Almost everyone suffers from acid reflux from time to time. But when it’s chronic, the problem may actually be gastroesophageal reflux disease (GERD) – a much more serious issue where acid chronically backs up from your stomach to esophagus.

“This is not your classic eat-pasta-and-feel-heartburn condition. Other parts of the body can be affected and damaged permanently if it’s not addressed,” says Amir Masoud, MD, a gastroenterologist and medical co-director of the Neurogastroenterology and Motility Center.

GERD can cause a whole host of complications and issues when left untreated. Here are some of the most common symptoms and side effects, according to Dr. Masoud.

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Here are 7 complications caused by GERD.

The backflow of acid into the digestive tract can cause a number of issues including:

  1. Heartburn. A burning sensation in your chest after eating spicy or fatty foods is the most common symptom. But unlike normal heartburn sufferers, people with GERD usually have heartburn two or more times a week.
  2. Esophageal dysmotility. Esophageal muscles are meant to tighten and relax to move foods along, but severe GERD can affect their coordination and strength, leading to problems swallowing.
  3. Chronic cough. When reflux is high, beyond the valve at the top of the esophagus, it can reach the vocal folds to cause problems like hoarseness, chronic throat clearing and the persistent feeling of a lump in your throat.
  4. Sinus problems. In serious cases, GERD can extend into the sinus cavities and cause symptoms like inflammation, congestion and pain.
  5. Tooth erosion. If your dentist is noticing acid erosion on your back teeth, the culprit is most likely severe reflux.
  6. Lung conditions. Reflux reaching the lungs can cause irritation, inflammation and scarring.
  7. Changes to the esophagus lining. An upper endoscopy is required to spot this change, called Barrett’s esophagus. It’s considered a pre-cancerous condition.

> Related: 4 Home Remedies for Heartburn That Actually Work

If you have one of these conditions, you’re more likely to get GERD.

Certain conditions increase your chance of getting GERD, including:

  1. Obesity. Extra weight, particularly around the abdomen, adds pressure to the stomach, pushing food and acid upward.
  2. Anatomical conditions: Things like a hiatal hernia, when part of the stomach pushes through the diaphragm and gets trapped in the chest, can worsen reflux by affecting both the pressure and function of the esophagus and stomach
  3. Connective tissue disorders. Conditions like scleroderma can weaken esophageal muscles meant to protect against reflux.
  4. Neurological disorders. Affecting normal esophageal function and swallowing, these can worsen reflux. Medications treating these disorders can also cause nausea and reflux.
  5. Chronic diabetes. Diabetes slows digestion and emptying of the stomach, meaning food can reflux for longer.

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When to see a doctor.

The first step might seem to suppress stomach acid, but Dr. Masoud says that only addresses part of the problem.

“Many doctors treat reflux as a problem of acid, but the real problem is reflux,” he explains. “You have to figure out why reflux is happening- is it the muscles, the stomach, the anatomy?”

Specialists can help with that detective work. In the meantime, Dr. Masoud suggests:

  • Eating small, frequent meals. This lessens pressure in the stomach which empties faster.
  • Staying upright after meals.
  • Losing weight, particularly if you carry more around the waistline.
  • Eating fruit high in pectin. The pectin in pears, for example, absorbs and thickens gastric juices, reducing reflux.
  • Trying over-the-counter supplements. Aloe vera, slippery elm and, especially, alginate, covered in the most studies, can reduce reflux.

“What consistently doesn’t work is OTC medications with alkaline antacid action like Tums, or inducing belches to get it out. This can actually worsen the problem long term,” Dr. Masoud says.