Causes
There is no known single cause of gastroesophageal reflux disease (GERD). It occurs when the esophageal defenses are overwhelmed by gastric contents that reflux into the esophagus. This can cause injury to tissue.
Symptoms
Causes of GERD: Reflux Chemistry and Anatomy. Gastroesophageal Reflux Disease (GERD) generally stems from just two underlying causes: those that have to do with reflux chemistry and those that stem from anatomical dysfunction. Chemical causes of GERD can include: fluids refluxed from the stomach irritating or damaging the esophagus.
Prevention
Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus. Many people experience acid reflux from time to time.
Complications
Overview. Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.
What causes gastroesophageal reflux?
What are the causes of GERD in adults?
What is Gerd and how does it affect the body?
What is the pathophysiology of acid reflux?
What is the main cause of gastroesophageal reflux disease?
GERD is caused by frequent acid reflux or reflux of nonacidic content from the stomach. When you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again.
How is gastroesophageal reflux disease acquired?
It happens when the valve that prevents stomach contents from going back up to the esophagus becomes weak or opens when it should not. GERD occurs more commonly in people: with obesity or people who are overweight because of increased pressure on the abdomen.
What causes GERD pathophysiology?
The pathophysiology of GERD is multifactorial and is best explained by various mechanisms involved, including the influence of the tone of the lower esophageal sphincter, the presence of a hiatal hernia, esophageal mucosal defense against the refluxate and esophageal motility.
What causes GERD Mcq?
Explanation: Obesity, pregnancy and smoking are all factors that contribute to the development of GERD. Note: Hiatal hernia is a condition when the upper part of the stomach protrudes up above the diaphragm (the strong muscle that separates the organs of the chest from those of the abdomen).
What are the four stages of GERD?
GERD is broken down into different stages based on how serious your symptoms are and how often they occur:Stage 1: Mild GERD. Minimal acid reflux occurs once or twice a month. ... Stage 2: Moderate GERD. ... Stage 3: Severe GERD. ... Stage 4: Precancer or cancer.
How can you prevent GERD?
Try to:Maintain a healthy weight. ... Stop smoking. ... Elevate the head of your bed. ... Start on your left side. ... Don't lie down after a meal. ... Eat food slowly and chew thoroughly. ... Avoid foods and drinks that trigger reflux. ... Avoid tight-fitting clothing.
Where is GERD most common?
GERD is a chronic and highly prevalent disorder. A recent systematic review showed that the prevalence of GERD is 18.1–27.8% in North America, 8.8–25.9% in Europe, 2.5–7.8% in East Asia, 8.7–33.1% in the Middle East, 11.6% in Australia, and 23.0% in South America.
Who does GERD affect most?
Although GERD symptoms are common in adults of all ages, the prevalence of GERD was highest in the 20-29 years age group and the age group 70-79 years had the lowest prevalence for both males and females.
Who is at risk of GERD?
Lifestyle risk factors that may contribute to GERD symptoms include excessive body weight, particularly obesity, moderate/high alcohol consumption, smoking, postprandial and vigorous physical activity, as well as lack of regular physical activity.
What is GERD anatomy?
Gastroesophageal reflux disease (GERD) is a condition in which reflux of gastric contents into the esophagus produces frequent or severe symptoms that negatively affect the individual's quality of life or result in damage to esophagus, pharynx, or the respiratory tract.
Is GERD a chronic disease?
The stage of GERD is determined by the frequency and severity of your symptoms. Receiving the appropriate treatment for your particular stage of GERD is important for keeping your condition from getting worse. GERD is considered a chronic disease and may not be entirely curable.
How common is reflux?
GERD is very common. The condition and its symptoms touch a huge number of people: 20% of the U.S. population. Anyone of any age can develop GERD, but some may be more at risk for it. For example, the chances you'll have some form of GERD (mild or severe) increase after age 40.
Which client is most likely to be at risk for developing gastroesophageal reflux disease?
GERD affects people of all ages—from infants to older adults. People with asthma are at higher risk of developing GERD. Asthma flare-ups can cause the lower esophageal sphincter to relax, allowing stomach contents to flow back, or reflux, into the esophagus.
Who is most affected by GERD?
