Causes of GERD (Gastroesophageal Reflux Disease)

Gastroesophageal reflux disease or GERD is a common condition that affects about one in every five people in the U.S. In GERD, acid from the stomach flows backwards often and can irritate the lining of the esophagus.

This can cause bothersome symptoms and, in some cases, complications. Learn why GERD occurs and factors that increase the risk for the condition.

GERD basics

GERD can develop when the lower esophageal sphincter, the muscle that connects the esophagus to the stomach, doesn’t work properly. The muscle opens and closes when swallowing, allowing food to enter the stomach. It stays closed at other times so that food stays in the stomach and out of the esophagus. In acid reflux, the muscle weakens or relaxes when it shouldn’t, causing contents from the stomach to flow backwards up the esophagus. When refluxed stomach acid comes into contact with the lining of the esophagus, it can cause heartburn (a painful, burning sensation in the throat or chest).

It's not uncommon to experience an episode of acid reflux from time to time. GERD is a more severe form of reflux that happens frequently and can damage the lining of the esophagus. In addition to heartburn, other symptoms of GERD include chest pain, nausea, a bad taste in the mouth from stomach acid, trouble or pain when swallowing, and a chronic cough or hoarseness.

Risk factors for GERD

While anyone can develop GERD, certain factors raise the risk for the condition. These include:

• Being pregnant. Hormonal changes during pregnancy can slow down the digestive process and cause the lower esophageal sphincter to relax. Later in pregnancy, the growing baby can push on the stomach and cause stomach contents to come up the esophagus. GERD usually improves after the baby is born.
• Having a hiatal hernia. In this condition, the opening in the diaphragm allows the upper part of the stomach to move into the chest.
• Being overweight or obese. Added weight can cause the lower esophageal sphincter to weaken. A hiatal hernia is also more common in people who are obese.
• Smoking or being exposed to secondhand smoke. Tobacco may relax the lower esophageal sphincter, cause the body to make more stomach acid and stop saliva production. Each of these factors may contribute to reflux.
• Having asthma. Asthma flare-ups may cause the lower esophageal sphincter to relax, and some asthma medications can make GERD symptoms worse.
• Taking certain medications. Benzodiazepines (sedatives), calcium channel blockers (medicines used to treat high blood pressure), certain asthma medicines, nonsteroidal anti-inflammatory drugs (NSAIDs) and tricyclic antidepressants can cause GERD or make symptoms worse.

Contact your health care provider if you have signs of GERD. The condition can be treated with lifestyle changes, medications or procedures. Treatment can help you feel better and reduce your risk of complications.

Published on January 18, 2021

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