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Acid Reflux (GERD)

Acid Reflux (GERD) Overview

Gastroesophageal reflux disease (GERD) is a condition in which the esophagus becomes irritated or inflamed because of acid backing up from the stomach. The esophagus or food pipe is the tube stretching from the throat to the stomach. When food is swallowed, it travels down the esophagus.

The stomach produces hydrochloric acid after a meal to aid in the digestion of food.

  • The inner lining of the stomach resists corrosion by this acid. The cells lining the stomach secrete large amounts of protective mucus.
  • The lining of the esophagus does not share these resistant features and stomach acid can damage it.
  • The esophagus lies just behind the heart, so the term "heartburn" was coined to describe the sensation of acid burning the esophagus.

Normally, a ring of muscle at the bottom of the esophagus, called the lower esophageal sphincter, prevents reflux (or backing up) of acid.

  • This sphincter relaxes during swallowing to allow food to pass. It then tightens to prevent flow in the opposite direction.
  • With GERD, however, the sphincter relaxes between swallows, allowing stomach contents and corrosive acid to well up and damage the lining of the esophagus.

GERD affects 25% to 40% of the adult population of the United States to some degree at some point. About 20% of adults experience GERD weekly or daily. Not just adults are affected; even infants and children can have GERD.

Acid Reflux (GERD) Causes

No one knows the exact cause of gastroesophageal reflux. The following are contributing factors that weaken or relax the lower esophageal sphincter, making reflux worse:

  • Lifestyle: Use of alcohol or cigarettes, obesity, poor posture (slouching)
  • Medications: Calcium channel blockers, theophylline (Tedral, Hydrophed, Marax, Bronchial, Quibron), nitrates, antihistamines
  • Diet: Fatty and fried foods, chocolate, garlic and onions, drinks with caffeine, acidic foods such as citrus fruits and tomatoes, spicy foods, mint flavorings
  • Eating habits: Eating large meals, eating quickly or soon before bedtime
  • Other medical conditions:  Hiatal hernia, pregnancy, diabetes, rapid weight gain

Hiatal hernia is a condition when the upper part of the stomach protrudes up above the diaphragm (the strong muscle that separates the organs of the chest from those of the abdomen).

  • Normally, the diaphragm acts as an additional barrier, helping the lower esophageal sphincter keep acid from backing up into the esophagus.
  • Hiatal hernia can be caused by persistent coughing, vomiting, straining, or sudden physical exertion. Obesity and pregnancy can make the condition worse.
  • A hiatal hernia makes it easier for the acid to back up.
  • Hiatal hernia is very common in people older than 50 years of age.
  • Hiatal hernia usually requires no treatment. In rare cases when the hernia becomes twisted or is making GERD worse, surgery may be required.
Medically Reviewed by a Doctor on 8/28/2014
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Read What Your Physician is Reading on Medscape

Gastroesophageal Reflux Disease »

Gastroesophageal reflux is a normal physiological phenomenon experienced intermittently by most people, particularly after a meal.

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