GERD risk factors: weight, pregnancy, smoking, medicines and hiatal hernia

GER and GERD

Gastroesophageal reflux (GER) happens when your stomach contents come back up into your esophagus. Many people have GER once in a while, and it often happens without causing symptoms (NIDDK). GER is also called acid indigestion, acid reflux, acid regurgitation, heartburn, or reflux (NIDDK).

GERD is a more severe and long-lasting condition in which GER causes repeated symptoms that are bothersome or leads to complications over time (NIDDK). MedlinePlus explains that if you have symptoms two or more times a week, or if they cause damage to the lining of your esophagus, you may have GERD (MedlinePlus). Researchers estimate that about 20 percent of people in the United States have GERD (NIDDK).

Who is more likely to have GERD

Anyone can develop GERD. You are more likely to have GERD if you (NIDDK):

• are overweight or have obesity. The BMI calculator shows where your weight falls.
• are a pregnant woman
• take certain medicines
• smoke or are regularly exposed to secondhand smoke

MedlinePlus also lists having a hiatal hernia, when part of the stomach pushes up into the chest (MedlinePlus). A hiatal hernia can increase the chance of getting GERD or make GERD symptoms worse (NIDDK). See hernia risk factors.

Why these factors matter

Your lower esophageal sphincter and diaphragm most often prevent GER. GERD may develop if your lower esophageal sphincter becomes weak or relaxes when it shouldn't (NIDDK). Factors that may affect the lower esophageal sphincter and lead to GERD include being overweight or having obesity, being pregnant, and smoking or inhaling secondhand smoke (NIDDK).

A hiatal hernia is a condition in which the opening in your diaphragm lets the upper part of the stomach move up into your chest (NIDDK).

Medicines that can cause GERD or make it worse

Some medicines can cause GERD or make GERD symptoms worse. Examples include (NIDDK):

• benzodiazepines, sedatives that make you calmer or sleepy
• calcium channel blockers, which are used to treat high blood pressure
• certain asthma medicines
• nonsteroidal anti-inflammatory drugs (NSAIDs)
• tricyclic antidepressants

NSAIDs are also one of the two most common causes of peptic ulcers; see peptic ulcer risk factors (NIDDK).

Certain foods, drinks, or medicines can also make GERD worse (MedlinePlus).

Symptoms

GER and GERD commonly cause heartburn, a painful, burning feeling in the middle of your chest, behind your breastbone, and regurgitation, when stomach contents come back up into your throat or mouth (NIDDK). Not all adults with GERD have heartburn or regurgitation. Other symptoms may include (NIDDK):

• chest pain
• nausea
• problems swallowing or pain while swallowing
• symptoms of complications in the mouth, throat, or lungs, such as chronic cough or hoarseness

When to see a doctor

You should see a doctor if you think you have GERD, or if your symptoms don't get better with over-the-counter medicines or lifestyle changes (NIDDK). You should also see a doctor if you have symptoms that could be related to GERD complications or other serious health problems, such as (NIDDK):

• chest pain
• loss of appetite
• persistent vomiting
• problems swallowing or pain while swallowing
• vomit that contains blood or looks like coffee grounds
• stool that contains blood or looks black and tarry
• unexplained weight loss

Get medical help right away if you have chest pain with shortness of breath, or pain in your jaw or arm. These can be signs of a heart problem (MedlinePlus).

Complications over time

Without treatment, GERD can sometimes cause serious complications over time, such as esophagitis, esophageal stricture, and Barrett's esophagus, as well as complications outside the esophagus (NIDDK). A small number of people with Barrett's esophagus develop a type of cancer called esophageal adenocarcinoma (NIDDK); see esophageal cancer risk factors.

Complications outside the esophagus may include asthma, chronic cough, hoarseness, laryngitis, and wearing away of tooth enamel (NIDDK).

Lifestyle changes doctors may recommend

Lifestyle changes may reduce your symptoms. Your doctor may recommend losing weight if you're overweight or have obesity, raising your head during sleep with a foam wedge or extra pillows, quitting smoking if you smoke, and changing your eating habits and diet (NIDDK). MedlinePlus adds eating smaller meals, avoiding lying down for at least 2 to 3 hours after eating, and avoiding foods that trigger symptoms, such as spicy foods, chocolate, caffeine, or fatty foods (MedlinePlus).

Common questions

Is occasional heartburn the same as GERD?

No. Having GER once in a while is common (NIDDK). GERD means repeated, bothersome symptoms or complications over time (NIDDK).

Can you have GERD without heartburn?

Yes. Not all adults with GERD have heartburn or regurgitation (NIDDK).

Does pregnancy raise the chance of GERD?

Yes. NIDDK lists being pregnant among the factors that may affect the lower esophageal sphincter and lead to GERD (NIDDK).