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Gastro-oesophageal Reflux Disease (GERD)

Also known as: GERD · GORD · acid reflux · heartburn

Reflux of gastric contents causing heartburn and regurgitation, sometimes with oesophagitis. Managed with lifestyle change and acid suppression.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Adults; risk with obesity, hiatus hernia, pregnancy, smoking, alcohol, large/fatty meals and certain drugs.

Red flags — escalate / refer

ALARM features — dysphagia, odynophagia, weight loss, GI bleeding/anaemia, persistent vomiting, or new symptoms over ~45–55 years → endoscopy (exclude malignancy/Barrett's).
Always exclude cardiac chest pain.

Work-up / diagnosis

1Typical symptoms — treat empirically.
2Endoscopy for alarm features, refractory symptoms, or Barrett's surveillance; pH-impedance studies in selected cases.

Management — overview

Lifestyle: weight loss, smaller meals, avoid late meals and triggers, elevate the head of the bed, and reduce smoking/alcohol.
Acid suppression with a proton-pump inhibitor (a symptom/healing course), then step down to the lowest effective dose.
Antacids/alginates for breakthrough symptoms.
Refractory or complicated disease → endoscopy ± anti-reflux surgery.

In-depthFull dosing & advanced protocol

Drug dosing

Proton-pump inhibitor (e.g. omeprazole)

Acid suppression

Adult dose: 20 mg once daily for 4–8 weeks, then step down / on-demand
Route: Oral

Caution: Review ongoing need; exclude cardiac pain and alarm features.

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

Antacid / alginate

Breakthrough symptoms

Adult dose: As needed after meals / at bedtime
Route: Oral

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

Refractory reflux & Barrett's

Refractory symptoms: confirm the diagnosis (pH-impedance), optimise PPI timing/dose, and consider surgery.
Barrett's oesophagus needs endoscopic surveillance for dysplasia.
Consider extra-oesophageal presentations (chronic cough, laryngitis) and PPI de-prescribing where appropriate.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Proton-pump inhibitor (e.g. omeprazole)

Antacid / alginate

📈 Refractory reflux & Barrett's

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Proton-pump inhibitor (e.g. omeprazole)

Antacid / alginate

📈 Refractory reflux & Barrett's

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Refractory reflux & Barrett's

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Refractory reflux & Barrett's

References