Gastroesophageal Reflux Disease – Symptoms and Causes
Overview
Gastroesophageal reflux disease (GERD) happens when stomach acid regularly backs up into the esophagus, the tube connecting the mouth to the stomach. This backward flow, called acid reflux, can irritate the esophagus lining over time.
While occasional acid reflux is common, GERD develops when this happens regularly. The persistent nature of GERD distinguishes it from occasional reflux experiences.
Most people manage GERD effectively through lifestyle adjustments, medication therapy, and dietary changes. Surgery remains an option but is typically reserved for severe cases that don’t respond to other treatments.
With proper management, most people with GERD can control their symptoms and prevent complications.
Signs and Symptoms
Common signs of acid reflux include a burning feeling in your chest after meals, especially when lying down at night. You might also taste food or sour liquid coming back up into your throat.
Some people feel pain in their upper belly or chest, have trouble swallowing, or feel like there is something stuck in their throat.
Nighttime acid reflux can cause other problems too, such as constant coughing, voice box irritation, and worsening asthma symptoms.
When to Call a Doctor
Get emergency help right away if you have chest pain with shortness of breath, or pain in your jaw or arm. These might be signs of a heart attack, not acid reflux.
Make an appointment with your healthcare provider if you:
- Have bad or frequent acid reflux symptoms
- Use over-the-counter heartburn medicine more than twice a week
What Causes GERD
GERD happens when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backflow occurs due to problems with a muscle ring called the lower esophageal sphincter.
When working properly, this sphincter opens to let food pass into your stomach, then closes tightly. If this muscle weakens or doesn’t relax normally, acid can leak upward. The constant exposure to stomach acid irritates the esophagus lining.
Over time, this irritation leads to inflammation of the esophageal tissue. Many people experience occasional acid reflux, but GERD develops when this happens regularly, typically multiple times per week.
Risk Factors
Several conditions can raise your risk of developing GERD, including:
- Obesity
- Hiatal Hernia (when part of your stomach pushes up through your diaphragm)
- Pregnancy
- Connective Tissue Disorders (scleroderma)
- Slow Stomach Emptying
Certain habits can worsen acid reflux symptoms, including smoking, overeating, consuming fatty or fried foods, drinking alcohol, and taking medications such as aspirin.
These factors either increase pressure on your stomach or weaken the lower esophageal sphincter, allowing stomach acid to flow backward into your esophagus.
Possible Health Problems
When stomach acid repeatedly flows back into the esophagus, it can lead to several health issues over time. These problems develop due to ongoing irritation and damage to the esophagus.
Esophagitis
Stomach acid can damage the lining of the esophagus, causing inflammation known as esophagitis. This condition may cause painful swallowing, difficulty eating, bleeding in severe cases, and ulcers (open sores) in the esophagus.
The damaged tissue becomes red, swollen, and tender. Many people describe a burning pain that worsens after meals.
Esophageal Stricture
Long-term acid damage can lead to scar tissue forming in the esophagus. This scarring causes the food pathway to narrow, creating what doctors call an esophageal stricture.
People with this condition frequently feel like food is stuck in their throat, experience pain while eating certain foods, have a sensation of something lodged in their throat, and may lose weight unintentionally due to difficulty eating.
A stricture can make eating uncomfortable and sometimes painful. Even drinking liquids may become difficult in severe cases.
Barrett’s Esophagus
Perhaps the most serious potential complication is Barrett’s esophagus. This condition occurs when acid damage causes changes in the cells lining the lower esophagus.
The normal tissue changes to a different type that is more resistant to acid, but brings other risks.
This change is worrying as it indicates chronic acid damage, raises the risk of esophageal cancer, and necessitates regular monitoring by healthcare providers.
Most people with Barrett’s esophagus never develop cancer, but the risk is higher than in the general population.
