Gastroesophageal Reflux: Causes, Symptoms, and Treatment

What is Gastroesophageal Reflux?

Gastroesophageal reflux (GERD) is a condition where stomach acid or bile irritates the lining of the esophagus, causing acid reflux. This happens when the lower esophageal sphincter (LES), a muscle that acts as a valve between the esophagus and the stomach, relaxes abnormally or weakens, allowing stomach contents to flow back up into the esophagus. GERD can lead to discomfort, chest pain, difficulty swallowing, and other symptoms, and if left untreated, it can cause complications such as esophagitis, ulcers, or even esophageal cancer.

Causes of Gastroesophageal Reflux

• Weak Lower Esophageal Sphincter (LES). The most common cause of GERD is a weakened LES, which allows stomach acid to flow back into the esophagus.
• Hiatal Hernia. This occurs when a portion of the stomach pushes up through the diaphragm into the chest cavity, which can contribute to acid reflux.
• Obesity. Being overweight can put increased pressure on the stomach, forcing stomach acid into the esophagus.
• Pregnancy. Hormonal changes during pregnancy can relax the LES, and the growing uterus can put pressure on the stomach, increasing the risk of acid reflux.
• Certain Medications. Some medications, such as antihistamines, calcium channel blockers, and sedatives, can relax the LES and trigger acid reflux.
• Smoking. Smoking can weaken the LES and impair the ability of the esophagus to clear acid from the stomach.

Symptoms

• Heartburn. A burning sensation in the chest, usually after eating, is the most common symptom of GERD.
• Regurgitation. The sensation of acid or food coming back up into the throat or mouth, often accompanied by a sour or bitter taste.
• Difficulty Swallowing. GERD can cause a feeling of a lump in the throat or difficulty swallowing, also known as dysphagia.
• Chest Pain. Some individuals with GERD may experience chest pain, which can be mistaken for a heart attack.
• Coughing and Hoarseness. Persistent coughing, especially at night, and a hoarse voice can occur as a result of acid irritation of the throat and vocal cords.

Treatment Methods

• Medications. Proton pump inhibitors (PPIs), H2-receptor antagonists, antacids, and prokinetic agents can help reduce stomach acid production and improve the functioning of the LES.
• Lifestyle Changes. Avoiding large meals, lying down after eating, and reducing intake of trigger foods (such as spicy, fatty, or acidic foods) can help alleviate symptoms.
• Weight Management. Losing weight can reduce the pressure on the stomach and prevent acid reflux in individuals who are overweight.
• Elevating the Head of the Bed. Raising the head of the bed by a few inches can help prevent acid from flowing back into the esophagus while sleeping.
• Surgery. In severe cases, when lifestyle changes and medications do not provide relief, surgical interventions such as fundoplication (wrapping the top of the stomach around the LES) may be considered.