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Causes of GERD

GERD stands for GastroEsophageal Reflux Disease

Gastroesophageal reflux is the backflow of acid and food particles that seep out of the stomach and up into the esophagus. This happens when the muscle between the esophagus and the stomach, the lower esophageal sphincter (LES), is weak or relaxes when it shouldn't. Also called esophageal reflux or reflux esophagitis.



Also, a hiatal hernia may contribute. 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 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
  • Pregnancy
  • Smoking
    Smoking causes the lower esophageal sphincter (LES) at the top of the stomach to relax.
    Article: Can smoking cause GERD? By: Dr. Ronen Arai
  • Lying down or bending over from the waist
  • Snacking before bedtime
  • Tight clothing (around the waist)
  • Vigorous exercise
  • 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 patients without producing GERD. They include celecoxib (Celebrex), rofecoxib (Vioxx), and valdecoxib (Bextra).

Glossary For This Page
Esophagus
Pronounced - eh-SAW-fuh-gus
Also spelled oesophagus. The organ that connects the mouth to the stomach. Also called gullet or food pipe.

Lower Esophageal Sphincter (LES)
Pronounced - LOH-wur uh-saw-fuh-JEE-ul SFEENK-tur
The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus.

Hiatal Hernia
Pronounced - hy-AY-tul HUR-nee-uh
A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. See also Diaphragm.

Diaphragm
Pronounced - DY-uh-fram
The muscle wall between the chest and the abdomen. It is the major muscle that the body uses for breathing.

Barrett's Esophagus
Pronounced - BAH-ruts eh-SAW-fuh-gus)
A condition in which the cells lining the lower part of the esophagus have changed or been replaced with abnormal cells that could lead to cancer of the esophagus. The backing up of stomach contents (reflux) may irritate the esophagus and, over time, cause Barrett's esophagus.

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GastroEsophageal Reflux Disease
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