GERD

Causes of GERD: Reflux Chemistry and Anatomy

This condition generally stems from two underlying causes, reflux chemistry and anatomical dysfunction.

Chemical causes can include:

• Fluids refluxed from the stomach irritating or damaging the esophagus. 
• General sensitivity of esophageal tissue, often caused by natural low acid intolerance, use of prescription drugs or other drugs, such as alcohol and tobacco. 

Most of the time GERD can be attributed to a patient’s anatomy. When a person with normal, healthy anatomy swallows, the valve between the esophagus and the stomach – called the gastroesophageal valve – opens, allowing food to pass. The valve then closes to prevent stomach contents from backwashing or refluxing back up into the esophagus. A normal valve serves as an effective anti-reflux barrier, and experts consider it the most important factor in preventing GERD.

For people with GERD, this valve becomes dysfunctional and does not close properly, which allows abnormal amounts of acidic and non-acidic fluids to backwash into the esophagus.

What causes the Gastroesophageal Valve to become dysfunctional?

Many factors can impact the gastroesophageal valve and cause acid reflux: 

• Genetic: Some people have valves that function less competently than others.
• Injury to the upper chest: Often the result of a sports-related injury or a traumatic accident, these injuries can cause the valve to lose its shape.
• Obesity or diet related issues: Excess weight can cause distortion of normal anatomy.
• Age: As people age, muscles change and affect the anatomy in the esophagus and stomach area.
  

Is reflux normal or something more serious?

GERD can look and feel different for each patient. Although chronic reflux can include a wide range of symptoms, they can be broadly grouped as typical or atypical depending on their severity.

Mild symptoms may include heartburn and regurgitation on occasion, perhaps after indulging in a heavy meal, greasy or acidic foods. Changes to your diet are sometimes sufficient to alleviate these symptoms and control mild acid reflux. Severe chronic GERD sufferers can experience symptoms several times a week or daily.

Typical symptoms

Contrary to popular belief, you don’t always experience heartburn when you have GERD. Although this is the most common symptom, it is not a guaranteed warning sign of this condition, nor is the absence of heartburn enough to rule it out. People managing GERD will often blame acid reflux for some or all of their symptoms. However, there are other stomach fluids besides acid that can reflux and cause discomfort and damage. In fact, non-acid reflux carries enormous risk to the esophagus.

GERD Symptoms

What happens if you don’t treat GERD?

Chronic, prolonged exposure to reflux may result in inflammation, irritation or swelling of the esophagus. This condition, known as esophagitis, can be accompanied by more concerning complications such as ulcers, hemorrhage or precancerous cellular changes.

While symptoms alone can significantly interfere with one’s quality of life, GERD also is associated with the development of Barrett’s esophagus, a condition that causes a cellular change in the lining of the lower esophagus. In a percentage of patients, it can progress to esophageal cancer, a potentially life-threatening illness. To avoid this and additional potential complications, it is important to take GERD symptoms seriously and seek evaluation and diagnosis from a healthcare professional as soon as possible.

Treatment Options

The severity of GERD varies and different treatment options are available. The most important goals of any GERD treatment are:

• Symptom control
• Prevention of GERD-related complications
• Healing of esophagitis

There are non-surgical treatments, such as lifestyle changes and medications, that can help control GERD. If your symptoms still persist and affect your daily life, surgery may be required. 

Click here to learn more about GERD treatment options.