If over-the-counter heartburn remedies don't work for you, or if you have heartburn two or more times a week, you may have gastroesophageal reflux disease (GERD). This condition usually occurs when there is a problem with the sphincter between the esophagus and the stomach. When this happens, acidic stomach juices can flow back up into the esophagus more frequently than normal, leading to symptoms like chest pain and difficulty swallowing. Risk factors can include pregnancy, alcohol, and stress. Over time, GERD can lead to bleeding, the formation of ulcers, or scarring and narrowing of the esophagus.