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Conditions InDepth: Gastroesophageal Reflux Disease (GERD)/Heartburn

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

The occasional back up of fluids is common and often called acid reflux or 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

A ring of muscle called the lower esophageal sphincter (LES) manages the flow of food from the esophagus to 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 inappropriate moments. This allows stomach acid and other contents to frequently pass back into the esophagus.

The stomach acid irritates the esophagus. It may contribute to breathing difficulties such as wheezing or congestion and damage to the voice. Overtime this irritation 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