GERD is believed to be caused by a combination of conditions that increase the presence of gastric content in the esophagus. These conditions include transient lower esophageal sphincter relaxation, decreased lower esophageal sphincter tone, impaired esophageal clearance, delayed gastric emptying, and decreased salivation.
Lifestyle factors can also cause increased risk of reflux.
Hiatal hernia frequently accompanies GERD and may contribute to prolonged gastric content exposure time following reflux. The excessive reflux experienced by patients with GERD overwhelms their intrinsic mucosal defense mechanisms, resulting in symptoms and sometimes damage. The most common symptom of GERD is heartburn. The reflux may also cause pulmonary symptoms such as coughing, wheezing, asthma, or aspiration pneumonia. The diagnostic test recommended for the evaluation of GERD is dependent upon the question being asked.