Gastroesophageal Reflux Disease (GERD) Causes and Symptoms

Gastroesophageal reflux disease (GERD) affects up to 10% of American adults daily. This makes it one of the most common conditions concerning gut health.

The main symptom of the condition is heartburn. Between 25-40% of healthy American adults also experience GERD at least once a month. It is a common problem in infants too. Sometimes it develops right at birth.

Why is GERD so common? What other symptoms come with this condition? By the end of this article, you will know what causes GERD and how it affects you.

What Happens When a Person Experiences GERD?

This condition occurs in the esophagus, the digestive tract, and runs from the pharynx to the stomach. At the bottom of the esophagus is a ring made of muscle tissue. The role of this muscle is to stay closed so food and stomach fluids do not flow backward when eating. When a person swallows food, this ring relaxes and allows food to enter the stomach. If this ring-shaped muscle doesn’t work properly, acid and bile reflux from the stomach enters the esophagus. This can then cause heartburn and damage to the lining.

GERD is more likely to happen after eating due to the food content and increased acid and fluids. It is also worse when lying down because gravity prevents reflux when a person stands.

gerd - woman eating with heartburn

What Causes GERD?

Why does the lower sphincter of the esophagus to stop working properly and cause reflux? Experts identified numerous factors that contribute to the condition. Fortunately, you can modify and resolve many of these risks.


Weight gain is a major factor in causing GERD. Even minimal weight gain contributes to the condition. As the person gains more weight, symptoms increase. A large study found people experienced 30% more symptoms for each additional point on the body mass index (BMI).


A variety of foods can trigger GERD as well. These include fatty foods, carbonated drinks, coffee, and other caffeinated beverages. Smoking and alcohol consumption also increases the risk of acid reflux.


Many medications can cause GERD, especially antihistamines and some antidepressants. These drugs have anticholinergic effects, which means they interfere with the esophagus’ lower sphincter.
Other drugs that can irritate the esophagus or aggravate acid reflux include:

  • Heart/blood pressure medications
  • Progesterone
  • Opioids
  • Painkillers
  • Drugs for osteoporosis treatment
  • Sedatives
  • Anti-anxiety medication
  • Antibiotics
  • Iron supplements
  • Potassium supplements

If a particular drug causes symptoms, talk to your doctor. They may have an alternative treatment available.

Pre-exiting Conditions

Certain medical conditions can increase the risk of GERD as well. Diabetes can delay the emptying of the stomach and worsen reflux.

There are many digestive conditions associated with GERD too. For example, there is a significant overlap between irritable bowel syndrome (IBS), small bacterial growth (SIBO), and acid reflux. Helicobacter pylori (H. pylori) and other digestive tract infections contribute to GERD too. Various food allergies and sensitivities may also cause the condition.

Overeating & Other Factors

When you eat too much, you may experience symptoms of GERD. In children, overfeeding is a common reason for acid reflux. Other causes of the condition include:

  • Delayed emptying of the stomach
  • Chronic lung diseases
  • Food allergies (especially cow’s milk)
  • Galactosemia
  • Pyloric stenosis
  • Malrotation of the intestines
gerd - woman holding her throat in pain

Symptoms of GERD

Heartburn is the most obvious symptom of GERD. People typically describe it as a burning sensation or pain behind the breastbone.

Another symptom experienced includes regurgitation, which happens when stomach contents reach the mouth. The acid irritates the esophagus and throat, leading to a sore throat. Some may feel a lump in their throat, have a cough, wheeze, or have hoarseness.

Is GERD Life-Threatening?

Most cases of acid reflux are mild and manageable with the right treatment. However, if left untreated, GERD can cause serious complications and potentially become life-threatening.
Chronic acid reflux can lead to difficulty swallowing or dysphagia. This can become more severe over time.

Inflammation of the esophagus (esophagitis) is also possible. This manifests with similar, but more severe, symptoms of GERD and causes pain when swallowing.

Blood in the stools or vomit suggests a GERD complication with bleeding. It may also cause anemia due to an iron deficiency and mild bleeding over a period of time.

Open sores can develop on the esophagus, leading to erosive esophagitis. Chronic irritation and inflammation can create strictures and narrow the esophagus. This makes swallowing solid foods difficult.

Finally, abnormal cells in the esophagus (Barrett’s esophagus) can lead to esophageal cancer.


If you experience symptoms of GERD, see your doctor. They can diagnose you based on medical history, a physical exam, and an endoscopy with biopsy. Sometimes pH testing and manometry are necessary.

It’s helpful to keep a daily journal to track the time you eat, what you eat, medications, and symptoms. This can help identify triggers of GERD.

You can successfully treat this condition through lifestyle changes and medication. There are also ways to stop acid reflux quickly for quicker relief.