Gastroesophageal reflux disease Health Article

Definition

Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.

Alternative Names

Peptic esophagitis; Reflux esophagitis; GERD; Heartburn - chronic; Dyspepsia - GERD

Causes, incidence, and risk factors

When you eat, food passes from the throat to the stomach through the esophagus (also called the food pipe or swallowing tube). Once food is in the stomach, a ring of muscle fibers prevents food from moving backward into the esophagus. These muscle fibers are called the lower esophageal sphincter, or LES.

If this sphincter muscle doesn't close well, food, liquid, and stomach acid can leak back into the esophagus. This is called reflux or gastroesophageal reflux. This reflux may cause symptoms, or can even damage the esophagus.

The risk factors for reflux include hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities), pregnancy, and scleroderma.

Obesity, cigarettes, and possibly alcohol also increase the chance of GERD.

Heartburn and gastroesophageal reflux can be brought on or worsened by pregnancy and many different medications. Such drugs include:

• Anticholinergics (e.g., for seasickness)
• Beta-blockers for high blood pressure or heart disease
• Bronchodilators for asthma
• Calcium channel blockers for high blood pressure
• Dopamine-active drugs for Parkinson's disease
• Progestin for abnormal menstrual bleeding or birth control
• Sedatives for insomnia or anxiety
• Tricyclic antidepressants

If you suspect that one of your medications may be causing heartburn, talk to your doctor. Never change or stop a medication you take regularly without talking to your doctor.

Symptoms

More common symptoms are:

• Feeling that food may be left trapped behind the breastbone
• Heartburn or a burning pain in the chest (under the breastbone)
  • Increased by bending, stooping, lying down, or eating
  • More likely or worse at night
  • Relieved by antacids
• Nausea after eating

Less common symptoms are:

• Cough or wheezing
• Difficulty swallowing
• Hiccups
• Hoarseness or change in voice
• Regurgitation of food
• Sore throat