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GERD Resources

GERD
symptom tracker

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Acid reflux and heartburn

Gastroesophageal reflux disease, or GERD, is a digestive disease characterized by chronic acid reflux, which occurs when stomach acid flows back into the esophagus. If you suffer from chronic heartburn, acid reflux, or similar symptoms, you may have GERD.

Complete the symptom tracker below and share the responses with your gastroenterologist. Each question represents a potential symptom for GERD. Information on this site should not be used as a substitute for talking with your gastroenterologist for potential diagnosis and treatment information.

* Indicates a required field.

Do you experience coughing?*1-2



Do you experience regurgitation?*1



Do you experience a burning feeling in your chest (heartburn)?*1



Do you experience acid backing up into your throat or esophagus (reflux)?*1



Do you have trouble swallowing?*1,3



Do certain foods or drinks trigger discomfort?* (Select all that apply)

 
 
 
 

Does discomfort typically start after these activities (lying down, exercising, sleeping, eating within 3 hours of going to bed)?* (Select all that apply)

 
 
 
 

Do symptoms cause disruptions in your life?* (Select all that apply)

 
 
 
 

How frequently do you experience symptoms?*




  1. Spechler SJ, Souza RF. Barrett's Esophagus. N Engl J Med. 2014;371(9):836-45.
  2. Kurokawa R, Kanemitsu Y, Fukumitsu K, et al. The diagnostic utility of the frequency scale for the symptoms of gastroesophageal reflux disease questionnaire (FSSG) for patients with subacute/chronic cough. Journal of Asthma. 2021;58(11):1502-1511. doi:10.1080/02770903.2020.1805750
  3. Madsen MM. M. Barrett esophagus. Salem Press Encyclopedia of Health. 2019. Accessed March 7, 2022.
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