Causes of reflux disease

Reflux disease, usually called gastro-oesophageal reflux disease (GERD), happens when stomach acid and contents flow back up into the food pipe (oesophagus). A muscle ring at the bottom of the oesophagus, the lower oesophageal sphincter, normally acts as a one-way valve. Reflux disease develops when that valve relaxes at the wrong time or is too weak.

Common causes and contributors

• A weak or often relaxing lower oesophageal sphincter.
• Hiatus hernia, where part of the stomach pushes up through the diaphragm.
• Excess body weight, especially around the belly, which raises pressure on the stomach.
• Pregnancy, due to hormones and a growing womb.
• Large meals, late dinners and lying down soon after eating.
• Smoking and alcohol, which relax the valve and irritate the lining.
• Slow stomach emptying, as in diabetes.
• Certain medicines, such as some painkillers (NSAIDs), calcium channel blockers, sedatives and some asthma drugs.

Common triggers Fatty or fried food, chocolate, mint, coffee, tea, fizzy drinks, citrus, tomato, onion and spicy food trigger symptoms in many people, though triggers differ from person to person.