Although GERD symptoms are common in adults of all ages, the prevalence of GERD was highest in the 20-29 years age group and the age group 70-79 years had the lowest prevalence for both males and females.
Who is at risk of GERD?
Lifestyle risk factors that may contribute to GERD symptoms include excessive body weight, particularly obesity, moderate/high alcohol consumption, smoking, postprandial and vigorous physical activity, as well as lack of regular physical activity.
Where is GERD most common?
GERD is a chronic and highly prevalent disorder. A recent systematic review showed that the prevalence of GERD is 18.1–27.8% in North America, 8.8–25.9% in Europe, 2.5–7.8% in East Asia, 8.7–33.1% in the Middle East, 11.6% in Australia, and 23.0% in South America.
What is reflux disease?
Reflux disease is when there is a strong indication when the ph falls below a 4. There is a strong relationship with a ph of 4 in the esophagus and onset of symptoms patient is experiencing. Symptoms correlate with pH below 4! there is peristaltic wave that allows food to travel to the stomach.
What is GERD in medical terms?
Tap card to see definition 👆. Gastroesophageal Reflux Disease (GERD) is a disorder that results in EXCESS stomach acid in the esophagus. The most common symptom of GERD is regular heartburn. - when patient experieces heartburn 2 or more days per week. Click again to see term 👆. Tap again to see term 👆.
How long does it take for erosive esophagitis to heal?
Therapy of choice for symptom relief and healing of erosive esophagitis is an 8-week PPI course. There is similar efficacy among all PPIs. For maximal pH control, delayed-release PPIs should be administered 30-60 minutes before a meal. PPIs should be started at once daily dosing prior to the first meal each day.
Why is there a higher rate of reflux during bedtime?
When standing gravity helps stomach contents move forward (less reflux at this time) there is a much higher rate of reflux during bedtime because lying down. - can elevate bed to help with acid exposure at night. GERD due to too much acid production.
What is stricture in GERD?
stricture: reduction in the diameter of the esophagus (Narrowing of the esophagus lumen) globus sensation (dysphasia): feeling of blocked esophagus. Serious disease progression of GERD: Barretts esophagus. Barretts esophagus is a pre cancerous condition, its adenocarcinoma of the esophagus which is an enhanced form of cancer.
Where does esophagitis start?
over time esophagitis forms which is inflammation of the esophagus. This starts in the lower part of the esophagus and in severe cases it can be more closer to the mouth
Why does my stomach bend over?
Body position and acid reflux. When people bend over we increased pressure in the stomach that can force the contents of stomach into the esophagus.
What is the cause of acid reflux?
Acid reflux occurs when the sphincter muscle at the lower end of your esophagus relaxes at the wrong time, allowing stomach acid to back up into your esophagus. This can cause heartburn and other signs and symptoms. Frequent or constant reflux can lead to gastroesophageal reflux disease (GERD). Gastroesophageal reflux disease (GERD) ...
How often does acid reflux occur?
Many people experience acid reflux from time to time. GERD is mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week. Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications ...
What are the risks of GERD?
Conditions that can increase your risk of GERD include: Obesity. Bulging of the top of the stomach up into the diaphragm (hiatal hernia) Pregnancy. Connective tissue disorders, such as scleroderma. Delayed stomach emptying. Factors that can aggravate acid reflux include: Smoking.
What happens when you swallow?
When you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again. If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus. This constant backwash of acid irritates the ...
What causes scar tissue in the esophagus?
Over time, chronic inflammation in your esophagus can cause: Narrowing of the esophagus (esophageal stricture). Damage to the lower esophagus from stomach acid causes scar tissue to form. The scar tissue narrows the food pathway, leading to problems with swallowing.
Why does stomach acid flow back up into the esophagus?
If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus. This constant backwash of acid irritates the lining of your esophagus, often causing it to become inflamed.
How do you know if you have GERD?
Symptoms. Common signs and symptoms of GERD include: A burning sensation in your chest (heartburn), usually after eating, which might be worse at night. Chest pain. Difficulty swallowing. Regurgitation of food or sour liquid. Sensation of a lump in your throat.
What causes GER and GERD?
