You may have experienced the result of acid reflux before--such as heartburn, indigestion, difficulty swallowing, a chronic cough or asthma--or you may have had reflux without any symptoms. However, sometimes it is difficult to tell why the reflux occurs. Acid reflux, or gastroesophageal reflux (GER) can be caused by a number of different things, some of which are temporary or easily controlled.
Sphincter Malfunction
Acid reflux occurs when acid from the stomach flows back up into the esophagus. Normally the lower esophageal sphincter (LES)--which is found between the stomach and esophagus--relaxes when you swallow and closes to keep stomach contents down. However, if the LES relaxes at the wrong time or cannot close properly because it has been weakened by food or drugs, reflux occurs.
Esophagus Malfunction
If symptoms of reflux include hoarseness or a chronic cough, the cause might be a problem with the esophagus. Motility abnormalities prevent the muscles in the esophagus from moving food along properly. An adult-ringed esophagus, which occurs most often in men, has multiple rings that make swallowing difficult.
Stomach Malfunction
Abnormal muscle or nerve function in the stomach causes a condition called impaired motility. When the stomach muscles do not contract properly to move food along, the stomach remains full longer, and acid has a better chance to back up.
Hiatal Hernia
A hiatal hernia is a condition in which the LES and the upper part of the stomach have moved above the diaphragm, which is a wall of muscle that normally separates the chest from the stomach. Part of the diaphragm's function is to help the LES keep stomach contents down; however, if a hiatal hernia is present, the diaphragm cannot do that, and reflux occurs more easily. This is fairly common in otherwise healthy people over 50, and there usually are not any other symptoms.
Stomach Pressure
Eating too much food at once can cause the LES to have difficulty staying closed. To prevent this, eat smaller meals throughout the day instead of a few large ones.
Being overweight or obese puts extra pressure on the stomach, which can cause the LES to malfunction. Having a baby taking up much of the space in your abdomen also puts pressure on your stomach, which is why a lot of pregnant women suffer from reflux.
Position
Wearing a tight belt or clothing can force stomach contents back into the esophagus. Bending over can cause gravity to let the LES open up at the wrong time. Lying down after eating also allows acid to splash easily into the esophagus, so it is best to stay upright for at least 2 hours after each meal. If reflux is bad at night, try raising the head of your bed by 6 to 8 inches by putting large wooden blocks under the feet.
Food and Drugs
Certain foods and beverages encourage the LES to relax and can contribute to reflux. Those include spicy, fatty, fried and acidic foods, such as tomato sauces and citrus fruits. Garlic, onions, peppermint and chocolate are also common culprits, as are foods and beverages that contain caffeine.
Smoking lowers pressure in the LES, letting it relax, so cigarettes can cause reflux, especially after meals. Some medications also lower LES pressure, including aspirin, morphine, meperidine, diazepam and anticholinergics, such as belladonna, atropine, and propantheline.
