bed
  • maintaining a moderate weight
  • wearing looser fitting clothes

There are a few different types of OTC medications for acid reflux:

(Video) How to treat ACID REFLUX AT HOME - HEARTBURN TREATMENT(GERD)

Antacids

According to one 2020 article, antacids work by neutralizing the acid present in a person’s stomach.

According to the United Kingdom’s National Health Service (NHS), antacids can provide relief from symptoms for a couple of hours. However, they do not treat the underlying cause of acid reflux, and the NHS do not recommend long-term use.

Some examples of antacids include:

  • calcium carbonate (Tums)
  • sodium bicarbonate (Alka-Seltzer)
  • magnesium trisilicate (Gaviscon)
  • aluminum hydroxide (Maalox)

A pregnant person can safely take antacids that contain aluminum salts.

Though they are generally safe for short-term use, there are some risks associated with taking antacids continually.

Chronic use of aluminum hydroxide antacids may increase the risk of toxicity in infants and those experiencing renal failure. Symptoms may include:

  • constipation
  • fecal impaction
  • vomiting
  • nausea
  • stomach cramps
  • magnesium deficiency
  • anemia

Chronic use of calcium carbonate may result in:

  • abdominal pain
  • constipation
  • nausea
  • vomiting
  • headache
  • flatulence
  • dry mouth

H2 receptor blockers

H2 receptor blockers are a type of medication that researchers initially developed for treating peptic ulcers.

The body can rapidly absorb H2 blockers, providing acid-suppression that can last several hours.

According to a 2018 article in the journal, LiverTox, H2 receptors block histamine type 2 receptors in the stomach.

By blocking the receptors, the medication slows or reduces the amount of acid the stomach produces.

The ACG state that H2 blockers improve heartburn symptoms and help the esophagus lining to heal. However, this may require a higher dosage.

According to the International Foundation for Gastrointestinal Disorders, H2 receptor blockers include:

  • famotidine (Pepcid)
  • nizatidine (Axid)
  • cimetidine (Tagamet)
  • ranitidine (Zantac)

Ranitidine

Since April 2020, the FDA have requested the removal of ranitidine from the market in the United States due to the unacceptable levels of NDMA, which is a potential carcinogen.

Those who are taking ranitidine should stop taking it and talk to a healthcare provider about an alternative medication. They should dispose of the product as per the product’s instructions.

Some potential side effects of H2 blockers include:

  • constipation
  • drowsiness
  • muscle aches
  • diarrhea
  • fatigue
  • headache

Proton pump inhibitors

Proton pump inhibitors (PPI) are a type of medication that reduces the amount of acid a person’s stomach makes.

The state that PPIs are more effective than H2 blockers. They can also heal the esophageal lining.

The Food and Drug Administration (FDA) state that a person can take OTC PPIs for 14 days, up to three times a year.

Two OTC examples of PPIs include:

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  • omeprazole (Prilosec)
  • lansoprazole (Prevacid)

Though generally safe and effective for long term use, there are potential side effects from using a PPI.

According to the International Foundation for Gastrointestinal Disorders, some potential side effects include:

  • nausea
  • bloating
  • headache,
  • abdominal pain
  • diarrhea

If OTC medications are not effective, a person may consider talking to their doctor about prescription options.

Some prescription medications include:

Prokinetics

Prokinetics are medications that help the stomach process food faster. According to the NIDDK, some examples include:

  • metoclopramide (Reglan)
  • bethanechol (Urecholine)

Though generally safe, prokinetics do not mix well with all medication.

They can also cause side effects such as:

  • fatigue
  • nausea
  • depression
  • diarrhea
  • odd physical movement
  • anxiety

PPIs

Like the OTC versions, prescription-strength PPIs reduce the amount of acid the stomach produces. The difference tends to be in the strength of the dose and offering of approved medications.

