You might assume that the symptoms of acid reflux—and the more chronic condition of gastroesophageal reflux disease (GERD)—are based solely on food choices and lifestyle. Yet, genetics may also play a role in developing GERD. In fact, the University of Maryland Medical Center (UMMC) estimates that about 30 to 40 percent of reflux may be hereditary.
Genetic factors may play an especially important role in Barrett’s esophagus, a pre-cancerous condition caused by severe GERD. Evidence of inherited risk exists in many other cases of GERD as well. Researchers speculate that this could be based on muscular or structural problems in the stomach or esophagus.
A number of studies have suggested that there may be a genetic component to the condition. Research published in the American Journal of Gastroenterology revealed that a certain genotype known as “GNB3 C825T” was more commonly found in GERD patients than in healthy controls.
In addition, studies of twins and families have repeatedly demonstrated a genetic predisposition to GERD. Below is summary of some of the more compelling research findings.
A study published in the journal Gut compared heartburn incidence in more than 2,000 sets of identical twins, 18 percent of who identified themselves as having GERD symptoms.
Researchers found that an individual was 1.5 times more likely to suffer from GERD if their identical twin also had it. The study found that genes accounted for 43 percent of acid reflux symptoms after accounting for known risk factors.
Another twin study published in Gastroenterology compared the appearance of GERD in both fraternal and identical twins. GERD was defined as “heartburn or acid regurgitation appearing at least weekly.” Researchers concluded that genetic traits rather than shared environment influenced GERD because identical twins were more likely than fraternal twins to share reflux symptoms. Genetics were found to account for up to 39 percent of GERD symptoms in the study population.
The study published in Gut mentions two lines of evidence that also suggest the importance of heredity in GERD.
The first is exemplified by research published in the journal Cancer Epidemiology, Biomarkers & Prevention. Barrett’s esophagus was discovered in seven members of a single family in this study. Some family members who didn’t suffer from the condition were found to have other types of dysfunctions with the area where the esophagus and stomach meet. Researchers concluded that inherited factors appear to play a role in the development of Barrett’s esophagus.
The second line of evidence receives support from a study in the American Journal of Gastroenterology. Researchers examined the prevalence of reflux symptoms among relatives of patients with GERD. The study found familial clustering of reflux symptoms in the relatives of patients with reflux symptoms or Barrett’s esophagus.
Findings published in Gastroenterology suggested a family-based predisposition to reflux. However, this study found that genetic predisposition might be higher in families of patients with Barrett’s esophagus than in families with less severe reflux symptoms.
Are eating right and managing the condition through lifestyle changes no longer important if genes are responsible for heartburn and other GERD symptoms? Absolutely not. Researchers say that symptoms can worsen for those who fail to follow lifestyle best practices for GERD.
To help control symptoms, remember to:
- avoid foods and beverages that you and your doctor have determined to trigger your reflux symptoms
- wait three to four hours after finishing meals before lying down
- wear pants with loose waistbands to avoid putting pressure on your abdomen
- raise the head of your bed four to eight inches off the ground—or use a wedge-shaped pillow under your head—to let gravity aid your efforts.
Some who are genetically predisposed may experience acid reflux regardless of what they do. However, for most people, individual actions are equally—if not more—important. Regardless of your genetic risk factors, you should continue to practice lifestyle management for GERD as directed by your doctor for best results.