Gastroesophageal Reflux Disease (GERD) can lead to ulcer formation in certain situations. While classical reflux symptoms may suggest the presence of GERD, a definitive diagnosis relies on more objective assessments. These typically include an endoscopic examination and a 24-hour esophageal pH monitoring to measure gastric acid exposure in the esophagus. Complications associated with GERD can include bleeding, ulcers, esophageal perforation, or stricture formation.