Causes of Gastroesophageal reflux disease

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There are two main causes of GORD.

There is a muscle at the join between the stomach and the oesophagus, which relaxes to let food into the stomach but tightens to stop stomach acid coming out and into the oesophagus. In some people, the sphincter does not work very well, and this causes acid reflux.

Acid reflux can also happen when there is a lot of pressure on the stomach. This might happen after a very large meal, during pregnancy, if you are constipated, or when you wear tight-waisted clothes or bend forward.

In most people, reflux doesnâ€™t cause a problem. The body will naturally drain the acid back into the stomach and the symptoms will be relieved. Some people have a very sensitive oesophagus, so even a very small amount of acid can cause irritation, leading to oesophagitis.

Heartburn is only one of the symptoms of acid reflux and GORD.

In people with simple heartburn, heartburn happens occasionally after particularly big or spicy or fatty meal. In people with GORD, it happens frequently and after any type of food.
Smoking relaxes the sphincter muscles, so makes acid reflux more likely.
Some people find that particular foods, such as fatty foods, chocolate, or oranges, relax the sphincter, while others such as coffee and tomatoes directly irritate the oesophagus.
Particular medicines such as diazepam can also relax the sphincter or irritate the oesophagus.

Having a hiatus hernia can also cause GORD. In this type of hernia, part of the stomach pokes through the diaphragm, the main breathing muscle under the lungs. The muscles in the diaphragm are then stretched and canâ€™t allow the sphincter to close, so acid can escape from the stomach up into the oesophagus.