GERD stands for GastroEsophageal Reflux Disease

Hiatal Hernia
A hiatal hernia may contribute to gastroesophageal reflux. A hiatal hernia occurs when the upper part of the stomach is above the diaphragm, the muscle wall that separates the stomach from the chest. The diaphragm helps the lower esophageal sphincter (LES) keep acid from coming up into the esophagus. When a hiatal hernia is present, it is easier for the acid to come up. In this way, a hiatal hernia can cause reflux. A hiatal hernia can happen in people of any age; many otherwise healthy people over 50 have a small one.

Other Factors That May Cause GERD

Some people are born with a naturally weak lower esophageal sphincter (LES). For others, however, certain lifestyles, medications, activities or food choices may be the contributing factor.

Alcohol Use – Alcohol has mixed effects on GERD. It relaxes the lower esophageal sphincter (LES) muscles and, in high amounts, may irritate the mucous membrane of the esophagus. All alcoholic beverages increase stomach acid levels. A combination of heavy alcohol use and smoking even increases the risk for esophageal cancer. Small amounts of alcohol, however, may actually protect the mucosal layer.

Overweight – Can contribute to heartburn or GERD. Use the Body Mass Index Calculator to determine if you are at a healthy weight, overweight, or obese.

Pregnancy – may contribute to heartburn or GERD.

Smoking – Smoking causes the lower esophageal sphincter (LES) at the top of the stomach to relax.

Lying down or bending – Lying down or bending over from the waist can contribute to heartburn or GERD.

Snacking before bedtime – may contribute to heartburn or GERD.

Tight Clothing – wearing clothes that are tight around the waist.

Vigorous exercise – may contribute to heartburn or GERD.

Medications – There are dozens of nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin, ibuprofen (Motrin, Advil, Nuprin, Rufen), and naproxen (Aleve) and many prescription agents that also may contribute to heartburn or GERD. A person with GERD who takes the occasional aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) will not necessarily experience adverse effects. This is especially true if there are no risk factors or indications of ulcers. Acetaminophen (Tylenol) is a good alternative for those who want to relieve mild pain.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are being studied for protection against Barrett’s esophagus. Newer nonsteroidal anti-inflammatory drugs (NSAIDs) called COX-2 inhibitors may prove to be cancer protective in these people without producing GERD. They include celecoxib (Celebrex), rofecoxib (Vioxx), and valdecoxib (Bextra).