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Gastroesophageal Reflux Disease (GERD; or GORD when spelling oesophageal, the Barrett's esophagus,BE, form) is defined as chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus.
GERD is commonly due to transient or permanent changes in the barrier between the esophagus and the stomach. This can be due to incompetence of the lower esophageal sphincter (LES), transient LES relaxation, or association with a hiatal hernia.
Having GERD indicates a problem with the lower esophageal sphincter. Increased acidity or production of gastric acid can contribute to the problem, as can obesity, tight-fitting clothes and pregnancy. It is also thought that yeast infections of the digestive tract can cause GERD-like symptoms.
HypochlorhydriaAnother paradoxical cause of GERD-like symptoms is not enough stomach acid (hypochlorhydria). The valve that empties the stomach into the intestines is triggered by acidity. If there is not enough acid, this valve does not open and the stomach contents is churned up into the esophagus. There is still enough acidity to cause irritation to the esophagus.
Factors that can contribute to GERD are:- Hiatus hernia, which increases the likelihood of GERD due to mechanical and motility factors
- Zollinger-Ellison syndrome, which can be present with increased gastric acidity due to gastrin production
- Hypercalcemia, which can increase gastrin production, leading to increased acidity
- Scleroderma and systemic sclerosis, which can feature esophageal dysmotility
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