Breathing fire sounds cool in theory. (Dragons are lit.) But IRL, it’s the pits. Folks with gastroesophageal reflux disease (GERD) know what we’re talking about.

GERD is a digestive disease that can cause chronic heartburn (among other annoying AF symptoms). This can include vomiting, trouble swallowing, chest pain, bitter or acidic taste in your mouth, gagging, laryngitis, and coughing. Here are the deets.

An estimated 20 percent of Americans have GERD. The two most common symptoms in adults are heartburn and regurgitation.

Other symptoms may include:

  • nausea
  • burping
  • chest pain
  • pain when swallowing
  • trouble swallowing (aka dysphagia)
  • a bitter or acidic taste in your mouth

Hit up your doctor if you also experience:

  • asthma
  • laryngitis
  • chest pain
  • chronic cough
  • tooth erosions
  • a raspy, hoarse voice
  • globus sensation (when you feel a lump in your throat that isn’t really there)

These symptoms might be a sign of a more serious case of GERD or an underlying condition.

Babies are known to have yak attacks on the reg. Around 70 to 85 percent of 2-month-old bébés regurgitate daily. While it’s usually nothing to worry about, there are some GERD symptoms to look out for.

This includes:

  • colic
  • gagging
  • wheezing
  • coughing
  • refusal to eat
  • frequent vomiting
  • trouble swallowing
  • arching their back during or after a feeding

FYI: Some of these symptoms can be a sign of tongue-tie. Your pediatrician can let you know what’s what.

Nighttime GERD symptoms are similar to daytime symptoms but tend to be more intense. It also increases your risk for:

  • laryngitis
  • a chronic cough
  • trouble sleeping

This might be because:

  • Gravity. It’s easier for stomach acid to come up when you’re lying down.
  • Salvia. Spit, which helps neutralize stomach acid, isn’t produced as much at night.
  • You swallow less at night. Swallowing can help push stomach acid back down.

Pro tip: Have your last nosh at least 3 hours before bedtime. This might reduce your risk of a late-night GERD flare-up.

Reminder: The most common GERD symptoms are heartburn and regurgitation. Other symptoms can include:

  • nausea
  • burping
  • dysphagia (trouble swallowing)
  • odynophagia (painful swallowing)
  • upper abdominal pain
  • a bitter taste in the back of your mouth

To ease these symptoms, you can try an OTC option such as:

  • Antacids to help neutralize stomach acid.
  • H2 receptor blockers to help reduce stomach acid.
  • Proton pump inhibitors (PPIs) to help reduce and block stomach acid production.

Your doc might prescribe a stronger medication if OTC treatments don’t do the trick.

GERD can be triggered by lots of lifestyle factors. Some common causes include:

  • Diet. Certain foods can trigger a GERD flare-up. It varies from person-to-person, but common culprits include fatty foods, spicy stuff, caffeinated drinks (e.g., coffee, tea, or soda), and acidic fruits like pineapples, tomatoes, or citrus.
  • Alcohol. Alcohol can increase your risk of GERD. Certain booze — like beer or wine — can make you produce more gastric acid. Also, alcohol relaxes your muscles which might make it easier for acid to creep up the esophagus. It’s sort of like Thanos and Voldemort team up to ruin $1 shot night.
  • Pregnancy. Your chance of getting GERD goes up when your eggo is preggo. In fact, as many as 45 percent of pregnant peeps get frequent heartburn. This might be due to hormonal fluctuations (especially in the first trimester).
  • Anxiety. Research shows anxiety can take your GERD to the next level. A 2013 study found that anxiety can increase symptoms such as upper abdominal pain and heartburn.

Lots of folks dig OTC antacids, H2 receptor blockers, or proton pump inhibitors (PPIs). But these options only provide temporary relief.

For long-term GERD, you might need to make some lifestyle changes. Here are some top tips:

  • Don’t smoke. Smoking is associated with higher rates of GERD. If you smoke, quitting can reduce your symptoms and improve your overall health.
  • Keep it loose. Uber tight clothing can put extra pressure on the abdomen which can increase your risk of indigestion. So let it all hang out, honey.
  • Tweak your diet. Ditch drinks or foods that trigger your GERD. If you’re not sure which noms are to blame, keep a food diary or use an app. This helps you keep track of your symptoms.
  • Aim for a moderate body weight. Being overweight or having obesity can put extra pressure on your abdomen. This might increase your risk of GERD.

Here’s a recap of common GERD symptoms, triggers, and treatments.

GERD symptoms in adultsGERD symptoms at nightGERD symptoms in babiesFoods to avoid with GERDActivities to avoid with GERDOver-the-counter (OTC) GERD medications
heartburnheartburnfrequent vomitingacidic fruits (e.g., citrus, tomatoes, or pineapple)drinking alcoholantacids like Rolaids, Tums, or Mylanta
vomitingvomitinggaggingcaffeinated drinks like coffee, tea, soda, or energy drinkssmokingproton pump inhibitors (PPIs) like Prevacid 24h, Nexium 24h, Prilosec, or Zegerid
issues or pain swallowingtrouble sleepingtrouble swallowingfatty or fried foodseating before bedH2-blockers like Tagamet HB, Pepcid Complete, Axid AR, or Zantac
chest painchronic coughwheezingspicy foodovereating
bitter or acidic taste in your mouthbitter or acidic taste in your mouthcoughingmint
laryngitis (inflammation of your voice box)refusal to eatonions
trouble sleepingarching their back during or after a feedinggarlic
colic (crying that lasts more than 3 hours)chocolate

GERD symptoms can range from slightly uncomfortable to hella painful. Sometimes an OTC acid reflux treatment can help reduce discomfort. But you should talk with your doctor if you get heartburn more than twice a week.