Your lower esophageal sphincter and diaphragm most often prevent GER, which is when stomach contents come back up into your esophagus. However, many people have GER once in a while.
Why does GERD develop?
GERD may develop if your lower esophageal sphincter becomes weak or relaxes when it shouldn’t. Factors that may affect the lower esophageal sphincter and lead to GERD include
What is the burning feeling in the middle of your chest?
Gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) commonly cause symptoms such as. heartburn, a painful, burning feeling in the middle of your chest, behind your breastbone, rising from the lower tip of your breastbone toward your throat.
What are the symptoms of GERD?
symptoms of complications in the mouth, throat, or lungs, such as chronic cough or hoarseness. Symptoms of GERD may include chronic cough. You should see a doctor if you think you have GERD, or if your symptoms don’t get better with over-the-counter medicines or lifestyle changes.
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What are the symptoms of a swollen stomach?
chest pain. loss of appetite. persistent vomiting. problems swallowing or pain while swallowing. signs of bleeding in the digestive tract, such as. vomit that contains blood or looks like coffee grounds. stool that contains blood or looks black and tarry. unexplained weight loss.
Can GERD cause stomach acid?
regurgitation, or stomach contents coming back up through your esophagus and into your throat or mouth, which may cause you to taste food or stomach acid. However, not all adults with GERD have heartburn or regurgitation. Other symptoms may include. chest pain. nausea.
What causes GERD?
It occurs when the esophageal defenses are overwhelmed by gastric contents that reflux into the esophagus. This can cause injury to tissue. GERD can also be present without esophageal damage (approximately 50 – 70% of patients have this form of the disease).
What causes reflux in the stomach?
What causes reflux? After swallowed food travels down the esophagus, it stimulates cells in the stomach to produce acid and pepsin (an enzyme), which aid digestion. A band of muscle at the lower part of the esophagus, called the lower esophageal sphincter (LES), acts as a barrier to prevent the back-flow ...
What muscle separates the stomach and the chest?
The diaphragm is a muscle that separates the chest (containing the esophagus) from the abdomen (containing the stomach). If the diaphragm is not intact, it can compromise the ability of the LES to prevent acid reflux. A hiatal hernia may decrease the sphincter pressure necessary to maintain the anti-reflux barrier.
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Why does my LES relax after eating?
The LES may relax after having large meals leading to distension of the upper part of the stomach. When that happens there is not enough pressure at the LES to prevent reflux. In some patients the LES is too weak or cannot mount enough pressure to prevent reflux during periods of increased pressure within the abdomen.
Can GERD be present without esophageal damage?
GERD can also be present without esophageal damage (approximately 50 – 70% of patients have this form of the disease). Gastroesophageal reflux occurs when the LES barrier is somehow compromised. Occasional reflux occurs normally, and without consequence other than infrequent heartburn, in people who do not have GERD.
What causes acid reflux?
Other causes of acid reflux disease. Other common causes of acid reflux disease include: 1 Being overweight or obese 2 Eating a heavy meal and lying on your back or bending over at the waist 3 Snacking close to bedtime or lying down right after a meal 4 Taking aspirin or ibuprofen, some muscle relaxers, or certain blood pressure medications
Why does acid reflux go away after delivery?
This is caused by increasing levels of hormones combined with pressure from the growing fetus. Usually worst during the third trimester, the symptoms almost always go away after delivery. Smoking. Smoking may contribute to acid reflux disease by doing any of the following: Damaging mucus membranes.
Does smoking cause esophageal cancer?
Smoking also increases the risk for cancer of the esophagus. Acid reflux foods. Eating large meals or lying down right after a meal can trigger heartburn or other symptoms of acid reflux disease, such as a dry cough or trouble swallowing. These are some of the common acid reflux foods that trigger symptoms: Alcohol.
Does drinking alcohol cause acid reflux?
These are some of the common acid reflux foods that trigger symptoms: Drinking alcohol also increases the risk of esophageal cancer. The more you drink , the greater the risk. When coupled with smoking, the risk is even greater than for using either alcohol or tobacco alone. Other causes of acid reflux disease.
Does the diaphragm help with acid reflux?
When it works correctly, the diaphragm normally helps keep acid from rising into your esophagus. But if you have a hiatal hernia, it is easier for acid to move up into your esophagus. Pregnancy. Many women experience acid reflux for the first time during pregnancy.