Some examples of prescription-strength PPIs include:

  • omeprazole (Prilosec)
  • lansoprazole (Prevacid)
  • rabeprazole (Aciphex)
  • pantoprazole (Protonix)
  • esomeprazole (Nexium)
  • dexlansoprazole (Dexilant)

H2 receptor blockers

Similar to the OTC versions, H2 receptor blockers block histamine receptors in the stomach. This causes a reduction in the production of stomach acid.

The main differences in the prescription forms are an increase in the dose and strength.

The higher dose can help the esophageal lining to heal. According to the ACG, 50% of people who take prescription-strength H2 blockers twice a day stop experiencing symptoms. They can also help maintain remission in 25% of those with GERD.

A person may need to use a combination of medications to treat their acid reflux effectively.

Antacids, PPIs, and H2 blockers all work in slightly different ways, and according to the NIDDK, a person may need to try a combination of medication to help control symptoms.

A person should use caution when combining or taking multiple medications. A doctor can advise people on the safety of using acid reflux medications based on their health conditions and other medications.

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Sometimes, certain medications may not create the desired effects. According to an older study, researchers found that taking H2 inhibitors with PPIs did not produce any greater effect in reducing symptoms.

The main difference between OTC and prescription-strength medication is the size of the doses.

A person should talk to their doctor about prescription medications if OTC medication is not working for them.

According to the ACG, different medications can provide different results:

DrugHow do they workEliminate symptoms?Heal esophagitis?Help prevent GER from returning?
AntacidsNeutralize the acidxx
H2 Blockers (OTC)Mildly suppress the acidxx
H2 blockers (prescription)Moderately suppress the acid
PPIsSignificantly suppress the acid
ProkineticsHelps the stomach empty quickly

Insurance plans may cover at least some of the cost of prescription medications, but they do not typically cover the cost of OTC medications.

According to Medicare, Part D helps pay for generic and brand-name drugs.

A person can learn more about Medicare and prescription drugs here.

Medicaid may cover OTC and prescription mediation.

When to see a doctor

(Video) GERD Treatment | Acid Reflux Treatment | Heartburn Treatment - All You Need to Know

A person should talk to their doctor if they have persistent or frequent acid reflux.

Frequent or intense heartburn may be a sign a person has gastroesophageal reflux disease (GERD).

According to the NIDDK, GERD is a more severe form of GER. A person may need additional treatment, such as surgery, if medications and lifestyle changes do not work.

There are several medication options for people seeking to control their acid reflux.

Options include both OTC and prescription medications.

A person should talk to a doctor if they have frequent acid reflux that OTC and lifestyle changes do not appear to help.

A person should also talk to their doctor about taking new medication.

Q:

Which medications can people combine, and how can they do it safely?

A:

Mixing over the counter medications (OTC) for GER are not recommended without medical advice. If taking an OTC H2 Blocker or OTC PPI, taking an occasional tablet or liquid antacids, such as Tums or Gaviscon, might be helpful. If you need to take the antacids frequently in addition to the OTC H2 Blocker or PPI, see your doctor for a thorough checkup. A person should only combine OTC strengths of an H2 Blocker and a PPI under their doctor’s direction.

Alan Carter, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

(Video) Heartburn, Acid Reflux, & GERD- Best Relief Options of Diet, Over the Counter, or Prescription PPI

FAQs

When should you seek emergency for acid reflux? ›

If the pain is not relieved shortly after taking antacids, or is accompanied by these symptoms, seek emergency medical care:
  • Squeezing/tightening in the chest.
  • Feeling out of breath.
  • Pain, aching or discomfort radiating from the chest to the arms, back or neck.
  • Sudden fatigue, dizziness or feeling lightheaded.
  • Cold sweat.

How do you know if acid reflux is severe? ›

persistent difficulty swallowing or choking, which can indicate severe damage to the esophagus. trouble breathing, which can indicate a serious heart or lung problem. bloody or black, tarry stools, which can indicate bleeding in the esophagus or stomach.

