Gastroesophageal reflux disease (GERD), commonly known as acid reflux, occurs when stomach contents flow backward into the esophagus, causing heartburn, regurgitation, chest discomfort, and sometimes chronic cough or hoarseness. This happens because the lower esophageal sphincter (LES), a muscle that normally prevents backflow, becomes weak or relaxes inappropriately, allowing acid to irritate the food pipe repeatedly. If left untreated, persistent reflux can lead to inflammation (esophagitis), ulcers, scarring, and in rare cases, pre-cancerous changes known as Barrett’s esophagus. The global prevalence of GERD has been increasing in recent years, with around 14 % of adults worldwide affected according to recent meta-analyses. In India, community studies show notable rates, with higher prevalence in urban populations compared to rural areas and estimates ranging from about 8 % in some regions to higher figures in cities, reflecting shifting lifestyles. In Kolkata, according to Dr. Pradipta Sethy, Director, Gastroenterology, Manipal Hospital, EM Bypass and Mukundupur, the major patients are women, mostly pre-menopausal and menopausal, between the ages of 30-55 years. This rise can be attributed to several interconnected lifestyle and environmental factors.One major contributor is dietary change. Traditional diets rich in fiber and whole foods are increasingly replaced by high-calorie, processed, and high-fat foods, along with frequent consumption of spicy and fried items. These foods can relax the LES and increase gastric acid production, making reflux more likely. In addition, habitual late-night meals followed by lying down soon after eating are common in urban settings and further promote reflux episodes. Obesity and sedentary lifestyles are also important risk factors. Excess abdominal fat increases pressure on the stomach, forcing acid upward into the esophagus. Many adults with GERD in India and globally have overweight or central obesity, a trend growing alongside reduced physical activity. Stress and irregular eating patterns that accompany modern work life are additional contributors, often exacerbating symptoms and prompting unhealthy habits like caffeine or alcohol use, both of which can aggravate acid reflux. Thankfully, GERD can often be managed effectively through simple lifestyle modifications. Eating smaller, more frequent meals and avoiding known trigger foods such as citrus fruits, chocolate, caffeine, and high-fat foods can reduce reflux episodes. Waiting 2–3 hours after eating before lying down and elevating the head of the bed during sleep helps keep acid in the stomach by using gravity to support digestion. Maintaining a healthy weight through regular physical activity reduces abdominal pressure, while quitting smoking and limiting alcohol intake supports LES function and esophageal health. Managing stress with techniques such as meditation or yoga further helps control symptoms by improving overall digestive function. In conclusion, the rise of GERD in India mirrors global trends driven largely by dietary shifts, obesity, and modern lifestyle pressures. While medication is valuable for many patients, sustainable improvements often begin with these evidence-based lifestyle changes that address the root causes of acid reflux and improve long-term digestive health.