Gastroesophageal reflux disease (gerd)

[Marquetta]

In gastroesophageal reflux disease, stomach contents, including acid and bile, flow backward from the stomach into the esophagus, causing inflammation in the esophagus and pain in the bottom of the chest.

Reflux occurs when the ring-shaped muscle that normally prevents the contents of the stomach from flowing back into the esophagus (called the lower esophageal sphincter) does not function properly.
The most typical symptom is heartburn (a burning pain behind the breastbone).
The diagnosis is based on symptoms and sometimes esophageal pH testing.
The first treatment is avoiding trigger substances (such as alcohol and fatty foods) and taking drugs that reduce stomach acid, but, if these methods fail, doctors sometimes do surgery.

The esophagus is the hollow tube that leads from the throat (pharynx) to the stomach. The lower esophageal sphincter is the ring of muscle that holds the bottom of the esophagus closed so that food and stomach acid do not flow back up the esophagus. When people swallow, this sphincter normally relaxes to allow food into the stomach. (See also Overview of the Esophagus.)
Gastroesophageal reflux disease (GERD) is common. It occurs in 10 to 20% of adults. It also occurs frequently in infants, sometimes beginning at birth (see Gastroesophageal Reflux in Children).
The stomach lining protects the stomach from the effects of its own acid. Because the esophagus lacks a similar protective lining, stomach acid and bile that flow backward (reflux) into the esophagus may cause symptoms and in some cases damage.
Acid and bile reflux into the esophagus when the lower esophageal sphincter is not functioning properly. When a person is standing or sitting, gravity helps prevent the reflux of stomach contents into the esophagus, which explains why reflux can worsen when a person is lying down. Reflux is also more likely to occur soon after meals, when the volume and acidity of contents in the stomach are higher and the sphincter is less likely to work properly. Factors contributing to reflux include

Weight gain
Fatty foods
Caffeinated and carbonated beverages
Alcohol
Tobacco smoking
Certain drugs

Types of drugs that interfere with lower esophageal sphincter function include those that have anticholinergic effects (such as many antihistamines and some antidepressants), calcium channel blockers, progesterone , and nitrates. Delayed emptying of the stomach (for example, due to diabetes or use of opioids) can also worsen reflux.