Understanding GERD: Causes, Risk Factors, Symptoms, and Complications
Gastroesophageal Reflux Disease (GERD) is a chronic illness in which stomach acid repeatedly rushes back into the esophagus, irritating the lining 1. Occasional acid reflux is normal, but frequent reflux (more than twice a week) could suggest GERD. It is estimated that GERD affects a large proportion of adults in the United States.
Causes of GERD:
GERD occurs when the lower esophageal sphincter (LES), a valve that connects the esophagus and stomach, weakens or relaxes abnormally. This allows stomach acid to pass back into the esophagus. Several variables may contribute to this, including:
- Hiatal hernia: This occurs when the upper section of the stomach pushes through the diaphragm, potentially weakening the LES.
- Obesity: It causes increased abdominal pressure, which might impair the LES.
- Pregnancy: Similar to obesity, pregnancy increases abdominal pressure and can relax the LES.
- Smoking: Tobacco smoke can relax the LES and increase stomach acid production.
- Certain Medications: Sedatives, calcium channel blockers, and certain antidepressants can all relax the LES.
- Connective Tissue Disorders: Scleroderma and other connective tissue disorders can impair the esophageal muscles.
- Bile Reflux: The backward flow of bile from the small intestine into the stomach and esophagus can irritate the lining and contribute to the development or worsening of GERD.
- Hyperacidity: Excessive production of stomach acid increases pressure on the lower esophageal sphincter (LES), making it more prone to leakage and triggering GERD symptoms.
- Alcoholism: Chronic alcohol consumption weakens the lower esophageal sphincter and delays stomach emptying, both of which are key contributors to GERD.
Risk Factors for GERD
Several factors can increase your risk of developing GERD:
- Obesity or being overweight
- Hiatal hernia
- Pregnancy
- Smoking
- Older age
- Family history of GERD
- Certain medications
- Alcohol consumption
- Inactivity
- High intake of sweets and desserts
- Low intake of fibre
- Anxiety/Depression
Symptoms of GERD
The most common symptoms of GERD are:
Heartburn (a burning sensation in the chest)
Regurgitation (backwash of food or sour liquid)
Chest pain
Difficulty swallowing (dysphagia)
Sensation of a lump in the throat
Nausea
Sore throat
Chronic cough
Laryngitis (inflammation of the vocal cords)
New or worsening asthma
Water Brash
UGI Bleeding
Symptoms may worsen at night, after large or fatty meals, or when lying down.
Complications of GERD
Untreated GERD can lead to serious complications over time:
- Esophagitis: Inflammation of the esophagus that can lead to ulcers and bleeding.
- Esophageal Stricture: Scar tissue formation narrows the esophagus, making swallowing difficulties.
- Barrett’s Esophagus: Changes in the esophageal lining that can increase the risk of esophageal cancer.
Laryngopharyngeal Reflux (LPR): Reflux into the throat, which causes hoarseness, vocal cord issues, and potential aspiration into the airways.
Respiratory Problems: Asthma, pneumonia, and other respiratory issues can cause from acid entering the lungs.
Seeking Help
If you experience frequent acid reflux symptoms, consult a doctor. They may recommend lifestyle changes, medications, or further testing to diagnose and manage GERD.
