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Causes

By Mayo Clinic staff

CLICK TO ENLARGE

Illustration showing how GERD occurs in the esophagus How heartburn and GERD occur

Heartburn occurs when stomach acid backs up into your esophagus.

Normally when you swallow, your 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 the lower esophageal sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus, causing heartburn. The acid backup may be worse when you're bent over or lying down.

Risk factors Symptoms
References
  1. Ferri FF. Gastroesophageal reflux disease. In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05610-6..00016-0--sc0030&isbn=978-0-323-05610-6&type=bookPage&sectionEid=4-u1.0-B978-0-323-05610-6..00016-0--sc0030&uniqId=239147718-3. Accessed April 13, 2011.
  2. Kahrilas PJ. Clinical manifestations and diagnosis of gastroesophageal reflux in adults. http://www.uptodate.com/home/index.html. Accessed April 13, 2011.
  3. Kahrilas PJ. Medical management of gastroesophageal reflux disease in adults. http://www.uptodate.com/home/index.html. Accessed April 13, 2011.
  4. Michelfelder AJ, et al. Integrative medicine and gastrointestinal disease. Primary Care: Clinics in Office Practice. 2010;37:255.
  5. Kiefer D. Gastroesophageal reflux disease. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4160-2954-0..50046-6&isbn=978-1-4160-2954-0&type=bookPage&sectionEid=4-u1.0-B978-1-4160-2954-0..50046-6&uniqId=239147718-7. Accessed April 13, 2011.
  6. Achem SR. Noncardiac chest pain - Treatment approaches. Gastroenterology Clinics of North America. 2008;37:859.
  7. Understanding heartburn and reflux disease. American Gastroenterological Association. http://www.gastro.org/patient-center/digestive-conditions/heartburn-gerd. Accessed April 13, 2011.
  8. Kahrilas PJ, et al. American Gastroenterological Association medical position statement on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135:1383.
  9. Fennerty MB, et al. Short- and long-term management of heartburn and other acid-related disorders: Development of an algorithm for primary care providers. The Journal of Family Practice. 2009;58:S1.
  10. Weight management. U. S. Department of Agriculture. http://www.nutrition.gov/nal_display/index.php?info_center=11&tax_level=3&tax_subject=390&topic_id=1741&level3_id=6295&level4_id=0&level5_id=0&placement_default=0. Accessed April 13, 2011.
  11. Picco MF (expert opinion). Mayo Clinic, Rochester, Minn. April 24, 2011.
DS00095 May 21, 2011

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