Gastroesophageal reflux disease (GERD) is diagnosed when acid reflux occurs more than twice a week.
Acid reflux is when some of the acid content of the stomach flows up into the esophagus, into the gullet, which moves food down from the mouth. Despite the name, heartburn has nothing to do with the heart.
The stomach contains hydrochloric acid, a strong acid that helps break down food and protect against pathogens such as bacteria.
The lining of the stomach is specially adapted to protect it from the powerful acid, but the esophagus is not protected.
A ring of muscle, the gastroesophageal sphincter normally acts as a valve that lets food into the stomach but not back up into the esophagus. When this valve fails, and stomach contents are regurgitated into the esophagus, the symptoms of acid reflux are felt, such as heartburn.
GERD affects people of all ages, sometimes for unknown reasons. Often, it is due to a lifestyle factor, but it can also be due to causes that cannot always be prevented.
One cause that is not preventable is a hiatal (or hiatus) hernia. A hole in the diaphragm allows the upper part of the stomach to enter the chest cavity, sometimes leading to GERD.
Risk factors that are more easily controlled:
- obesity
- smoking (active or passive)
- low levels of physical exercise
- medications, including drugs for asthma,calcium-channel blockers, antihistamines, painkillers, sedatives, and antidepressants.
Pregnancy can also cause acid reflux due to extra pressure being placed on the internal organs.
Food and dietary habits that have been linked to acid reflux include:
- caffeine
- alcohol
- a high intake of table salt
- a diet low in dietary fiber
- eating large meals
- lying down within 2 to 3 hours of eating a meal
- consuming chocolate, carbonated drinks, and acidic juices
Symptoms
Acid reflux usually produces heartburn, whether it is due to a single episode of overeating or persistent GERD.
Heartburn is an uncomfortable burning sensation that occurs in the esophagus and is felt behind the breastbone area. It tends to get worse when lying down or bending over. It can last for several hours and often worsens after eating food.
The pain of heartburn may move up toward the neck and throat. Stomach fluid can reach the back of the throat in some cases, producing a bitter or sour taste.
If heartburn occurs two or more times a week, it is known as GERD for short.
