7 Common Causes of Gastroesophageal Reflux Disease

The persistent burning sensation you feel may occur because of numerous reasons

Massage Therapist Palpating the Abdomen
Ryan McVay/Digital Vision/Getty Images

If you suffer from Gastroesophageal reflux disease, you may wonder why, and if there are certain conditions that you may have that can cause GERD.

It Starts With the Lower Esophageal Sphincter

This muscular tissue opens and closes the lower end of the esophagus. The lower esophageal sphincter (LES) is an area of smooth muscles and hormones that helps maintain a pressure barrier between the stomach and the esophagus.

If the muscles weaken and lose tone, the LES can't close completely after food enters the stomach, which allows acid from the stomach to back up into the esophagus. There are several things that cause the LES to malfunction:

1. Impaired Stomach Function

More than half of GERD sufferers have abnormal nerve or muscle function in the stomach which, in turn, causes food and stomach acid to be digested too slowly. This will cause a delay in stomach emptying its contents, increasing pressure in the stomach and increasing the risk of acid reflux.

2. Medications That Cause GERD

There are various drugs, both over-the-counter and prescription, that can increase the risk for GERD, and worsen symptoms in those who already suffer from GERD.

Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin, ibuprofen (Motrin, Advil, Nuprin) and naproxen (Aleve). They are commonly associated with causing peptic ulcers, and also may cause GERD.

In people who already have GERD, they may increase the severity of symptoms. Research has shown that long-term NSAID users were twice as likely to have GERD symptoms as non-NSAID users.

Prescription drugs may also cause or worsen GERD. This list is not an inclusive of all drugs that can cause GERD. It is important to consult your doctor if you start experiencing any symptoms while on any medications.

Here are some common culprits:

  • Calcium channel blockers - used to treat high blood pressure and angina.
  • Anticholinergics - used in drugs that treat urinary tract disorders, allergies and glaucoma.
  • Beta adrenergic agonists - used for asthma and obstructive lung diseases.
  • Dopamine - used in Parkinson's disease.
  • Bisphosphonates - used to treat osteoporosis.
  • Sedatives
  • Antibiotics
  • Potassium
  • Iron pills

3. Asthma 

More than half of asthmatic sufferers also have GERD. It is still debated whether asthma causes the GERD, or if it is the other way around. There are a couple of reasons why the medical community associates the two conditions.

The first is that the coughing that accompanies asthma attacks may lead to changes in chest pressure, which can trigger reflux. Then there is the fact that certain asthmatic medications dilate the airways so it may relax the LES, also leading to reflux.

4. Pregnancy and Hormones 

Hormones affect the LES. For example, the increase of the hormone progesterone during pregnancy relaxes the LES.

Thus, it's not abnormal for pregnant women to experience heartburn.

5. Diabetes

People with diabetes, especially Type 1 diabetes, often develop a condition called gastroparesis. This condition affects about 20 perecent of diabetics and is characterized by delayed stomach emptying. Pressure within the stomach can increase, which in turn can result in reflux.

6. Hiatal Hernias 

The hiatus is a small hole in the diaphragm muscle, and the esophagus fits through as it joins the stomach. This hole is usually a snug fit, but for some people it may weaken and enlarge. When this happens, part of the stomach may protrude into it, producing a condition that is called hiatal hernia. The hernia may impair LES function. So far, there is no evidence that a hiatal hernia causes GERD, but it may increase GERD symptoms in persons with both conditions.

7. Abnormalities in the Esophagus 

There are some studies that show that most people with atypical GERD symptoms, such as feeling like there is a lump in the throat, hoarseness or chronic cough, have abnormalities in the esophagus. Problems with spontaneous muscle action in the esophagus, called peristalsis, commonly occurs in GERD sufferers. Studies haven't determined if peristalsis is the cause or the result of long-term GERD.

Continue Reading