GERD is a disease in which acid from the stomach flows back (refluxes) into the esophagus, causing irritation and sometimes damage to the lining of the esophagus. The reflux of stomach acid can come back high enough to affect the vocal cords or even flow into the lungs (called aspiration), causing damage to those tissues and organs as well.

The muscle that keeps contents of the stomach in the abdomen and out of the chest is called the diagram. The diaphragm has an opening through which the esophagus passes just before it empties into the stomach. This opening is called a hiatus. Weakness of the diaphragm around this opening may make reflux more likely either due to an increased pressure in the abdomen (from coughing, bending, or too much food in the stomach) or by gravity (lying down too soon after a meal).

Gastroesophageal reflux disease (GERD), or acid reflux, is a more severe form of gastroesophageal reflux (GER), which occurs when the liquid content of the stomach regurgitates or refluxes into the esophagus. The acidic content of the liquid causes inflammation and damage to the lining of the esophagus. Reflux occurs in most people, but only tends to cause GERDs when the acid content is very high in the liquid.

The cause of GERDs that develops in some people is unknown. Abnormalities with the lower esophageal sphincter, which allows the liquid to pass back up to the esophagus, can cause the condition. A weak diaphram can also cause GERD because it does not allow the diaphragm to keep the acid from rising. Swallowing disorders and abnormally slow emptying of the stomach can also increase the chance of developing GERD. Other risk factors for developing GERD include obesity, pregnancy and smoking. Symptoms can be triggered by spicy foods, caffeine or alcohol.

The primary symptom of GERDs is heartburn, which occurs as the liquid travels through the esophagus and stimulates the nerve fibers. Heartburn is felt as a burning pain in the middle of the chest. It can stretch from the abdomen to the neck and can even extend into the back. Heartburn from acid reflux occurs most often after eating or while lying down, when reflux is more likely to occur. Regurgitation, nausea and trouble swallowing are also common symptoms of GERD. More severe cases of GERD can lead to ulcers, asthma and narrowing of the esophageal inner cavity.

Chocolate, peppermint, and many high-fat foods seem to cause the diaphram to stay open longer than normal; citrus fruits and tomatoes increase acid production in the stomach. It also helps to avoid caffeinated drinks, such as soda.

If you experience heartburn at least two to three times a week, you may have gastroesophageal reflux disease, know as GERD. Heartburn, the most common symptom of GERD, is estimated to affect 10 million adults in the United States on a daily basis. Heartburn is experienced as a burning sensation in the center of the chest, which sometimes spreads to the throat. One may also feel an acid taste in the throat.

Symptoms of GERD vary from person to person. The majority of people with GERD have mild symptoms, with no visible evidence of tissue damage and little risk of developing complications. Sometimes there are no apparent symptoms, and the presence of GERD is revealed only when complications become evident.

• Your heartburn happens 2 or more times a week
• Your heartburn gets worse
• Your heartburn happens at night and wakes you from sleep
• Youve had heartburn now and then, but for several years
• You have difficulty or pain when swallowing
• Your discomfort or pain interferes with your daily activities

BUT - heartburn is not the only symptom of GERD
Chronic heartburn is the most common symptom of GERD. Acid regurgitation (refluxed material into the mouth) is another common symptom. But numerous less common symptoms other than heartburn may be associated with GERD. These may include:

• Waking up with a choking sensation
• Stomach pain (in the upper abdomen)
• iNon-burning chest pain
• Difficulty swallowing or food getting stuck
• Painful swallowing
• Persistent laryngitis/hoarseness
• Persistent sore throat
• Chronic cough, new onset asthma, or asthma only at night
• Regurgitation of foods/fluids
• Taste of acid in the throat
• Sense of a lump in the throat
• Worsening dental disease
• Recurrent pneumonia
• Chronic sinusitis

Symptoms that should always be brought to your doctor's attention are:

• Food getting stuck in your esophagus
• Unexplained weight loss
• Chest pain
• Choking and bleeding (you might notice dark stools)?

Heartburn that occurs more frequently than once a week, becomes more severe, or occurs at night and wakes a person from sleep, may be a sign of a more serious condition and consultation with a physician is advised. Even occasional heartburn if it has occurred for a period of 5 years or more, or is associated with difficulty in swallowing may signal a more serious condition. People with long standing chronic heartburn are at greater risk for complications including stricture or a potentially pre-cancerous disease that involves a cellular change in the esophagus called Barrett's esophagus.

Sometimes GERD can cause serious complications such as inflammation of the esophagus from stomach acid causes bleeding or ulcers. In addition, scars from tissue damage can narrow the esophagus and make swallowing difficult. Also, studies have shown that asthma, chronic cough, and pulmonary fibrosis may be aggravated or even caused by GERDs.

Some people develop Barrett's esophagus, where cells in the esophageal lining take on an abnormal shape and color, which over time can lead to cancer.

In a small subset of patients with GERD, a complication has been identified as a potentially pre-cancerous condition. The condition is called Barrett's esophagus. It is a condition in which normal tissue lining of the esophagus has been replaced by abnormal tissue lining called specialized intestinal metaplasia and is a risk factor associated with a type of cancer in the esophagus called esophageal adenocarcinoma.

The number of people who develop Barrett's esophagus is relatively small. If Barrett's esophagus is present, talk to your doctor about regular endoscopic screening. In the absence of Barrett's esophagus, there is no strong evidence that GERD is a risk factor for developing cancer.