Basics

What is GERD?

Gastroesophageal reflux disease (GERD) is a common condition caused by stomach contents (acid, bile salts, digestive enzymes) going back into the esophagus (the swallowing tube connecting our mouth and stomach). GERD is the most common upper gastrointestinal disease in Western countries with 10-20% of the population experiencing weekly symptoms.

Causes and Risks

Upon eating a meal, the food passes from the esophagus to the stomach. When food is inside the stomach, a muscular ring helps stop food from going back in to the esophagus. If the sphincter does not close properly, food and gastric acid may leak into the esophagus. This is known as reflux, which can harm the esophagus

Multiple risk factors have been identified for the development of GERD.  There seems to be a genetic predisposition in Caucasian males.  Poor movement of the esophagus decreases clearance of refluxed material (making the effects of reflux worse).  In addition, hiatal hernias (see paraesophageal section), certain foods (caffeine, peppermint, alcohol, among others), and medications (calcium channel blockers, nitrates, beta-blockers) can weaken the muscular ring separating the esophagus from the stomach, allowing more reflux.  Finally, increased pressure in the abdomen from obesity, pregnancy, or poor stomach emptying can also increase the risk of GERD.