Gastroesophageal reflux disease Health Article

Definition

Gastroesophageal reflux disease (GERD) is a condition in which food or liquid travels backwards from the stomach to 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

Causes, incidence, and risk factors

Gastroesophageal reflux is a common condition that often occurs without symptoms after meals. In some people, the reflux is related to a problem with the lower esophageal sphincter, a band of muscle fibers that usually closes off the esophagus from the stomach. If this sphincter doesn't close properly, food and liquid can move backward into the esophagus and may cause the symptoms.

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.

A number of studies suggest that obesity contributes to gastroesophageal reflux. For instance, the Nurses Health Study found that being overweight or obese significantly increased reflux symptoms in women. (Women who lost weight in the study, meanwhile, had fewer symptoms.)

Heartburn and gastroesophageal reflux can be brought on or worsened by pregnancy and by 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 medication you take regularly without talking to your doctor.

Symptoms

• Belching
• Cough or wheezing
• Difficulty swallowing
• Heartburn
  • Involves a burning pain in the chest (under the breastbone)
  • Increased by bending, stooping, lying down, or eating
  • More frequent or worse at night
  • Relieved by antacids
• Hoarseness or change in voice
• Nausea and vomiting
• Regurgitation of food
• Sore throat
• Vomiting blood