Why does my mother have GERD despite diet changes?

Question

Hi doctor,

My mother is 48 years old and has been experiencing acid reflux and heartburn for nearly a year. She often feels a burning sensation in the chest after meals and sometimes has a sour taste in the mouth, especially at night.

She has tried avoiding spicy foods and late dinners, and her doctor prescribed antacid medication, which provides temporary relief. Recently she also feels mild throat irritation in the morning.

Why does GERD continue even after diet changes?
How long is medication usually required to control symptoms?

Please help.

Thank you.

Answer 1

Hi doctor,

Welcome to icliniq.com.

I have read your query and understand your concern.

Your mother’s symptoms are very consistent with chronic GERD (gastroesophageal reflux disease), a condition in which stomach acid repeatedly flows back into the esophagus, leading to irritation and the typical burning sensation in the chest along with a sour or bitter taste in the mouth.

Even when appropriate dietary changes are made, GERD (gastroesophageal reflux disease) can persist because the main problem is often related to a dysfunction of the lower esophageal sphincter, a muscular valve that normally prevents acid from rising upward. When this valve becomes weak or relaxes inappropriately, reflux continues regardless of diet alone.

In addition, factors such as body position, especially lying down after meals, delayed stomach emptying, stress, and even certain medications can contribute to persistent symptoms. The presence of nighttime reflux and morning throat irritation suggests that acid exposure is occurring during sleep, which is quite common in chronic cases.

Antacids can neutralize stomach acid temporarily and provide short-term relief, but they do not address the underlying mechanism of acid production. For this reason, many patients require stronger medications such as proton pump inhibitors, which reduce acid production more effectively and allow the esophagus time to heal.

Typically, these medications are prescribed for an initial period of four to eight weeks, but in some individuals, especially those with long-standing symptoms, treatment may need to be continued for a longer duration or used intermittently to maintain symptom control.

If symptoms do not improve adequately despite proper treatment and lifestyle adjustments, further evaluation such as upper endoscopy, pH monitoring, and evaluation for complications such as esophagitis (inflammation of the esophagus) is needed.

Regular follow-up to assess response and consider further testing if symptoms continue.

Hope I have addressed all of your queries and concerns.

Let me know if I can assist you further.

Thank you.