What causes GERD?

When you eat or drink something, the food will pass from your mouth, into your esophagus and then into your stomach.

Figure 1: The esophagus

There is a valve mechanism at the top of your stomach called the lower esophageal sphincter (LES) (figure 2), which normally opens and closes to let food into the stomach (figure 3). It also stops the acid in the stomach from moving back into the esophagus. In people with GERD, the LES does not work properly and acid is allowed to pass up into the esophagus. This is also known as acid reflux (figure 4).

Figure 2: the lower esophageal sphincter (LES)

Figure 3: LES opens and closes to let food into the stomach

Figure 4: Acid reflux

If you suffer from GERD, you may find that certain things make the acid reflux worse. These include:

• Food
  • Certain foods or drinks, including alcohol, fruit juices, highly
    spiced foods, onions, peppermint, pepperfruits, coffee and chocolate
  • Large meals
  • Fatty foods
  • Eating too close to bedtime.
• Smoking
• Pregnancy
• Medical conditions
  • If the valve mechanism in the LES does not work properly.
  • If the stomach produces too much acid, it will be more likely that acid may leak into the esophagus.
  • Patients with hiatal hernias have an increased risk of suffering from acid reflux. An hiatal hernia is where a small part of the stomach sticks out above the diaphragm into the chest.
  • People who are obese are more likely to suffer from acid reflux.
• Some medicines can affect the LES so that it does not work properly. These include aspirin, oral contraceptives, tetracycline and iron supplements.
• Wearing tight clothes around the stomach may make acid reflux worse.
• Exercise or bending may bring on acid reflux
  

This quick guide is supported by Astrazeneca