What is the strongest medication for GERD? ›

Proton pump inhibitors

PPIs are the most powerful medications available for treating GERD.

Can acid reflux put you in hospital? ›

Mild acid reflux typically occurs in the same place each time you experience a flare-up of your symptoms. However, if the pain moves around your stomach or chest or it relocates to a new area entirely, you should go to the ER or your doctor immediately.

Why is my acid reflux getting worse? ›

Large meals. Large meals, like Thanksgiving dinner or an all-you-can-eat buffet, can trigger GERD symptoms. When you fill your stomach up to the brim, the valve between your stomach and esophagus (esophageal sphincter) relaxes, allowing stomach acid back into the esophagus. Eat small meals, but more frequently.

Does drinking water help acid reflux? ›

In general, drinking water can help balance the pH of a particularly acidic meal, which may help to lower the risk of acid reflux. Studies show that drinking mineral water with a high hydrogen carbonate content can help to alleviate the frequency and severity of acid reflux.

How long does it take for GERD to turn into Barrett's esophagus? ›

None of the 412 (80%) GERD patients with non-erosive disease developed Barrett's oesophagus over a mean follow-up time of 3.4 +/- 2.2 years (95% CI: 0-0.9%).

How do I know if my esophagus is damaged? ›

Symptoms
  1. Difficult swallowing.
  2. Painful swallowing.
  3. Chest pain, particularly behind the breastbone, that occurs with eating.
  4. Swallowed food becoming stuck in the esophagus (food impaction)
  5. Heartburn.
  6. Acid regurgitation.
23 Feb 2021

Which acid reflux medicine works fastest? ›

Gaviscon+ is the only antacid product that provides fast-acting, long-lasting heartburn relief. It quickly neutralizes stomach acid and helps keep acid down for hours. +Amongst national brands; *when used as directed.

What helps acid reflux go away? ›

Foods That Help Prevent Acid Reflux
  • High-fiber foods. Fibrous foods make you feel full so you're less likely to overeat, which may contribute to heartburn. ...
  • Alkaline foods. Foods fall somewhere along the pH scale (an indicator of acid levels). ...
  • Watery foods. ...
  • Milk. ...
  • Ginger. ...
  • Apple cider vinegar. ...
  • Lemon water.

What are the 4 types of GERD? ›

GERD is broken down into different stages based on how serious your symptoms are and how often they occur:
  • Stage 1: Mild GERD. Minimal acid reflux occurs once or twice a month. ...
  • Stage 2: Moderate GERD. ...
  • Stage 3: Severe GERD. ...
  • Stage 4: Precancer or cancer.

What is the difference between GERD and acid reflux? ›

The terms heartburn, acid reflux, and GERD are often used interchangeably. They actually have very different meanings. Acid reflux is a common medical condition that can range in severity from mild to serious. Gastroesophageal reflux disease (GERD) is the chronic, more severe form of acid reflux.

Can you live a long life with acid reflux? ›

Dr. Chandra said that once a diagnosis of GERD has been established, it may become a lifelong condition that will need management. She added that it's best to identify certain causes of your symptoms and learn to avoid or control circumstances to alleviate or even prevent symptoms.

Can GERD lead to heart failure? ›

People who have GERD are more likely than others to end up with heart disease, characterized by abnormal heartbeats, plaque buildup in the heart arteries or reduced blood flow to the heart. In 2010, heart disease caused one out of every four U.S. deaths.

What do they give you at the hospital for GERD? ›

They also can help heal damage in your throat or esophagus from acid reflux. They include esomeprazole (Nexium), lansoprazole (Prevacid 24HR), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (AcipHex).

How long can a GERD flare up last? ›

Minor cases of GERD can heal in less than a month while moderate cases can take 6 to 12 weeks of treatment.

Should I go to the hospital if my heartburn won't go away? ›

The takeaway

If you have heartburn that won't go away and won't respond to OTC medications, see your doctor for a diagnosis. Heartburn may be a symptom of a serious condition. Barrett's esophagus.

