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Conditions InDepth: Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a digestive disorder. It is the frequent incidence of acid reflux stomach, acid or other contents back up from the stomach into the esophagus. The esophagus is a tube that runs from the back of the mouth to the stomach. The reflux irritates the esophagus and over time, can cause permanent damage.

Heartburn, a burning feeling behind the breastbone, is the most common symptom of GERD. However, occasional or one time heartburn does not mean you have heartburn. GERD is the frequent occurrence of these symptoms, more than twice per week over several weeks. GERD will also have evidence of damage from the acid reflux.

Gastroesophageal Reflux

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Causes

The esophagus and stomach are designed to keep food flowing downward. A ring of muscle at the end of the esophagus, called the lower esophageal sphincter (LES), helps keep food in the stomach. The LES relaxes to let food pass into the stomach then closes shut to help keep contents in the stomach. Sometimes the LES does not close properly or relaxes at the wrong time. The stomach contracts and squeezes to help digest food and move it into the intestines. When the LES does not close properly the movement of the stomach can push stomach acid and other contents can leak back into the esophagus. The acid and contents can also move into the esophagus if you are lying down or bending over.

The stomach acid irritates the esophagus. For some the irritation may contribute to breathing difficulties such as wheezing, congestion, or damage to the voice. Over time, the acid wears away the lining of the esophagus and can lead to complications such as bleeding, narrowing, or inflammation of the esophagus. The damage may also increase the risk of developing Barrett’s esophagus.

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References:

Definition and facts for gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
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Accessed February 26, 2015.
Gastroesophageal reflux disease (GERD). EBSCO DynaMed website. Available at:
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Updated February 19, 2015. Accessed February 26, 2015.
Gastroesophageal reflux disease (GERD). The Merck Manual Professional Edition. Available at:
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Updated May 2014. Accessed February 26, 2015.
Katz PO, Gerson LB, et al. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):302-328.
Mitre MC, Katzka DA. Pathophysiology of GERD: Lower esophageal sphincter defects. GERD in the 21st Century, Series 5. Practical Gastro website. Available at:
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Published May 2004. Accessed February 26, 2015.
Understanding heartburn and reflux disease. American Gastroenterological Association website. Available at:
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Accessed February 26, 2015.
Last reviewed March 2014 by Daus Mahnke, MD
Last Updated: 2/26/2015

 

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