Last updated Jan. 24, 2023, by Teresa Carvalho, MS

✅ Fact-checked by José Lopes, PhD

Gastro-esophageal reflux disease (GERD), marked by chronic reflux of stomach acids, is a condition that affects the digestive tract and often results in heartburn. Around 40% of Rett syndrome patients have GERD, and it particularly affects those with restricted mobility and scoliosis.

Pain, anxiety, and excitement can worsen GERD and increase discomfort.

What causes GERD?

GERD occurs when the muscle situated at the lower end of the esophagus — the tube connecting the throat and stomach — does not close properly after food has passed into the stomach. This allows stomach contents to pass up to the esophagus. Acid from the stomach may also flow back into the esophagus because of delayed gastric emptying.

The condition can be painful and in extreme cases can damage the lining of the esophagus.

What are the symptoms of GERD?

Many different symptoms might indicate GERD, including:

  • weight loss despite a good appetite
  • sour breath, burps, or belching
  • frequent vomiting
  • food refusal or repeated chewing with hesitation to swallow (rumination)
  • coughing after feeding
  • lung problems
  • behavioral issues
  • dental erosion.

People with nighttime acid reflux also may experience other symptoms, such as:

  • persistent cough
  • laryngitis, inflammation of the voice box
  • asthma.

How is GERD diagnosed?

There are several tests and techniques, both invasive and non-invasive, that can aid in diagnosing GERD.

Esophageal pH monitoring

Esophageal pH monitoring, a test that measures the pH, or acidity of the esophagus, is one diagnostic tool. pH tells whether a substance is basic or acidic.

Upper gastrointestinal endoscopy

Doctors may perform an upper gastrointestinal endoscopy, a method that uses an endoscope — a flexible tube with a camera — to examine the lining of the mouth, esophagus, stomach, and small intestine (called the upper gastrointestinal tract).

Radionuclide scintigraphy

An imaging technique called radionuclide scintigraphy may be performed to check for aspiration of reflux into the lungs.

Transnasal esophagoscopy

This test is performed to detect damage in the esophagus. A thin, flexible tube with a video camera is inserted in the nose and goes into the esophagus to look for signs of damage. 

Other tests

Other tests include esophageal manometry, to measure muscle contractions in the esophagus while swallowing, and an X ray of the upper digestive system.

How is GERD treated?

GERD can be managed to a certain extent through diet and lifestyle changes. Some medications also are available to ease its symptoms. In more severe cases, surgery may be required.

Diet and lifestyle changes

  • Foods that trigger reflux, such as citrus fruits, alcohol, and caffeinated and sparkling drinks should be eliminated from the diet.
  • Certain medications, such as aspirin, may worsen reflux and should be avoided.
  • More frequent and smaller meals can help to increase the speed of digestion and may prevent acid reflux.
  • Thickening food, in consultation with a doctor or dietician, can sometimes be effective in preventing GERD.
  • Posture while eating is very important in preventing or at least managing the condition. Maintaining an upright position prevents the digestive organs from being cramped, allowing for the correct movement through the body of food, fluids, and digestive juices. If the patient needs to be fed lying down, then the person’s head should be elevated.
  • Wearing loose-fitting clothing around the stomach can help ease pressure that might trigger reflux.
  • Stress can exacerbate GERD. A stress-free and positive eating experience can be helpful in managing the condition.


  • Antacids, such as Mylanta, Rolaids, and Tums, are over-the-counter medicines that can be taken to neutralize stomach acid. While these products may provide quick relief, they cannot alone heal the esophagus if damaged.
  • Proton pump inhibitors such as lansoprazole, omeprazole, and pantoprazole decrease stomach acid production and may help ease symptoms.
  • H2-blockers, used for peptic ulcers, also can be used to diminish stomach acid.
  • Prokinetics, such as metoclopramide, work by increasing pressure on the lower esophageal sphincter that is situated between the esophagus and the stomach. They may provide some relief to patients.


When lifestyle changes and medications don’t help, a fundoplication surgery may be performed. The procedure consists of wrapping the upper part of the stomach around the lower end of the esophagus to avoid the backflow of stomach contents.

In GERD patients who also have obesity, weight loss surgery, called bariatric surgery, is recommended. Bariatric surgery can make the stomach smaller, limiting how much a person can eat at a time, and reduce the absorption of nutrients.

Rarely, an endoscopy may be recommended to help treat GERD. Using this method, doctors are able to stitch the top of the stomach around the lower esophageal sphincter or to deliver radiofrequency radiation to the sphincter.


Rett Syndrome News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.