Many people live with GERD for years, experiencing few if any symptoms, while others may have such severe discomfort that normal activities of daily living, as well as sleep, may be affected. Still others may be so accustomed to taking antacids after meals that they don't realize they have a potentially serious problem.

Unfortunately, because the severity of symptoms does not correlate with the severity of the disease, many people don't seek medical attention until the problem has persisted for several years or some other problem has evolved from the gastric discomfort. For example, inflammation of the esophagus from stomach acid can cause bleeding or ulcers.

In addition, scars from tissue damage can narrow the esophagus, producing strictures, which make swallowing difficult. Some people develop Barrett's esophagus, in which cells in the esophageal lining become abnormal, and in some cases, pre-cancerous. Additionally, studies have shown that asthma, chronic cough, and pulmonary fibrosis may be aggravated or even caused by GERD.

A thorough diagnostic evaluation is important to determine the type of problem a person has and to plan appropriate treatment. Medications and lifestyle modifications may be helpful in controlling the symptoms associated with a non-progressive form of GERD. But people with the progressive form of GERD, or who have a demonstrated hiatal hernia, gain the greatest benefit from surgery.