Acid Reflux

What is Acid Reflux? Acid Reflux is a common condition characterized by the upward flow of acidic gastric contents into the esophagus. When acid reflux is chronic and causes symptoms, it is diagnosed as gastroesophageal reflux disease (GERD). Over 20% of the adult population in high-income countries is affected by GERD.

What Causes Acid Reflux?

The abnormal upward flow direction of gastric content is primarily caused by a dysfunction of the lower esophageal sphincter (LES). Normal physiology of the LES includes transient lower esophageal sphincter relaxations (TLESR), where the muscle of the LES relaxes even when there is no swallowing. However, an increased number of postprandial relaxations exacerbates the risk of acid reflux.

There are several risk factors associated with acid reflux and the development of GERD:

  • Obesity
  • Older age
  • History of smoking
  • Excessive alcohol use
  • Genetics
  • Anxiety/depression
  • Sedentary lifestyle
  • Low socioeconomic status
  • Eating habits, such as type of food, quantity, and timing
  • Connective tissue disorders
  • Pregnancy
  • Lowered LES
  • Hiatal hernia
  • Delayed gastric emptying 

Signs and Symptoms of GERD

  • Heartburn
  • Regurgitation
  • Epigastric pain
  • Dysphagia
  • Chronic sore throat or cough
  • Changes in voice
  • Nausea
  • Dental erosion
  • Globus sensation
  • Asthma exacerbation

Untreated GERD can lead to further complications, such as Barrett esophagus, erosive esophagitis, esophageal strictures, and esophageal adenocarcinoma. 

Source: Maret-Ouda, J., Markar, S. R., & Lagergren, J. (2020). Gastroesophageal Reflux Disease. JAMA, 324(24), 2536.