GERD usually occurs when there is a problem with the sphincter between the esophagus and the stomach. When this happens, acidic stomach juices can flow back up into the esophagus more frequently than normal, leading to symptoms like heartburn. Risk factors include pregnancy, alcohol, and stress. Over time, GERD can lead to bleeding, ulcers, or scarring of the esophagus.
Many people accept the discomfort of heartburn as a normal part of life. However, heartburn can significantly interfere with your life; it may also be a symptom of more serious health problems.
If you have heartburn two or more times a week, or if you can't find relief with over-the-counter medications, you may have a condition called gastroesophageal reflux disease. This is also known as acid reflux disease or GERD.
If you or your doctor thinks you may have GERD, you probably have a lot of questions. This article can help answer some of these questions by explaining:
- What your stomach does with the food you eat
- What GERD is and how it's diagnosed
- The factors that can increase your risk of developing it or that can make your symptoms worse
- How GERD is treated.
The eMedTV archives also have a number of other articles that go into more detail about each topic discussed.
To better understand GERD, it's important to know what happens in the normal digestive process. As you chew your food and swallow it, particles travel from your mouth to the esophagus. The esophagus is a muscular tube that contracts and relaxes in a wave-like motion to help move food and liquids down toward your stomach. This is called "peristalsis."
Just before the esophagus gets to the stomach, it travels through your diaphragm. The diaphragm is a broad muscle that separates your stomach from your chest cavity. The opening in the diaphragm where the esophagus travels through is called the hiatus.
The esophagus then joins the stomach at the lower esophageal sphincter, also called the LES. This sphincter acts as a doorway between the esophagus and the stomach. After you swallow, it opens to let food into the stomach. Then the sphincter closes to keep food and stomach juices from going back up into the esophagus. The hiatus also helps close off the entryway to the stomach.
Inside your stomach, strong acids and enzymes make up the stomach juices that break down your food. Your stomach has special mechanisms that help protect it from these strong juices.
Your esophagus doesn't have these same defenses, so it's important for the LES to close off the stomach opening to keep the juices in the stomach. Sometimes, the acidic contents of the stomach do go back up, or reflux, into the esophagus. Some reflux is normal. Much of the time, this never causes any problems because the esophagus has some ways to protect itself. For example, the saliva in your esophagus can help neutralize stomach acid, and gravity and peristalsis help to wash the saliva and stomach juices back down into the stomach.
At other times, reflux can cause the burning, pressure, or pain in your chest or throat that most people call heartburn, acid indigestion. or GERD.