Gastroesophageal reflux disease (GERD) is a condition in which the esophagus, the food tube stretching from the throat to the stomach, becomes irritated or inflamed because a muscle at the end of this tube doesn't work properly, allowing acid to back up from the stomach. When food is swallowed, it travels down the esophagus.
The stomach produces hydrochloric acid after a meal to aid in the digestion of food.
- The inner lining of the stomach resists corrosion by this acid. The cells that line the stomach secrete large amounts of protective mucus.
- The lining of the esophagus does not share these resistant features and stomach acid can damage it.
- The esophagus lies just behind the heart, so the term heartburn was coined to describe the sensation of acid burning the esophagus.
Normally, a ring of muscle at the bottom of the esophagus, called the lower esophageal sphincter, prevents reflux (or backing up) of acid.
- This sphincter relaxes during swallowing to allow food to pass. It then tightens to prevent flow in the opposite direction.
- With GERD, however, the sphincter relaxes between swallows, allowing stomach contents and corrosive acid to well up and damage the lining of the esophagus.
GERD affects 25 percent to 40 percent of the adult population of the United States to some degree at some point, though research shows African Americans tend to suffer the condition less often than their white counterparts. About 10 percent of adults experience GERD weekly or daily. Adults aren't the only ones affected; even infants and children can have GERD. Untreated, the condition can lead to more serious problems.
No one knows the exact cause of GERD. The following are contributing factors that weaken or relax the lower esophageal sphincter, making reflux worse:
- Lifestyle: Use of alcohol or cigarettes, obesity, poor posture (slouching)
- Medications: Calcium channel blockers, theophylline (Tedral, Hydrophed, Marax, Bronchial, Quibron), nitrates, antihistamines
- Diet: Fatty and fried foods, chocolate, garlic, onions, drinks with caffeine, acidic foods such as citrus fruits and tomatoes, spicy foods, mint flavorings
- Eating habits: Eating large meals, eating quickly or soon before bedtime
- Other medical conditions: Hiatal hernia, pregnancy, diabetes, rapid weight gain
Sufferers may feel a burning in the chest or throat called heartburn. Sometimes, you can taste stomach fluid in the back of the mouth. If you have these symptoms more than twice a week, you may have GERD. You can also have GERD without having heartburn. Your symptoms could include a dry cough, asthma symptoms, or trouble swallowing.