Causes

Improperly Functioning LES

Acid reflux is a common and, in some cases, a chronic condition. Normally, the ring of muscle toward the end of the esophagus, called the lower esophageal sphincter (LES) acts like a valve. It opens to allow food and liquids to travel down into the stomach and then closes. This prevents stomach contents and acid (bile) from flowing back up the esophagus.

However, in some cases, the muscle weakens, loses tone, relaxes due to tobacco use or alcohol consumption, or there may be a physical abnormality with the muscle that causes it to function improperly. In these cases, the LES doesn't close properly when food empties into the stomach. The result is acid rising from the stomach up the esophagus, causing symptoms including heartburn and nausea.

Hiatal Hernia

Another cause of acid reflux is a hiatal hernia. The hiatus is a small hole through which the esophagus passes into the stomach. Usually, it fits snugly. However, if it's weakened or enlarged, the stomach muscles may protrude up into the chest through the diaphragm, producing a hiatus hernia. This is a common condition that more than half those over age 60 have. 

Learn more about hiatal hernias

Acid Reflux Triggers

Certain foods, beverages, and behaviors are thought to bring on acid reflux symptoms. The easiest way to prevent an acid reflux attack is to identify and avoid common or personal triggers. There is some evidence to suggest that consuming the foods and beverages listed may bring on symptoms. However, there is little to show that anything beyond losing weight and elevating the head while sleeping will help relieve them. Nevertheless, it could be worth avoiding these "suspects" if it helps with your GERD symptoms. Common known acid reflux triggers include:

  • citrus fruits
  • spicy, fatty, and fried foods
  • alcohol
  • caffeine and carbonated beverages
  • orange juice
  • chocolate
  • peppermint
  • vinegar
  • lying down after eating
  • overeating—a full stomach can make stomach contents press more against the lower esophageal sphincter (LES)

Other triggering suspects include:

  • peppermint
  • garlic and onions
  • tomatoes and tomato products like ketchup