What time of day is acid reflux the worst? ›

For most, GERD is worse at night, recognized as heartburn (a burning sensation in your chest), often after eating. Many people also feel the discomfort of acid reflux in the morning.

Why is my acid reflux medicine not working? ›

One of the most common reasons that patients with GERD do not respond to PPI therapy is that they are not compliant with the medication. Several studies have shown that at the end of 1 month, only approximately 50% of patients are taking their PPIs appropriately.

What are the 8 symptoms of GERD? ›

What are the symptoms of GERD (chronic acid reflux)?
  • Heartburn.
  • Regurgitation (food comes back into your mouth from the esophagus).
  • The feeling of food caught in your throat.
  • Coughing.
  • Chest pain.
  • Problem swallowing.
  • Vomiting.
  • Sore throat and hoarseness.
6 Dec 2019

Is Coke good for acid reflux? ›

Several studies found an association between drinking carbonated beverages and an increased risk of GERD, according to a 2021 review . The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) also recommends that people avoid carbonated drinks to reduce acid reflux and GERD.

Is banana good for acid reflux? ›

Bananas. This low-acid fruit can help neutralize stomach acid by coating an irritated esophageal lining. And not only are bananas alkaline, they're also rich in pectin, a soluble fiber that helps keeps food flowing nicely through the digestive tract.

Is burping good if you have acid reflux? ›

This is a completely normal occurrence that helps to rid your abdomen of excess air. According to a 2020 review, it's normal for a healthy person to burp up to 30 times a day. But acid reflux may cause you to burp more often. One of the reasons for an increase in burping is because acid reflux increases swallowing.

How does Barrett's esophagus make you feel? ›

The development of Barrett's esophagus is most often attributed to long-standing GERD , which may include these signs and symptoms: Frequent heartburn and regurgitation of stomach contents. Difficulty swallowing food. Less commonly, chest pain.

What is the survival rate for Barrett's esophagus? ›

During the 1960s and 1970s, only about 5% of patients survived at least 5 years after being diagnosed. Now, about 20% of patients survive at least 5 years after diagnosis.

How old are people with Barrett's esophagus? ›

Age — Barrett's esophagus is most commonly diagnosed in middle-aged and older adults; the average age at diagnosis is approximately 55 years.

What is the most common symptom of esophageal disease? ›

The most common symptom of esophageal disease is heartburn, which is defined as a sensation of substernal burning. Chest pain without typical heartburn may occur in a variety of esophageal disorders, including gastroesophageal reflux and motor disorders such as in achalasia.

What does damage to the esophagus feel like? ›

Sudden injuries of the esophagus usually cause pain, often felt as sharp pain under the breastbone. They may also cause bleeding, and blood may appear in vomit or stool. Fainting may occur due to this pain, especially if the esophagus ruptures.

What are the stages of esophagitis? ›

The Stages of GERD
StageSeverity
1Mild
2Moderate
3Severe
4Complications of GERD

How long does reflux medicine take to work? ›

Do not take nonprescription omeprazole for immediate relief of heartburn symptoms. It may take 1 to 4 days for you to feel the full benefit of the medication. Call your doctor if your symptoms get worse or do not improve after 14 days or if your symptoms return sooner than 4 months after you finish your treatment.

What is the safest acid reducer to take? ›

We recommend Pepto Bismol because it's a great liquid option and can be used to treat diarrhea. Prilosec's Acid Reducer is a good prroton pump inhibitor for people with chronic symptoms because it's formulated with omeprazole to reduce stomach acid.

What does it mean to have heartburn all the time? ›

If you have frequent or constant heartburn (more than twice a week or heartburn everyday), you may have gastroesophageal reflux disease (GERD). GERD is a digestive disorder that affects the lower esophageal sphincter (LES), a muscle that connects the esophagus and the stomach.

