by Terrie Schultz

Created on: May 04, 2009   Last Updated: May 11, 2009

Definition of Gastroesophageal Reflux Disease (GERD)
When digestion is functioning normally, food travels down the esophagus to the stomach, and the lower esophageal sphincter muscle at the base of the esophagus closes like a valve. When this muscle does not close properly or opens spontaneously, the stomach acid can leak back up into the esophagus. This condition is known as gastroesophageal reflux.

Over 60 million adults living in the US suffer from symptoms of heartburn or acid reflux on at least a monthly basis, and approximately 15 million are affected daily. While more common in people over 50, it can occur at any age.

Occasional heartburn or temporary acid reflux is not usually something that causes concern. However, when it occurs more frequently than twice a week, it is diagnosed as gastroesophageal reflux disease, or GERD, a chronic disorder that can cause serious complications and requires medical attention.

Symptoms
The most common symptom of GERD is heartburn, an uncomfortable burning sensation that often begins in the chest behind the sternum, and can travel up to the throat. It is sometimes accompanied by an unpleasant sour or bitter taste in the mouth. However, many people who are diagnosed with GERD don't exhibit the classic symptoms of heartburn. A significant number experience chest pains that can be mistaken for heart problems.

If the acid reflux reaches the larynx (the area in the throat that contains the vocal cords), it can give rise to a variety of symptoms including difficulty swallowing, hoarseness, chronic sore throat, cough, or laryngitis. In severe cases, it can even lead to laryngeal cancer. Asthma can result if the acid reflux enters the bronchial tubes. An estimated 70% of the cases of adult onset asthma may actually be caused by GERD.

Risk Factors
While it is not clear why some people develop GERD, there are certain factors that are known to contribute to the disease, including smoking, obesity, and certain types of food. Physical abnormalities such as a hiatal hernia can also be factors.

Smoking exacerbates the symptoms of acid reflux disease in several ways. Saliva plays an important role in protecting the esophagus by neutralizing stomach acid and helping to wash it down. Smoking decreases saliva production while increasing production of stomach acid, as well as causing changes in the composition of the acid that make it more harmful. Smoking can also cause the lower esophageal sphincter muscle to become weaker, and slows down the

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