Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the ring of muscle between your oesophagus and your stomach. This ring is called the lower oesophagal sphincter (LES). If you have it, you may get heartburn or acid indigestion. Doctors think that some people may have it because of a condition called hiatal hernia. In most cases, you can ease your GERD symptoms through diet and lifestyle changes. But some people may need medication or surgery.
The term “gastroesophageal” refers to the stomach and esophagus. Reflux means to flow back or return. Gastroesophageal reflux is when what’s in your stomach backs up into your esophagus.
In normal digestion, your LES opens to allow food into your stomach. Then it closes to stop food and acidic stomach juices from flowing back into your esophagus. Gastroesophageal reflux happens when the LES is weak or relaxes when it shouldn’t. This lets the stomach’s contents flow up into the esophagus.
Risk Factors for Reflux
More than 60 millReflux Causes
The term “gastroesophageal” refers to the stomach and oesophagus. Reflux means to flow back or return. Gastroesophageal reflux is when what’s in your stomach backs up into your oesophagus.
In normal digestion, your LES opens to allow food into your stomach. Then it closes to stop food and acidic stomach juices from flowing back into your oesophagus. Gastroesophageal reflux happens when the LES is weak or relaxes when it shouldn’t. This lets the stomach’s contents flow up into the oesophagus.
Risk Factors for Reflux
More than 60 million American adults have heartburn at least once a month, and more than 15 million adults have heartburn every day, including many pregnant women. Recent studies show that Reflux in infants and children is more common than doctors thought. It can cause vomiting that happens over and over again. It can also cause coughing and other breathing problems.
Some doctors believe a hiatal hernia may weaken the LES and raise your chances of gastroesophageal reflux. A hiatal hernia happens when the upper part of your stomach moves up into the chest through a small opening in your diaphragm (diaphragmatic hiatus). The diaphragm is the muscle separating the abdomen from the chest. Recent studies show that the opening in the diaphragm helps support the lower end of the oesophagus.
Many people with a hiatal hernia will not have problems with heartburn or reflux. But having a hiatal hernia may allow stomach contents to reflux more easily into the oesophagus.
Coughing, vomiting, straining, or sudden physical exertion can raise the pressure in your belly and lead to a hiatal hernia. Many otherwise healthy people ages 50 and over have a small one. Although it’s usually a condition of middle age, Hiatal hernias affect people of all ages.
Hiatal hernias usually don’t need treatment. But it may be necessary if the hernia is in danger of becoming strangulated or twisted in a way that cuts off the blood supply. You may also need to treat it if you have one along with severe Reflux or esophagitis (inflammation of the oesophagus). Your doctor may perform surgery to make the hernia smaller or to prevent strangulation. Several other things can make it more likely that you’ll have Reflux:
Being overweight or obese
Delayed emptying of the stomach (gastroparesis)
Diseases of connective tissue such as rheumatoid arthritis, scleroderma, or lupus
Diet and lifestyle choices may make acid reflux worse if you already have it:
- Certain foods and drinks, including chocolate and fatty or fried foods, coffee, and alcohol
- Large meals
- Eating too soon before bed
- Certain medications, including aspirin
The most common symptom of Reflux is heartburn (acid indigestion). It usually feels like a burning chest pain that starts behind your breastbone and moves upward to your neck and throat. Many people say it feels like food is coming back into the mouth, leaving an acid or bitter taste.
The burning, pressure, or pain of heartburn can last as long as 2 hours. It’s often worse after eating. Lying down or bending over can also result in heartburn. Many people feel better if they stand upright or take an antacid that clears acid out of the oesophagus.
People sometimes mistake heartburn pain for the pain of heart disease or a heart attack, but there are differences. Exercise may make heart disease pain worse, and rest may relieve it. Heartburn pain is less likely to go along with the physical activity. But you can’t tell the difference, so seek medical help right away if you have any chest pain.
Besides pain, you may also have
- Bad breath
- Trouble breathing
- A hard time swallowing
- Wearing away of tooth enamel
- A lump in your throat
If you have acid reflux at night, you may also have:
- A lingering cough
- Asthma that comes on suddenly or gets worse
- heartburn every day, including many pregnant women. Recent studies show that Reflux in infants and children is
- more common than doctors thought. It can cause vomiting that happens over and over again. It can also cause coughing and other breathing problems.