Is milk good for acid reflux? ›

Milk is rich in calcium and protein, which may have beneficial effects that help relieve heartburn.

Which fruit is good for acid reflux? ›

Melons – Watermelon, cantaloupe and honeydew are all low-acid fruits that are among the best foods for acid reflux.

How is Stage 3 GERD treated? ›

Treatment options

Medical interventions may include : over-the-counter or prescription antacids. acid reducers such as H2 blockers or proton pump inhibitors. surgery such as fundoplication (sewing the top of the stomach around the esophagus) or bariatric surgery (weight loss surgery)

What can be confused with GERD? ›

Because the condition is relatively unknown, gastroparesis can be mistaken for other types of GI disorders like GERD. Many symptoms of gastroparesis mirror symptoms of GERD. Both disorders may be accompanied by abdominal pain, indigestion and a sensation of fullness, so they are easily confused for one another.

What happens if GERD is left untreated? ›

If GERD is left untreated, esophagitis can cause bleeding, ulcers, and chronic scarring. This scarring can narrow the esophagus, eventually interfering with your ability to swallow. One major complication which occurs in about 10% to 15% of people with chronic or longstanding GERD is Barrett's esophagus.

How do you know if your acid reflux is serious? ›

Seek immediate medical care if you have chest pain, especially if you also have shortness of breath, or jaw or arm pain. These may be signs and symptoms of a heart attack. Make an appointment with your doctor if you: Experience severe or frequent GERD symptoms.

How do I know if my heartburn is serious? ›

Seek help right away if you have severe chest pain or pressure, especially when combined with pain in the arm or jaw or difficulty breathing. Make an appointment with your health care provider if: Heartburn occurs more than twice a week. Symptoms persist despite use of nonprescription medications.

Does stress cause acid reflux? ›

Yes, it's possible. Emotional stress can increase acid production in the stomach, aggravating gastroesophageal reflux disease (GERD). In people with GERD, the lower esophageal sphincter muscle (which acts as a door between the stomach and the esophagus) doesn't work properly.

Can acid reflux affect your brain? ›

His studies suggest that increased acidity—or low pH—in the brain is linked to panic disorders, anxiety, and depression. But his work also indicates that changes in acidity are important for normal brain activity too.

What is the safest antacid to take long term? ›

Oral pantoprazole is a safe, well tolerated and effective initial and maintenance treatment for patients with nonerosive GERD or erosive esophagitis.

Does GERD make you tired? ›

Gastroesophageal reflux disease, known as GERD, can cause fatigue in people who have difficulty sleeping due to symptoms. For example, a person may repeatedly wake in the night to cough or because of pain associated with heartburn.

Can reflux affect blood pressure? ›

NEW YORK (Reuters Health) - In patients with both gastroesophageal reflux disease (GERD) and essential hypertension, episodes of reflux can trigger elevations in blood pressure (BP), especially at night, according to research from China.

What does GERD chest pain feel like? ›

You have a sharp, burning feeling just below your breastbone or ribs. The chest pain can be accompanied by an acidic taste in your mouth, regurgitation of food, or a burning in your throat. Pain generally doesn't spread to your shoulders, neck, or arms, but it can.

What does GERD pain feel like? ›

GERD can cause chest pain that mimics a heart attack. Described as a squeezing pressure behind the breast bone, GERD-related chest pain can last for hours. And like a heart attack, it can also radiate down your arm to your back.

What happens if acid reflux goes untreated? ›

However, when acid reflux occurs frequently and is left untreated, it can lead to conditions such as esophagitis, ulcers, strictures, aspiration pneumonia, and Barrett's esophagus. People who have frequent episodes of acid reflux are also at a slightly increased risk for developing esophageal cancer.

Should I go to the hospital if my heartburn won't go away? ›

The takeaway

If you have heartburn that won't go away and won't respond to OTC medications, see your doctor for a diagnosis. Heartburn may be a symptom of a serious condition. Barrett's esophagus.

