What causes GERD?

The reason some people develop GERD is still unclear. However, research shows that in people with GERD, the LES relaxes while the rest of the esophagus is working. Anatomical abnormalities such as a hiatal hernia may also contribute to GERD. A hiatal hernia occurs when the upper part of the stomach and the LES move above the diaphragm, the muscle wall that separates the stomach from the chest. Normally, the diaphragm helps the LES keep acid from rising up into the esophagus. When a hiatal hernia is present, acid reflux can occur more easily. A hiatal hernia can occur in people of any age and is most often a normal finding in otherwise healthy people over age 50. Most of the time, a hiatal hernia produces no symptoms.

Other factors that may contribute to GERD include

• obesity
  
• pregnancy
  
• smoking
  

Common foods that can worsen reflux symptoms include

• citrus fruits
  
• chocolate
  
• drinks with caffeine or alcohol
  
• fatty and fried foods
  
• garlic and onions
  
• mint flavorings
  
• spicy foods
  
• tomato-based foods, like spaghetti sauce, salsa, chili, and pizza
  
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