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Conditions InDepth: Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a digestive disorder. It is the back-up of acid or other contents from the stomach into the esophagus. The esophagus is a tube that runs from the back of the mouth to the stomach.

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 GERD. GERD symptoms occur more than 2 times per week for several weeks. The reflux irritates the esophagus, which can cause permanent damage over the course of time.

Gastroesophageal Reflux

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Causes

The esophagus and stomach are designed to propel food downward. A ring of muscle, called the lower esophageal sphincter (LES), is at the far end of the esophagus, closest to the stomach. It relaxes to let food pass into the stomach then closes shut to prevent it from backing up. Normally, the stomach contracts and squeezes to help digest food and move it into the intestines. When the LES does not close properly or relaxes at the wrong time, the movement of the stomach can push acid and other contents back into the esophagus, causing heartburn. This can also happen when you are lying down or bending over.

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 like bleeding, stricture, or inflammation of the esophagus. The damage may also increase the risk of developing Barrett’s esophagus, an abnormal change in the cells in the lower part of the esophagus. Barrett's esophagus increases the risk of esophageal cancer.

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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 May 2015 by Daus Mahnke, MD
Last Updated: 5/20/2015

 

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