What Causes Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a chronic disorder
Gastroesophageal reflux disease (GERD) is a chronic disorder

Gastroesophageal reflux disease (GERD) is a chronic disorder in which acid reflux occurs at least two times a week for several weeks. Acid reflux is a condition in which the acidic stomach contents leak back in the food pipe (esophagus) and cause heartburn.

GERD occurs when the lower esophageal sphincter (LES) is weak or relaxed. LES is present between the lower part of the esophagus and the upper part of the stomach. This sphincter works like a valve preventing the food and acid in the stomach from flowing backward up (refluxing) into the esophagus.

Factors that can weaken the LES and cause acid reflux include:

  • Increased pressure on the abdomen due to obesity or pregnancy
  • Hiatus hernia (a condition in which the upper part of the stomach moves up into the chest due to the weakening of the diaphragm)
  • Spicy foods, fried or fatty foods, and dairy products
  • Certain medicines:
  1. Calcium channel blockers (medicines that treat high blood pressure)
  2. Antihistamines (medicines for treating allergic reactions)
  3. Painkillers
  4. Sedatives (medicines that help put you to sleep)
  5. Antidepressants (medicines that treat depression)

What are the symptoms of GERD?

If you have GERD, you may experience tasting food or stomach acid in your throat.

  • Regular heartburn (most common symptom occurring in the middle of the chest)
  • Pain/discomfort in your chest
  • Pain/discomfort in the upper part of your abdomen
  • Nausea
  • Vomiting
  • Dysphagia (difficulty in swallowing)
  • Halitosis (bad breath)
  • Respiratory problems (throat irritation, hoarse voice, recurrent cough)

How is GERD diagnosed?

The doctor can diagnose simple acid reflux by just taking your medical history and asking for medical complaints. Dietary modifications and a few simple medications are usually sufficient to relieve the condition. If these measures fail to provide relief, your doctor may ask you to get tested for GERD. Tests for GERD include:

  • Upper gastrointestinal (GI) endoscopy and biopsy: A thin, flexible tube with a camera and a light source (endoscope) is inserted into the bowel through the mouth. This helps in visualizing the internal structure of the esophagus and stomach and look for any GERD-related changes. The doctor may cut a small piece from the esophagus or stomach (biopsy) and send it to the laboratory for examination.
  • Upper GI series: You will be told to swallow a liquid (barium compound). X-rays of your esophagus and stomach will be taken as the liquid passes through these organs.
  • Esophageal pH and impedance monitoring: These are 24-hour monitoring tests that measure the amount of food and acid reflux in your esophagus and check whether your symptoms are correlated with the reflux.
  • Bravo wireless esophageal pH monitoring: This is a 48-hour test that measures how much acid and food is refluxed in 48 hours.
  • Esophageal manometry: Your healthcare provider inserts a small flexible tube with sensors into your nose to enter your esophagus. The sensors present in the tube measure the strength of the muscles in different parts of your esophagus including the lower esophageal sphincter (LES).

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Medically Reviewed on 9/29/2020
References
Gastroesophageal Reflux Disease. Available at: https://emedicine.medscape.com/article/176595

GERD (Chronic Acid Reflux). Available at: https://my.clevelandclinic.org/health/diseases/17019-gerd-or-acid-reflux-or-heartburn

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