How long can a GERD flare up last? ›

Minor cases of GERD can heal in less than a month while moderate cases can take 6 to 12 weeks of treatment.

Should I go to urgent care for severe heartburn? ›

Heartburn is a painful burn sensation you feel in your chest after eating a meal high in fat. It's generally not considered a medical emergency, but if it lasts more than two days or recurs after multiple hospital visits, then you should seek treatment at an urgent care center.

What does a damaged esophagus feel like? ›

Painful swallowing. Chest pain, particularly behind the breastbone, that occurs with eating. Swallowed food becoming stuck in the esophagus (food impaction) Heartburn.

How do they test for acid reflux? ›

The test involves placing a catheter (a thin tube), or a special device called a pH probe, into your esophagus. The catheter or device will measure your acid level (known as pH level) for 24 to 96 hours. The test can show if you have acid reflux or GERD (gastroesophageal reflux disease).

How long does it take for GERD to turn into Barrett's esophagus? ›

None of the 412 (80%) GERD patients with non-erosive disease developed Barrett's oesophagus over a mean follow-up time of 3.4 +/- 2.2 years (95% CI: 0-0.9%).

Why won't my heartburn go away even with medicine? ›

The technical definition of GERD is mild acid reflux that occurs twice a week or moderate to severe acid reflux that occurs once a week. When over-the-counter medicines don't make a dent in the horrible heartburn, you likely have GERD.

Does drinking water help acid reflux? ›

In general, drinking water can help balance the pH of a particularly acidic meal, which may help to lower the risk of acid reflux. Studies show that drinking mineral water with a high hydrogen carbonate content can help to alleviate the frequency and severity of acid reflux.

Does drinking water help heartburn? ›

A person with acid reflux, or heartburn, might feel a burning, often painful sensation in their throat and chest. Drinking water, low fat milk, and herbal teas may help reduce symptoms. Acid reflux, or heartburn, occurs when stomach acid flows up into a person's esophagus, or food pipe.

How do I know what stage of GERD I have? ›

Stage 1 (mild): A person has infrequent heartburn and regurgitation happening once or less each week. Stage 2 (moderate): A person has regurgitation or heartburn occurring a few times a week. Stage 3 (severe): A person has regular heartburn, a chronic cough, regurgitation, a hoarse voice, and regurgitation of food.

What are the 8 symptoms of GERD? ›

What are the symptoms of GERD (chronic acid reflux)?
  • Heartburn.
  • Regurgitation (food comes back into your mouth from the esophagus).
  • The feeling of food caught in your throat.
  • Coughing.
  • Chest pain.
  • Problem swallowing.
  • Vomiting.
  • Sore throat and hoarseness.
6 Dec 2019

How do you calm a GERD flare up? ›

Here's how to control your symptoms

Avoid foods that trigger your heartburn, especially in the afternoon or evening. Elevate the head of your bed to enlist gravity to help fight regurgitation. Take over-the-counter antacids like Tums or Rolaids, or acid suppressors such as Prilosec, Nexium, or Pepcid.

Can heartburn send you to the ER? ›

However, you should seek medical advice or go to the emergency room (ER) for heartburn if the symptoms recur frequently or if you get any of the following additional symptoms: Breathing difficulties. Persistent difficulties with swallowing. Choking.

What's the difference between acid reflux and heartburn? ›

Acid reflux is the backflow of stomach contents into the esophagus. The feeling of acid reflux is heartburn: a mild burning sensation in the mid-chest, often occurring after meals or when lying down. Gastroesophageal reflux disease (GERD) is a more serious form of acid reflux.

What's the difference between acid reflux and GERD? ›

The terms heartburn, acid reflux, and GERD are often used interchangeably. They actually have very different meanings. Acid reflux is a common medical condition that can range in severity from mild to serious. Gastroesophageal reflux disease (GERD) is the chronic, more severe form of acid reflux.

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