Normal individuals, particularly after eating, routinely experience a quiet upward movement of stomach contents into the esophagus, the muscular tube between the throat and the stomach. Most of us remain completely unaware of this daily backward movement, or physiologic reflux. The sphincter automatically opens after one swallows food and then closes rapidly to prevent regurgitation. Swallowed saliva is also protective against GERD, neutralizing any gastric acid that enters the esophagus. In many reflux patients, however, no predisposing factor is identifiable.
GERD patients range from infants to the elderly.
Most people with symptoms experience only occasional heartburn, but others suffer from intense daily reflux. Typical GERD symptoms are indigestion and pain or pressure in the chest. Although gastric acid does appear to be the main factor, investigators have proposed that enzymes and other chemicals from the stomach, liver, and pancreas contribute as well. GERD can cause or contribute to asthma, pneumonia, hoarseness, chronic cough, abnormal functioning of the larynx, and even dental problems. GERD can also cause esophageal ulcers with bleeding that requires hospitalization, even blood transfusions.