Conditions We Treat Heartburn & Acid Reflux

Acid Reflux & GERD Causes

The lower esophageal sphincter (LES) is a muscle at the end of the esophagus that is designed to close quickly after food passes through in order to keep stomach acid from traveling into the esophagus. In acid reflux and GERD, this muscle may weaken or relax, allowing acid to flow backward and cause a variety of unpleasant symptoms.

Abdominal pressure can result in a weakened LES, which explains why acid reflux frequently occurs in overweight and pregnant people.

A hiatal hernia could contribute to acid reflux/GERD. This stomach abnormality occurs when part of the stomach and the LES migrate above the diaphragm, which typically separates the stomach and the chest. This condition gives stomach acid an easier path up into the esophagus. However, some people with hiatal hernias do not have reflux issues.

Other factors that may increase the risk of acid reflux/GERD include:

• Lying down after a big meal
• Snacking before bed
• Smoking
• Alcohol usage
• Eating fried or spicy foods
• Certain foods such as chocolate, onion, garlic, tomato, citrus, vinegar, and mint
• Caffeinated drinks and fruit juices
• Medications including anti-depressants, antihistamines, asthma medication, muscle relaxers, pain relievers, and blood pressure medication

Acid reflux can often be diagnosed based on a medical history and a discussion of symptoms and lifestyle habits. If GERD is suspected, a number of tests are available to confirm this and to uncover any complications, including damage to the lining of the esophagus which can lead to esophageal cancer.

A barium swallow (esophagram) can help pinpoint any problem areas in the esophagus, as well as reveal the presence and location of a hiatal hernia or ulcers. This test involves x-rays taken after drinking barium, a chalky liquid dye that makes the stomach and esophagus show up clearly on the x-rays.

An upper endoscopy provides a look inside the esophagus and stomach via a thin, flexible tube with a camera attached that is inserted through the mouth. This quick procedure provides valuable information about the state of a patient’s esophagus. A biopsy may be performed at the same time. If this test reveals an esophageal abnormality, no other tests are usually required to confirm the GERD diagnosis.

Esophageal manometry takes an in-depth look at how the esophagus is functioning. During this test, a tiny tube goes through the nose and into the esophagus. The patient swallows small amounts of liquid as esophageal function is recorded. This test also monitors lower esophageal sphincter (LES) movement.

A valuable test called pH monitoring detects the frequency and duration that stomach acid regurgitates into the esophagus. It takes about 24 hours and involves placement of a small recording device through the nose and into the esophagus. The patient can typically participate in normal activities during this test. pH monitoring may be recommended when patients show GERD symptoms, but other testing methods reveal no esophageal damage.