Gastro-esophageal reflux disease or acid-reflux disease (GERD) is a condition in which the contents of the stomach reflux backwards into the esophagus (food pipe). Since the stomach contents are acidic in nature, this damages the inner lining of the food pipe and causes symptoms of heartburn, pain, etc.
Some amount of reflux of stomach contents is normal in all individuals but not everyone develops GERD. The main reason behind this is that only in some individuals this refluxed fluid is more acidic and remains in the esophagus for longer duration thus causing GERD. Dietary causes and certain faulty habits are frequently responsible for initiating this condition in individuals who are prone to develop it.
At the junction of the food pipe (esophagus) and the stomach is a muscular gateway (called lower esophageal sphincter or LES). Under normal circumstances, this sphincter remains contracted so that no contents of the stomach can go back into the esophagus but when this sphincter becomes relaxed due to any reason or is weak, it may allow the contents of the stomach to flow back into the esophagus causing inflammation of the lining of the oesophagus. There can also be many other causes of GERD which will be discussed in details later.
There are multiple causes responsible for initiating GERD, and different causes may be functioning in different individuals or even in the same individual at different times. The commonest causes responsible for GERD have been listed below:
-> Abnormally weak contractions of the sphincter
-> Abnormal relaxations of the sphincter
Both of the above contribute to increases chances of backflow of the stomach contents into the esophagus.
A condition in which there is protrusion of the stomach up into the opening normally occupied by the esophagus in the diaphragm [the muscle that separates the chest (thoracic) cavity from the abdomen.
Co-ordinated esophageal contractions cause the forward movement of food from the esophagus into the stomach. When the wave of contraction is defective, the refluxed acid is not pushed back into the stomach and it can cause damage to the lining of the esophagus.
When food remains in the stomach for a longer duration, the stomach is distended for longer time and this increases the chances of reflux of the stomach contents.
There are several other contributing factors for GERD which are as follows:
Dietary habits: Fatty and fried foods, chocolates, garlic and onions, drinks with caffeine, acid foods such as citrus fruits and tomatoes, spicy foods, mint flavorings, pungent foods, etc
Habits: Use of alcohol, cigarettes; poor posture (slouching) especially after meals
Drugs: Calcium channel blockers, antihistamines, theophylline, nitrates,
Eating habits: Large meals, eating soon before sleeping
Other contributory conditions: Obesity, pregnancy, diabetes, rapid weight gain, etc.
Stress: Though this has not been directly linked to GERD, most patients report an increase in their symptoms during stressful times.
Uncomplicated GERD presents with the following symptoms commonly: