What Causes GERD?

Gastroesophageal reflux disease, or GERD, causes painful symptoms like heartburn and acid regurgitation. Although there are many theories on the causes of GERD, experts aren't sure exactly what causes it. There are two main categories of risks that can contribute to GERD—those that you can't change, and those that you can.

Uncontrollable Risk Factors

These variables are out of your control. Although you can't do anything to change them, it's important to know that these conditions can lead to GERD.
  • Hiatal hernia. A hiatal hernia describes a condition where the upper part of the stomach, which is usually separated from the esophagus by the diaphragm, is actually above the diaphragm. This allows acid to enter the esophagus easily. Although a person of any age could develop a hiatal hernia, it is more likely to occur in a person over the age of 50.
  • Pregnancy. The same hormones that allow a woman’s hips to widen during pregnancy in preparation for childbirth also lead to the relaxation of the esophageal sphincter, allowing stomach contents to enter back into the esophagus. Also, the increase in size of the uterus during pregnancy creates more pressure on the stomach and may force the stomach acid up into the esophagus.
  • Other medical conditions. Research has shown that a host of medical conditions can potentially lead to GERD, including: gastroparesis (a complication with many causes, including diabetes, in which your stomach takes too long to empty), asthma, scleroderma (a swelling of muscle tissues that prevents the digestive muscles from working properly), Zollinger-Ellison syndrome (a rare condition that results in very high amounts of stomach acid), peptic ulcer, cancer, scoliosis, cystic fibrosis, other gastrointestinal disorders, food allergies, chest trauma, and more.
Although these risk factors are outside of your control, there are many lifestyle habits that you CAN change to help prevent symptoms of GERD.

Controllable Risk Factors

These are behaviors and factors that you can modify to lower your risk of suffering from GERD.
  • Your alcohol use. The lower esophageal sphincter normally prevents stomach contents from entering the esophagus. But alcohol is a depressant. It relaxes the body in many ways, and it also relaxes the lower esophageal sphincter, allowing acid to enter the esophagus. People with GERD should limit or avoid alcohol.
  • Your weight. Excess fat in the abdomen puts increased pressure on the stomach, causing a reflux of stomach acid. Even a small amount of weight loss can help decrease GERD symptoms.
  • Your smoking habits. Smoking decreases the strength of the lower esophageal sphincter, allowing stomach acid reflux. Quitting this habit can benefit your health in many ways, including a reduction in the incidence of GERD.
  • Your diet. Some foods are known to trigger symptoms in people with GERD. Chocolate and spicy foods are just a couple of common culprits. If you are suffering from this disease, consider keeping a heartburn journal to pinpoint your food triggers.
  • Your sleeping habits. When you're upright (standing or sitting), gravity helps hold stomach contents in their place, so allow two to three hours for your food to digest before lying down or sleeping. When you do lie down, try to keep your head and upper body elevated (raise the head of your bed or use extra pillows, for example) to further prevent reflux.
  • Your exercise habits. Exercising too soon after eating can increase your chances of heartburn. Most types of exercise contract your abdominal muscles, increasing the pressure on your stomach and forcing stomach acid back into the esophagus. Wait two to three hours after eating before you begin exercising.
Although GERD can sometimes be just a nuisance, often it can cause serious complications if left unchecked. Inflammation of the esophagus due to the damage caused by stomach acid can lead to bleeding, ulcers, and scarring. In some instances, the damage to the esophagus can be so severe that it leads to cancer. The seriousness of these complications warrants a change in lifestyle to prevent their occurrence.

Because GERD is so common, there are also a host of treatment options if lifestyle changes alone don't help. Work closely with your doctor to create a plan that works for you.