What causes acid reflux in the esophagus?
Any one of the following factors, or a combination of these factors, can result in disruption of the gastroesophageal valve and abnormal exposure of the esophagus to acid reflux: 1 Genetic: Anatomy varies from person to person. Some people naturally have valves that function less competently than others. 2 Injury to the upper chest: Often the result of a sports-related injury or a traumatic accident, these incidents can cause the valve to lose its shape. 3 Obesity or diet related issues: Excess weight can cause distortion of normal anatomy. 4 Age: As people age, musculature can lose its integrity and affect the anatomy in the esophagus and stomach area.
What Causes the Gastroesophageal Valve to Become Dysfunctional?
Any one of the following factors, or a combination of these factors, can result in disruption of the gastroesophageal valve and abnormal exposure of the esophagus to acid reflux:
What is the valve between the esophagus and the stomach called?
When a person with normal, healthy anatomy swallows, the valve between the esophagus and the stomach (gastroesophageal valve) opens. This allows food to pass.
What is the role of a valve in GERD?
A normal, healthy valve serves as an effective antireflux barrier and experts consider it the most important factor in preventing GERD. For people with GERD, this valve becomes dysfunctional and does not close appropriately.
Why is my esophageal tissue sensitive?
general sensitivity of esophageal tissue, often caused by natural low acid intolerance, use of prescription drugs or other drugs as alcohol and tobacco. Most of the time, however, GERD can be attributed to a patient’s own anatomy. The biology of swallowing, for healthy patients, is simple.
Can you have acid reflux twice a week?
If you suffer any symptoms of reflux more than twice a week, you may have chronic acid reflux. Take the GERD-HRQL survey and bring the results to a doctor for a GERD evaluation.
What is the procedure to treat GERD?
Treatment. Laparoscopic anti-reflux surgery for GERD may involve a procedure to reinforce the lower esophageal sphincter, called Nissen fundoplication. In this procedure, the surgeon wraps the top of the stomach around the lower esophagus after reducing the hiatal hernia, if present.
How to reduce acid reflux?
Lifestyle changes may help reduce the frequency of acid reflux. Try to: Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to reflux into your esophagus. Stop smoking. Smoking decreases the lower esophageal sphincter's ability to function properly.
How long does it take for a monitor to pass through your esophagus?
The monitor might be a thin, flexible tube (catheter) that's threaded through your nose into your esophagus, or a clip that's placed in your esophagus during an endoscopy and that gets passed into your stool after about two days. Esophageal manometry. This test measures the rhythmic muscle contractions in your esophagus when you swallow.
What is the best medication for acid reflux?
Medications that block acid production and heal the esophagus. These medications — known as proton pump inhibitors — are stronger acid blockers than H-2-receptor blockers and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC, Zegerid OTC).
What is the procedure that involves inserting a long, flexible tube (endoscope) down your throat and into?
Endoscopy. Endoscopy. An endoscopy procedure involves inserting a long, flexible tube (endoscope) down your throat and into your esophagus. A tiny camera on the end of the endoscope lets your doctor examine your esophagus, stomach and the beginning of your small intestine (duodenum). Your doctor might be able to diagnose GERD based on ...
How to stop a swollen stomach from eating?
Eat food slowly and chew thoroughly. Put down your fork after every bite and pick it up again once you have chewed and swallowed that bite. Avoid foods and drinks that trigger reflux. Common triggers include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
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Our caring team of Mayo Clinic experts can help you with your Gastroesophageal reflux disease (GERD)-related health concerns Start Here
What is gastroesophageal reflux disease?
