Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backwards from the stomach into the oesophagus (the tube from the mouth to the stomach). This can irritate the oesophagus and cause heartburn and other symptoms.

Causes

When you eat, food passes from the throat to the stomach through the oesophagus. A ring of muscle fibres in the lower oesophagus prevents swallowed food from moving back up. These muscle fibres are called the lower oesophageal sphincter (LES).

When this ring of muscle does not close all the way, stomach contents can leak back into the oesophagus. This is called reflux or gastroesophageal reflux. Reflux may cause symptoms. Harsh stomach acids can also damage the lining of the oesophagus.

The risk factors for reflux include:

  • Use of alcohol (possibly)
  • 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)
  • Obesity
  • Pregnancy
  • Scleroderma
  • Smoking

Heartburn and gastroesophageal reflux can be brought on or made worse by pregnancy. Symptoms can also be caused by certain medicines, such as:

  • Anticholinergics (for example, seasickness medicine)
  • Bronchodilators for asthma
  • Calcium channel blockers for high blood pressure
  • Dopamine-active drugs for Parkinson disease
  • Progestin for abnormal menstrual bleeding or birth control
  • Sedatives for insomnia or anxiety
  • Tricyclic antidepressants

Common symptoms of GERD include:

  • Feeling that food is stuck behind the breastbone
  • Heartburn or a burning pain in the chest
  • Nausea after eating

Less common symptoms are:

  • Bringing food back up (regurgitation)
  • Cough or wheezing
  • Difficulty swallowing
  • Hiccups
  • Hoarseness or change in voice
  • Sore throat

Symptoms may get worse when you bend over or lie down, or after you eat. Symptoms may also be worse at night.

Anti-reflux surgery may be an option for people whose symptoms do not go away with lifestyle changes and medicines. Heartburn and other symptoms should improve after surgery. But you may still need to take drugs for your heartburn.

There are also new therapies for reflux that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach).

When to contact a medical professional

Call your healthcare provider if symptoms do not improve with lifestyle changes or medicine.

Also call if you have:

  • Bleeding
  • Choking (coughing, shortness of breath)
  • Feeling filled up quickly when eating
  • Frequent vomiting
  • Hoarseness
  • Loss of appetite
  • Trouble swallowing (dysphagia) or pain with swallowing (odynophagia)
  • Weight loss

Prevention

Following heartburn prevention techniques may help prevent symptoms. Obesity is linked to GERD, so maintaining a healthy body weight may help prevent the condition.