What Causes GERD?

GERD usually arises from the opening of your lower esophageal sphincter, which permits stomach acid to pass into your oesophagus. This could be brought on by or caused by specific diseases, drugs, or lifestyle choices.

A common ailment known as gastroesophageal reflux disease (GERD) causes stomach contents to reflux back into the oesophagus. Heartburn and the taste of food or stomach acid in your mouth can result from this.

GERD is common, but it can also lead to serious issues that could affect your health in the long run. Some suffer from dental decay, esophageal malignancy, or difficulty swallowing.

Knowing the causes of GERD might help you manage and avoid the illness. Certain GERD risk factors are unavoidable, but you may be able to lower your risk of getting the disease by changing your way of living.

How does GERD develop?

A muscle called the lower esophageal sphincter (LES) aids in preventing stomach contents from refluxing back into your esophageal tract. Where your stomach and oesophagus converge is where the LES is situated. To prevent stomach contents from escaping, the LES should first relax to allow food to travel into your stomach before closing tightly.

When the LES isn't shutting properly, GERD frequently follows. It either relaxes when it shouldn't or is feeble.

The LES can be impacted by several factors, such as smoking, pregnancy, or obesity. Some medical disorders, such as hiatal hernias or certain drugs, can worsen or increase your chance of developing GERD.

Hiatal hernia

When the top portion of your stomach bursts through the diaphragm, which is positioned above it, you have a hiatal hernia. The LES may weaken as a result of this.

Rarely does a hiatal hernia produce symptoms. But the most typical symptom when it happens is gastric reflux.

Increased pressure around the abdominal muscles, such as that experienced during pregnancy, heavy lifting, or prolonged coughing, is frequently the cause of hiatal hernias. An endoscopy or barium swallow can be used by a physician to check for a hiatal hernia.

Pregnancy

GERD is a common condition in pregnancy. As the pregnancy goes on, the hormones progesterone and oestrogen rise, which lowers LES pressure. Food may take longer to move through the digestive system as the uterus grows larger because it puts additional strain on the organs in general.

Pregnant women who experience acid reflux are between 30 and 50 percent of the population; the intensity of the reflux increases as the pregnancy goes on.

Obesity

Studies show that obesity increases the risk of GERD. A big international study found that the risk of developing GERD was 35% higher in obese individuals than in non-obesity individuals. They also had a higher risk of developing GERD-related problems.

GERD can be exacerbated by obesity in the following ways:

• elevated stomach pressure
• food's delayed passage via the oesophagus
• increased esophageal acid exposure
• increased frequency of LES issues

Smoking

Another risk factor for GERD is tobacco use. The LES pressure can be lowered by smoking, which can lead to the reflux of stomach contents into the oesophagus.

Saliva that is low in bicarbonate can also result from smoking. Saliva has a vital role in removing acid from the oesophagus. Thus, smoking can aggravate GERD symptoms by blocking the excretion of acid.

By causing the LES to relax, cannabis use may also exacerbate GERD. Despite the conflicting evidence supporting the link, experts continue to recommend that physicians rule out cannabis usage as a possible cause of GERD symptoms.

Medications

Additionally, several drugs may exacerbate the symptoms of GERD or even create it. This could be due to a drug that shortens the time it takes for food to pass through the oesophagus, irritates the lining of the oesophagus, or lowers LES pressure.

Some examples of drugs that might either trigger or exacerbate GERD are:

• nonsteroidal anti-inflammatory drugs (NSAIDs)
• calcium channel blockers
• some asthma medications
• opioids
• benzodiazepines
• tricyclic antidepressants
• oral contraceptives
• GLP-1 agonists such as tirzepatide (Mounjaro) and semaglutide (Ozempic)

You should probably discuss your risk of GERD with a doctor if you take any drugs. A physician may suggest other medications or strategies for managing gastroesophageal reflux disease.

Foods that cause acid reflux

Everybody has different meals that set them off for GERD. You may want to keep a diet journal to identify the items that aggravate your symptoms so that you can control them. You may also decide to stay away from specific foods that are linked to acid reflux, like:

• spicy food
• citrus fruits (oranges, lemons)
• chocolate
• mint
• caffeine
• tomatoes
• onions
• garlic
• alcohol
• carbonated beverages (soda, sparkling water)

Because gravity is not working to keep your stomach acid in check when you lie down for three hours after eating, this might also aggravate acid reflux.

When to contact a doctor

A doctor may be able to assist you if you have GERD symptoms or are at risk for developing the disease. They could be able to:

• assist you in a smoking cessation programme
• suggest methods for addressing obesity
• suggest substitute prescription drugs
• provide advice on GERD management throughout pregnancy.

If you have a hiatal hernia, your doctor may suggest surgery. This is contingent upon the degree of the hernia, your symptoms, and how it impacts your digestive system.

Takeaway

LES malfunction is one of the primary causes of GERD. The muscle known as the lower esophageal sphincter (LES) keeps stomach contents out of your oesophagus. GERD can occur if your LES is weak or relaxes when it shouldn't.

Pregnancy, smoking, obesity, hiatal hernias, and some medications can all raise the risk of GERD.

Consider eliminating frequent acid reflux triggers foods, such as spicy foods, citrus fruits, and fizzy drinks, to help lessen symptoms. Reducing the frequency of acid reflux at night or GERD symptoms can also be achieved by avoiding lying down for three hours after eating.