Stages of GERD

GERD has no single official staging system, but doctors describe how it can progress when acid exposure continues. Most people stay in the early stages.

Stage 1: Occasional reflux

Heartburn after large or trigger meals, less than twice a week. Lifestyle change often controls it.

Stage 2: Frequent reflux

Symptoms two or more times a week, sometimes with night symptoms. A doctor may advise acid-lowering medicine for a few weeks.

Stage 3: Oesophagitis

Acid inflames and erodes the lining of the food pipe. Endoscopy shows erosions graded A to D. Treatment is needed for healing.

Stage 4: Complications

• Stricture: scarring that narrows the food pipe and causes trouble swallowing
• Bleeding ulcers in the food pipe
• Barrett's oesophagus: a change in the lining that slightly raises the long-term risk of cancer of the food pipe

Not everyone progresses

Many people stay at a mild level for life. Long-standing, severe or untreated symptoms, obesity, smoking and age over 50 raise the chance of progression.

What you can do

Treat symptoms early, change triggers, and follow the doctor's advice on tests and review.

Key point

Difficulty swallowing, weight loss, vomiting blood or black stools needs prompt medical care. Chest pain with sweating or breathlessness: call 112 or 102.

Before you see a doctor

Bring a list of all your medicines and supplements to the appointment, along with a note of when symptoms occur, what you ate, and whether they wake you at night. This helps your doctor choose the right tests and treatment without delay.