Gastroesophageal reflux disease (GERD) is a chronic gastrointestinal disorder characterized by the regurgitation of gastric contents into the esophagus. It is one of the most commonly diagnosed digestive disorders in the US with a prevalence of 20%, resulting in a significant economic burden in direct and indirect costs and adversely affects the quality of life[1][2]. GERD is caused by multiple different mechanisms that can be intrinsic, structural, or both, leading to the disruption of the esophagogastric junction barrier resulting in exposure of the esophagus to acidic gastric contents. Clinically, GERD typically manifests with symptoms of heartburn and regurgitation. It can also present in an atypical fashion with extra-esophageal symptoms such as chest pain, dental erosions, chronic cough, laryngitis, or asthma[3][4]. Based on endoscopic and histopathologic appearance, GERD is classified into three different phenotypes: non-erosive reflux disease (NERD), erosive esophagitis (EE), and Barrett esophagus (BE)[5]. NERD is the most prevalent phenotype seen in 60-70% of patients followed by erosive esophagitis and BE seen in 30% and 6-12% of patients with GERD, respectively. [1][5][6]. Over the years, the mainstay in the management of GERD has been lifestyle modifications, and proton pump inhibitors (PPIs). However, medically refractory GERD is becoming increasingly common, requiring a tailored approach in the management of GERD.
How to treat GERD?
Individuals should also be counseled about avoiding meals at least 3 hours before bedtime and maintaining good sleep hygiene as it has been shown that minimal disturbances in sleep are associated with suppression of TLESRs, resulting in decreased reflux episodes[27][33]. Studies have also shown improvement in GERD symptoms and pH monitoring studies with the elevation of the head end of the bed. Diet modification with the elimination of chocolate, caffeine, and spicy foods, citrus, and carbonated beverages in GERD is controversial and is not routinely recommended as per current ACG guidelines[29].
What is the esophageal mucosa?
The esophageal mucosa comprises various structural and functional constituents that function as a protective defense barrier against the luminal substances encountered with GERD [18]. This defensive barrier can be breached by prolonged exposure to the refluxate, which consists of both acidic gastric contents (hydrochloric acid and pepsin) and alkaline duodenal contents (bile salts and pancreatic enzymes) leading to mucosal damage. The influence of gastroparesis on GERD is unknown. It is believed that delayed gastric emptying contributes to GERD symptoms due to gastric distention and increased exposure to the gastric refluxate[18].
What is the function of the esophageal squamous epithelium?
The esophageal squamous epithelium serves to function as a protective defense barrier against the retrograde migration of refluxate. Disruption of this epithelial defense is a common phenomenon in GERD and NERD [25]. The histopathological features of GERD are not unique to this condition due to minimal biopsy criteria for diagnosis and varying sensitivity and specificity in the diagnosis[26].In fact, the histopathologic diagnosis of GERD is made based on an array of microscopic findings that include features of inflammation, basal cell hyperplasia, papilla elongation, and dilatation of intercellular spaces[26].
What is the prevalence of GERD?
A systematic review by El-Serag et al. estimated the prevalence of GERD in the US between 18.1% to 27.8%. However, the true prevalence of this disorder could be higher because more individuals have access to over-the-counter acid, reducing medications[2][13][2]. The prevalence of GERD is slightly higher in men compared to women[14]. A large meta-analysis study by Eusebi et al. estimated the pooled prevalence of GERD symptoms to be marginally higher in women compared with men (16.7% (95% CI 14.9% to 18.6%) vs. 15.4% (95% CI 13.5% to 17.4%)[12]. Women presenting with GERD symptoms are more likely to have NERD than men who are more likely to have erosive esophagitis[15]. However, men with longstanding symptoms of GERD have a higher incidence of Barrett's esophagus (23%) compared to women (14%)[16].
What are the symptoms of GERD?
The typical clinical presentation of GERD is heartburn and regurgitation. However, GERD can also present with various other symptoms that include dysphagia, odynophagia, belching, epigastric pain, and nausea [27]. Heartburn is defined as a retrosternal burning sensation or discomfort that may radiate into the neck and typically occurs after the ingestion of meals or when in a reclined position[28]. Regurgitation is a retrograde migration of acidic gastric contents into the mouth or hypopharynx[28]. GERD presentation is considered to be atypical when patients present with extraesophageal symptoms such as chest pain, chronic cough, asthma, laryngitis, dental erosions, dysphonia, and hoarseness, and globus sensation[3][4].
Is GERD multifactorial?
The pathophysiology of GERD is multifactorial and is best explained by various mechanisms involved, including the influence of the tone of the lower esophageal sphincter, the presence of a hiatal hernia, esophageal mucosal defense against the refluxate and esophageal motility.