Reflux Disease (GERD) Causes

No one knows the exact cause of gastroesophageal reflux. The following are several 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, acid foods such as citrus fruits and tomatoes, spicy foods, mint flavorings
• Eating habits - Eating large meals, eating 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.
• A hiatal hernia makes it easier for the acid to back up.
• Hiatal hernia can be caused by persistent coughing, vomiting, straining, or sudden physical exertion. Obesity and pregnancy can make the condition worse.
• Hiatal hernia is very common in people older than 50 years.
• Hiatal hernia usually requires no treatment. In rare cases when the hernia becomes twisted or is making GERD worse, surgery may be required.

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GERD - Proton Pump Inhibitors

The eMedicineHealth physician editors ask:

Heartburn symptoms caused by GERD are usually relieved by drugs called proton pump inhibitors (Prilosec, Prevacid, Aciphex, Protonix, Nexium, Zegerid); however, proton pump inhibitors sometimes do not work well. If your symptoms were not relieved by treatment with proton pump inhibitors, can you please describe your GERD symptoms that did not improve? If you have other treatments that have been effective, please comment on those.

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