🔥 Men's Health
Acid Reflux and GERD
That burning in your chest — causes, treatment, and when to worry
Acid reflux — stomach acid flowing back into the oesophagus — causes heartburn, the burning sensation in the chest that millions of Nigerians experience regularly. When it happens more than twice a week, it is called GERD (gastro-oesophageal reflux disease). GERD is very common, very treatable, but easy to confuse with heart pain — it is important to know the difference.
Signs and Symptoms
✓ Heartburn — a burning sensation in the chest, often after eating
✓ Acid regurgitation — sour or bitter liquid coming back into the mouth or throat
✓ Difficulty swallowing (dysphagia) — in more severe cases
✓ Chest pain — can mimic heart pain; GERD chest pain is usually burning, related to eating, and relieved by antacids
✓ Chronic cough or hoarseness — from acid irritating the throat
✓ Sensation of a lump in the throat
✓ Worsening at night or when lying down
When to Seek Help
Chest pain that is new or severeAlways rule out heart attack first — if in doubt, go to the emergency room. GERD chest pain and cardiac chest pain can feel similar.
Difficulty swallowingDysphagia requires urgent investigation — it can indicate oesophageal stricture or oesophageal cancer.
Vomiting blood or black stoolHaematemesis or melaena indicates GI bleeding — seek emergency care immediately.
Symptoms not responding to PPIs after 4–8 weeksWarrants endoscopy to exclude Barrett's oesophagus or other pathology.
Tests & Diagnosis
🧪 Clinical diagnosis
Typical heartburn and acid regurgitation in response to triggers can be diagnosed clinically — no test needed initially.
🧪 Therapeutic trial of PPI
If symptoms are typical, a trial of proton pump inhibitor for 4–8 weeks is both diagnostic and therapeutic.
🧪 Upper GI endoscopy (OGD)
Examines the oesophagus, stomach, and duodenum directly. Indicated if alarm features are present, symptoms persist despite treatment, or duration is long.
🧪 24-hour pH monitoring
Measures acid exposure in the oesophagus — the gold standard for confirming GERD in atypical cases.
🧪 H. pylori test
Helicobacter pylori can cause dyspepsia and peptic ulcers — stool antigen test or urea breath test.
Frequently Asked Questions
Is heartburn the same as a heart attack?
No — but they can feel similar. Heartburn is a burning sensation usually felt in the chest and often related to eating; it may move to the throat. Heart attack pain is typically a pressure, tightness, or squeezing sensation that may spread to the jaw or left arm, often with sweating or breathlessness. When in doubt, seek emergency care.
Are PPIs safe to take long-term?
Yes for most people, but long-term PPI use has been associated with small increases in risk of kidney disease, vitamin B12 and magnesium deficiency, and clostridium difficile infection. Use the lowest effective dose. Annual review with your doctor is recommended.
Does eating pepper cause GERD?
Spicy food can trigger heartburn in people who already have reflux — it relaxes the lower oesophageal sphincter temporarily. But spicy food does not cause GERD in people without it. Reducing spice helps manage symptoms but is not a cure.
What is Barrett's oesophagus?
A complication of long-term GERD where the oesophageal lining changes to a type more resistant to acid — but with a small risk of progressing to oesophageal cancer. Requires regular endoscopic surveillance. Diagnosed on biopsy during endoscopy.
Can I take antacids daily?
Antacids are safe short-term, but daily use for months without investigation is not ideal. If you need antacids every day, see a doctor — you likely have GERD that would benefit from a PPI and lifestyle changes, and an endoscopy to exclude structural disease.