Causes and Diagnoses

Causes and Diagnoses of Gastroesophageal Reflux Disease

The exact cause of GERD is unknown. In individuals with GERD, the lower esophageal sphincter tends to relax while the rest of the esophagus is working. GERD is more likely to develop in individuals who have a hiatal hernia (in which the upper part of the stomach moves into the lower esophagus).

Risk factors for GERD

There are certain factors that increase an individual’s risk of developing GERD, including:

  • Obesity
  • Pregnancy
  • Smoking

Some foods may also worsen reflux symptoms, including:

  • Citrus fruit
  • Chocolate
  • Caffeinated drinks
  • Alcoholic beverages
  • Fatty and/or fried foods
  • Garlic and/or onions
  • Mint
  • Spicy foods
  • Tomato-based foods such as chili, spaghetti sauce, pizza or salsa

Diagnosing gastroesophageal reflux disease

If GERD symptoms do not resolve from changes in lifestyle and medications, additional tests may need to be performed to determine if another condition is causing symptoms. Those tests include:

  • Esophagram/barium swallow: A special series of X-rays is taken of your esophagus after you drink small amounts of a liquid containing barium, a contrast material that coats your esophagus and shows up well on X-rays.
  • Upper endoscopy: Your physician will lightly sedate you and may numb your throat before sliding an endoscope (a thin, flexible plastic tube with a light and a lens at the end of it) down your throat. This tiny camera lets the physician see the surface of your esophagus to confirm GERD. The physician may, if necessary, perform a biopsy (obtain small tissue samples) by using forceps (tiny tweezers) that are passed through the endoscope. A pathologist will examine the sample to determine if the tissues are abnormal.
  • pH monitoring examination: A nasogastric tube is passed through your nose into the lower esophagus for 24 to 48 hours to monitor how and when acid enters the esophagus. If used in conjunction with a food diary (a log indicating the amounts and types of food eaten at specific times), this allows your physician to find a correlation between symptoms and reflux. This test may be used to determine whether respiratory symptoms are caused by reflux.