Gastroesophageal reflux disease (GERD) is a condition in which the esophagus becomes irritated or inflamed due to reverse flow of acid from the stomach. The esophagus is the tube starting from throat and extending up to the stomach. The food carried through esophagus to the stomach. The stomach secretes hydrochloric acid after a meal to help in the digestion of food. The inner lining of the stomach protects corrosion by this acid with the help of protective mucus secretion. This protective function is absent in esophagus. As a result acid coming in to contact with esophagus can damage it. As the esophagus lies just behind the heart, sometimes the sensation of acid burning in the esophagus is also know as heartburn. Normally, the reflux or reverse flow of acid to esophagus is prevented by a ring of muscle at the bottom of the esophagus, called the lower esophageal sphincter. This sphincter relaxes during swallowing to allow food to pass. It then closes or contracts to prevent flow in the opposite direction. In case of GERD, this sphincter relaxes while the food is being swallowed, which allows stomach contents and corrosive acid to revert back to esophagus and cause damage to the lining of the esophagus. GERD can affect any age group from infants and children to adults. No one knows the exact cause of gastroesophageal reflux. The following are several contributing factors that weaken or relax the lower esophageal sphincter, making reflux worse:

• Lifestyle: alcohol, cigarettes, obesity, constant lying posture


• Medications - Calcium channel blockers, theophylline, nitrates, antihistamines


• Diet - Fatty and fried foods, chocolate, garlic and onions, drinks with caffeine, acid foods such as citrus fruits and tomatoes, spicy foods, mint flavorings


• Eating habits - Eating large meals, eating soon before bedtime


• Other medical conditions - Hiatal hernia, pregnancy, diabetes, rapid weight gain

GERD - gastroesophageal reflux disease - is more than just chronic heartburn. The irritation of esophagus caused by stomach acid can lead to complications such as narrowing of the esophagus, ulcers and even a slightly increased risk of esophageal cancer. Most people can manage the discomfort of heartburn with lifestyle modifications and over-the-counter medications.

Common signs and symptoms of GERD include:

• Heartburn


• Chest pain, especially at night while lying down


• Bloating


• Difficulty swallowing


• Coughing, wheezing, asthma, hoarseness or sore throat


• Regurgitation of food or sour liquid

When you swallow, the lower esophageal sphincter - a circular band of muscle around the bottom part of your esophagus - relaxes to allow food and liquid to flow down into your stomach. Then it closes again. However, if this valve relaxes abnormally or weakens, stomach acid can flow back up into your esophagus, causing frequent heartburn and disrupting your daily life. The acid backup is worse when you bend over or lie down. This constant backwash of acid can irritate the lining of your esophagus, causing it to become inflamed. Over time, the inflammation can erode the esophagus, producing bleeding, or narrow the esophagus, causing difficulty swallowing or even breathing problems. When there's evidence of esophageal irritation or inflammation, you have GERD. However, many people with GERD will have a normal-appearing esophagus despite symptoms. GERD may be related to other conditions such as hiatal hernia. In this condition, also called diaphragmatic hernia, part of your stomach protrudes into your lower chest. If the protrusion is large, a hiatal hernia can worsen heartburn by further weakening the lower esophageal sphincter muscle.

Some factors that can make GERD worse include:

• Certain foods, such as fatty foods, spicy foods, chocolate, caffeine, onions, tomato sauce, carbonated beverages and mint


• Alcohol


• Large meals


• Lying down soon after eating


• Certain medications, including sedatives, tranquilizers and calcium channel blockers for high blood pressure


• Cigarette smoking

Conditions that cause difficulty with digestion can increase the risk of GERD. These include:

• Obesity


• Hiatal hernia


• Pregnancy


• Asthma


• Diabetes


• Peptic ulcer


• Delayed stomach emptying


• Zollinger-Ellison syndrome

In addition to irritation and inflammation of the esophagus, chronic reflux of stomach acid into the esophagus can lead to one or more of the following conditions if left untreated:

• Esophageal narrowing (stricture)


• Esophageal ulcer


• Barrett's esophagus

You may eliminate or reduce the frequency of heartburn by making the following lifestyle changes:

• Control your weight


• Eat smaller meals


• Loosen your belt


• Eliminate heartburn triggers


• Avoid stooping or bending


• Don't lie down after a meal


• Raise the head of your bed


• Don't smoke