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Acid reflux - Heartburn / GERD
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Acid reflux - Heartburn / GERD 

From MayoClinic.com

Diseases & Conditions A-Z

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DIGESTIVE SYSTEM
Diseases & Conditions  

Signs and symptoms

If you experience heartburn, you may also experience these signs and symptoms:

  • Chest pain, especially at night while lying down

  • Difficulty swallowing (dysphagia)

  • Coughing, wheezing, asthma, hoarseness or sore throat

  • Regurgitated blood

  • Stool that's black, which may mean it contains partially digested blood

Causes

When you swallow, the lower esophageal sphincter — a circular band of muscle around the bottom part of your esophagus — relaxes to allow food and liquid to flow down into your stomach. When it relaxes at any other time, stomach acid flows back up into your esophagus, even if you're in an upright position. The acid backup is worse when you're bent over or lying down. Some factors that can cause the sphincter to relax abnormally include:

  • Fatty foods

  • Chocolate, caffeine, onions, spicy foods, mint and some medications

  • Alcohol

  • Large meals

  • Lying down soon after eating

  • Tranquilizers, such as benzodiazepines including diazepam (Valium) and alprazolam (Xanax)

  • Theophylline (Elixophyllin), an asthma medication

Risk factors

Conditions that cause difficulty with digestion can increase the risk of heartburn. These include:

  • Obesity. Excess weight puts extra pressure on your stomach and diaphragm, the large muscle that separates your chest and abdomen, forcing open the lower esophageal sphincter and allowing stomach acids to back up into your esophagus. Eating very large meals or meals high in fat may cause similar effects.

  • Hiatal hernia. In this condition, also called diaphragmatic hernia, part of your stomach protrudes into your lower chest. If the protrusion is large, a hiatal hernia can worsen heartburn by further weakening the lower esophageal sphincter muscle.

  • Pregnancy. Pregnancy results in greater pressure on the stomach and a higher production of the hormone progesterone. This hormone relaxes many of your muscles, including the lower esophageal sphincter.

  • Asthma. Doctors aren't certain of the exact relationship between asthma and heartburn. It may be that coughing and difficulty exhaling lead to pressure changes in your chest and abdomen, triggering regurgitation of stomach acid into your esophagus. Some asthma medications that widen (dilate) airways may also relax the lower esophageal sphincter and allow reflux. Or it's possible that the acid reflux that causes heartburn may worsen asthma symptoms. For example, you may inhale small amounts of the digestive juices from your esophagus and pharynx, damaging lung airways.

  • Diabetes. One of the many complications of diabetes is gastroparesis, an uncommon disorder in which your stomach takes too long to empty. Left in your stomach too long, stomach contents can regurgitate into your esophagus and cause heartburn.

  • Peptic ulcer. An open sore or scar near the valve (pylorus) in the stomach that controls the flow of food into the small intestine can keep this valve from working properly or can obstruct the release of food. Food doesn't empty from your stomach as fast as it should, causing stomach acid to build up and back up into your esophagus.

  • Delayed stomach emptying. In addition to diabetes or an ulcer, abnormal nerve or muscle functions can delay emptying of your stomach, causing acid backup into the esophagus.

  • Connective tissue disorders. Diseases such as scleroderma that cause muscular tissue to thicken and swell can keep digestive muscles from relaxing and contracting as they should, allowing acid reflux.

  • Zollinger-Ellison syndrome. One of the complications of this rare disorder is that your stomach produces extremely high amounts of acid, increasing the risk of acid reflux.

Acid reflux > 1 > 2 > 3 > 4 > 5 > 6 >

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.

 


 



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Last Modified : 05/14/08 07:31 AM